I concur with comments of @Catherine. I have seen some persons advocating for Clozapine as a first choice, not second or third. However, there are other considerations to being on Clozapine, so the norm is that doctors go to it after other meds have not had satisfactory results. Do the research to see how long any one AP takes to become fully effective. But certainly, there may be a time sooner than later to switch. Our son was switched from Invega Sustenna (after 4 months, but several shorter times on this previously, never medication compliant except for ECT, and multiple catatonic episodes) to Clozapine 3 months ago. We are seeing dramatic improvement and almost no observable side effects…occasional drooling but even that seems to have disappeared. He is on a couple other adjunct meds at tiny doses. So, when it was time for next Invega shot, we just started Clozapine once he had a satisfactory WBC count. Because it is a daily pill and available in as small as 50 mg., it is easy to titrate it up. This did not require hospitalization.
After reading your responses I talked to my son’s doctor. She agreed that my son is still not doing well even after taking layers of antipsychotics. He is still not able to keep his hygeine like hair cut , shaving, nail cutting showers etc. and we both agreed that haldol and depakote have been helping my son and not invega sustenna that much and zyprexa is also kind of redundant at this point. She agreed that clozapine is a good medicine but it comes with its own risk profile to which I responded that it was true but then we do have the blood tests to check for the risks. Finally she agreed that as a first step she will stop invega and put him on haldol injection and then we will see how it goes. I don’t know what does that mean. She is probably try to reduce the variety of drugs that he is taking now. Probably that will make the switch easier or what. My son has an appointment tomorrow I guess. So looking forward what the doctor prescribes! Will share with you guys.
My son had his appointment with his psychiatrist today and he allowed me to join in with him. The doctor explained the risks and benefits of clozapine and has asked him to go for blood test for ANC. He will hopefully get it done tomorrow and we will see from there.
Thank you so much for your support I am praying to God that this may be the answer to our prayers. Thank you everybody!
Yea! Just a note…the first time our son had the blood test, his counts were too low. But it was a fluke, and his counts have been OK ever since then.
Yes got it. Will keep it in mind. Hopefully he will go for the blood test today.
My son has been under conservatorship and has been on clozapine for the last almost 4 yrs and had been stable. Currently taking 400mg. Now they have removed the conservatorship a couple weeks back. Before getting conserved, my son always had med compliance issues, cold turkey etc. Now because he is in independent living and there is no one to help him with his meds, his case manager has been asking the doctor to put him back on injection to help deal with compliance. I liked clozapine and how my son feels more natural on clozapine but I am also scared of him becoming non compliant. Please share your thoughts. Thank you very much!
I would really encourage the clozapine if you can help support the blood draws.
He has been stable for 4 years! I think it is a risk to make a change now.
Of course I don’t have any way of knowing if an injectable will also work well, but based on what you said in your early post, pre-clozapine things were not as good.
I think that clozapine is unique among the antipsychotics. What does your son think about it?