Posted by Louisiana Sportsman on April 14, 2014, at 19:59:50
In reply to Re: replace Abilify with perphenazine?, posted by Christ_empowered on April 14, 2014, at 15:57:07
> OK. Instead of *replacing* the Abilify with perphenazine, what about adding a low dose of...something...maybe loxapine (?)...top keep agitation and residual mild psychosis at bay?
>
> Your thoughts? I see the doc next month. The last thing I want is to add in Haldol or any other public health standard rx.I forgot that your oxcarbamazepine would reduce blood levels of aripiprazole. I guess this is amateur hour lol.
Normally, I would suggest raising the dosage of your antipsychotic if you're still experiencing agitation and residual mild psychosis, but I believe your insurance may put a #30 quantity dispensed on Abilify.
Totally different story when you're augmenting and not replacing Abilify with another neuroleptic.
OK, I'm not really sure if I'm buying into adding in another neuroleptic, but let's say that I am.
I think the best choice is the perphenazine-amitriptyline combination. If you think you can mix in an atypical then I advise risperidone.
Why avoid Haldol? It is probably one of the best typicals. Too potent? You may not like perphenazine then.
I understand you're not wanting to have two atypicals combined, but you're thinking that's it OK to add a typical? That's what you're thinking?
Second choice would be loxapine then. If you're against Haldol, then every other typical is going to be too potent for you. Loxapine is the only typical without a ridiculous dopamine binding affinity and it still has 11.
Loxapine and Perphenazine(alone too)/amitriptyline are going to be sedating due to H1 affinity. If you can handle a strong dopaminergic typical then the one with the least sedation that maintains a little serotonergic action that I could suggest is fluphenazine. Trifluphenazine is slightly more sedating.
My favorite suggestion is the perphenazine-amitriptyline combo, but you can consider loxapine and maybe fluphenazine?
If you're having agitation, how about Klonopin? Obviously benzos aren't suggested/effective for this condition, especially with the mild psychosis, but it could help, short-term?
poster:Louisiana Sportsman
thread:1063976
URL: http://www.dr-bob.org/babble/20140328/msgs/1064219.html