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Harm Reduction Safe Withdrawal From Clozapine?

I know this is a harm reduction site, but I thought a question such as mine doesn't really require the advice of a doctor (although my doctor's advice would be the best bet). Basically, I want to hear from anyone who has tapered down their dose gradually till it ceased completely. My doctor would not be keen for me to cease using this medication, as well.
 
Michael_25 said:
I know this is a harm reduction site, but I thought a question such as mine doesn't really require the advice of a doctor (although my doctor's advice would be the best bet). Basically, I want to hear from anyone who has tapered down their dose gradually till it ceased completely. My doctor would not be keen for me to cease using this medication, as well.
Click to expand...

I am not passing judgement here first of all, but if you are RXd clozapine of all the antipsychotics, you certainly have no business coming of it without your doc knowing, assuming of course the clozapine is for schizophrenia?

Of all antipsychotics, clozapine is the most dangerous and also most efficacious. Your dr went thru he'll to get you on clozapine bc the risk of agranulocytosis is present and dangerous. No other antipsychotic has such a dangerous and deadly side effect. Therefore, your doctor has actually thought he/she needed the best antipsychotic a c the benefit to your health outweighed possible immune system damage.

I am fully qualified so believe me when I do not fuck with your clozapine dose, ever.

What's more, if it is treating your schizophrenia, why come off it? Kinda rhetorical because I know the negative schiz effects like diminished cognition are not addressed by antipsychotics targeting the D, ACh, 5HTP subtypes.

I feel for you, but understand switching to an atypical antipsychotic has a clear correlation between efficacy and weight gain. due to metabolic changes. You should consider yourself special to have such an efficacious drug and that it works for you! ie it doesn't kill you.


Nb apparently clozapine's primary mechanism of action is via allosteric modulation of muscarinic M1 in the frontal cortex by a clozapine metabolite. I did R&D on this. Its called N-Desmethyl clozapine
 
^ the white blood cell count is to make sure your change in dose doesn't kill off all of em (called agranulocytosis as mentioned above).
Go and read up on warfarin and ask yourself would you titer your own dose of that? Similar dangers though different classes.

You cannot discontinue yourself. Your dr didn't tell you this?!
 
Yeah man, this isn't some opiate or benzo you just want to come off because you don't want to be on it anymore... It is treating a very serious condition. Why do you want to come off of it if it's helping you?

For people who are ready to taper off of a serious medication like that, (with their doctor) it sometimes takes years of weening in order for your brain to properly adjust to the change in levels. If you do it wrong, serious symptoms of schizophrenia can occur like delusions and auditory/visual hallucinations.

Are you trying to switch to another medication or just wanting to come off of them all together..?
 
Even if your doctor isn't keen on it, you can still choose to discontinue the drug. However I'm not recommending you do such a thing, as DJSIM said, if you are put on clozapine in the first place, your doctor obviously had good reason as it isn't a first line anti-psychotic by any means. I also think I remember you saying in the past that you have a schizoid disorder which should be treated in all honesty, even if being treated with medication isn't something you enjoy. I personally don't like to take medications for mental health issues, and prefer to use other means for helping dealing with mental health issues. If you aren't getting many or any side-effects and just want to consume drugs, I'd recommend you not do this. Discontinuing a drug like this to consume drugs recreationally isn't a smart thing, and consuming most drugs recreationally when you have such a disorder isn't a smart thing either. Even opioids like oxycodone can have a vast negative effect on people with mental disorders. I knew someone with BPD (borderline personality disorder) that would have their BPD worsen/symptoms show greatly once they aren't high anymore. Stimulants obviously can make one psychotic and make their psychosis worse. Psychedelics shouldn't be touched with someone with such mental health problems for the obvious as well.

Basically if you do plan on discontinuing, talk to your doctor to do it safely, but I really don't recommend you do this unless your doctor agrees with you reasons for doing so.
 
djsim said:
I am not passing judgement here first of all, but if you are RXd clozapine of all the antipsychotics, you certainly have no business coming of it without your doc knowing, assuming of course the clozapine is for schizophrenia?

Of all antipsychotics, clozapine is the most dangerous and also most efficacious. Your dr went thru he'll to get you on clozapine bc the risk of agranulocytosis is present and dangerous. No other antipsychotic has such a dangerous and deadly side effect. Therefore, your doctor has actually thought he/she needed the best antipsychotic a c the benefit to your health outweighed possible immune system damage.

I am fully qualified so believe me when I do not fuck with your clozapine dose, ever.

What's more, if it is treating your schizophrenia, why come off it? Kinda rhetorical because I know the negative schiz effects like diminished cognition are not addressed by antipsychotics targeting the D, ACh, 5HTP subtypes.

I feel for you, but understand switching to an atypical antipsychotic has a clear correlation between efficacy and weight gain. due to metabolic changes. You should consider yourself special to have such an efficacious drug and that it works for you! ie it doesn't kill you.


Nb apparently clozapine's primary mechanism of action is via allosteric modulation of muscarinic M1 in the frontal cortex by a clozapine metabolite. I did R&D on this. Its called N-Desmethyl clozapine
Click to expand...
The reason I'm trying to ween of the clozapine is because in six weeks I'll be seeing a doctor in regard to getting assessed for ADD. However, to get medication for ADD the psychiatrist NEEDS a drug screen. I'm worried that clozapine will be detected and he will therefore not prescribe me any stimulant.

I'm on clozapine because the shrinks believe I have a "psychosis." I think that's misdiagnosis, though. I'm still having the same trouble now as I did before starting the medication half a year ago. I previously tried olanzapine and Seroquel -- they were just as useless.

mr.scagnattie said:
Yeah man, this isn't some opiate or benzo you just want to come off because you don't want to be on it anymore... It is treating a very serious condition. Why do you want to come off of it if it's helping you?

For people who are ready to taper off of a serious medication like that, (with their doctor) it sometimes takes years of weening in order for your brain to properly adjust to the change in levels. If you do it wrong, serious symptoms of schizophrenia can occur like delusions and auditory/visual hallucinations.

Are you trying to switch to another medication or just wanting to come off of them all together..?
Click to expand...
Read the above post I quoted.
 
From clozapine to stimulants doesn't sound too good either, how about just being honest for people trying to treat you? You should be telling about your medication (past&present) to your doctor anyway, not to discontinue it because of some drug screen.
 
Michael_25 said:
The reason I'm trying to ween of the clozapine is because in six weeks I'll be seeing a doctor in regard to getting assessed for ADD. However, to get medication for ADD the psychiatrist NEEDS a drug screen. I'm worried that clozapine will be detected and he will therefore not prescribe me any stimulant.

I'm on clozapine because the shrinks believe I have a "psychosis." I think that's misdiagnosis, though. I'm still having the same trouble now as I did before starting the medication half a year ago. I previously tried olanzapine and Seroquel -- they were just as useless.

Read the above post I quoted.
Click to expand...

Can you clarify your symptoms? I'm an MD so can probably assess whether the clozapine is needed. I do understand schizophrenia is a terrible condition and patients often hate taking their meds, but I can assure you coming off clozapine to go ADD meds is not a good idea.

I think you should go with honesty. If nothing has got better over the last couple years it suggests perhaps you may not have the answers to fixing the problems present. I was like this in a different way... Basically telling partial truths and omitting pertinent info to different doctors was what I was doing, but at the end of the day it just makes things worse as I was just a glorified prescription drug shopper.

Jus remember, schizophrenia doesn't go away if this other doctor decides you're ADD.
 
djsim said:
Can you clarify your symptoms? I'm an MD so can probably assess whether the clozapine is needed. I do understand schizophrenia is a terrible condition and patients often hate taking their meds, but I can assure you coming off clozapine to go ADD meds is not a good idea.
Click to expand...

I thought many patients value clozapine if they happen to respond to it and if it won't kill them. I'm hearing its almost like a magic cure for some schizophrenics. I'm not saying the OP should stay on it if he doesn't feel like he gets anything from it, but this conversation should happen between him and his doctor when we are talking about managing life threatening medications, not really BL stuff.
 
If you have schizoid symptoms I'd really highly recommend no trying ADD medications as they can make them worse. Also, you may not be even ADD. If you haven't disclosed the medications you are taking to the doctor who is planning on scripting amphetamines to you, or disclosing other medical histories he can't make an accurate diagnosis.
 
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