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Mental Health What is the Best Antipsychotic?

emotionalnumb

emotionalnumb

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If you had to choose one, in peoples’ personal experience which antipsychotic is better (more tolerable) ~ why/why not…
 
I liked risperidone the most in general because it had the least amount of side effects for me. However it was also the least sedating, which sometimes was desirable. For me it was the most functional and therefore the best for daily use.

Olanzapine made me gain weight (the others didn't) and also made me feel the most zombie like. My least favorite.

Quetiapine is OK but it can give me its own unique side effects like RLS due to it's anticholinergic effects. Hit or miss for me, but the best for occasional use IMO.
 
Clozapine is popularly understood as the most effective. They don't know how it works quite, but it is the best.
 
Negentropic said:
I liked risperidone the most in general because it had the least amount of side effects for me. However it was also the least sedating, which sometimes was desirable. For me it was the most functional and therefore the best for daily use.

Olanzapine made me gain weight (the others didn't) and also made me feel the most zombie like. My least favorite.

Quetiapine is OK but it can give me its own unique side effects like RLS due to it's anticholinergic effects. Hit or miss for me, but the best for occasional use IMO.
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@Negentropic I'm curious to know whether you've been on Risperidone injections or the pills. The reason I ask is because I was on and off the pills for a couple of years and didn't have many side effects that I can remember. It wasn't until I got a few injections that it caused anhedonia, flat affect, and sexual side effects that lasted for months after I stopped the injections.

To answer the OP, for me Abilify has been the one that gave me the most benefits with the least side effects. I was just talking to my psychiatrist about it yesterday and he told me Abilify however is the weakest antipsychotic and that if someone's symptoms are very severe, he won't even consider recommending it. I do know that it is normally best used in conjunction with an anti-depressant or a mood stabilizer rather than as a stand alone medication. I've never taken Abilify injections so I can't speak on whether the injections have more or worse side effects than the pills.

I tried Quetiapine briefly but it made me so fatigued that I stopped taking it within a week of starting it.
 
@Jerry Atrick pills, 2mg/day for risperidone taken at night

I can only remember olanzapine causing some anhedonia

I think taking the pills at night minimizes such side effects unlike injections which I was never offered or pressured to take. My shrink was pretty wary of them and APs in general iirc. I could tell he cared about my well being more than just textbook symptom management. Miss that guy.
 
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I take Seroquel. I tolerate it very well, with almost zero side effects, except like a stuffed nose when it's peaking.
Although it has a short half life and I don't notice it during the day (I take it at night) it definitely blunts my emotions somewhat and it has an effect on my thinking.
But Seroquel has helped me immensely, I only experience some relatively mild moodswings and they are much less frequent. It has allowed me to actually to live a normal life without every day being utter chaos. The blunting does hurt and it manifests itself in many ways but as time goes by I forget more and more about it.... I take 400mg for bipolar as monotherapy, it appears I am quite lucky to get by with that relatively small amount of a relatively mild AP.
 
Never used in my life good antipsychotic.Really doubt,that exist such thing.May be there are useful ones,if that means good
 
I like Haldol the most. It really helps with the paranoid anxiety I suffer from. I take 3mg every 24 hours. I can tolerate much more though. I'm talking 10mg fast acting injection. Though that is only when I'm in benzo/alcohol withdrawal and haven't slept in days.

I dislike all the atypical antipsychotics. Olanzapine and Quetiapine made me gain a lot of weight. Risperidone made me extremely restless to the point I had to smoke a fat joint every few hours just so I could stay still.

I think that these drugs really should not be taken daily for the majority of people.
 
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I've tried most of the modern antipsychotics, for me they didn't work at all but side effects wise the partial agonists (aripiprazole, cariprazole) are much lighter than the full antagonists. Also these two aren't antihistaminergic so less weight gain.

Weird that some people actually like haloperidol. I had once 1mg and got immediate extrapyramidal symptoms requiring akineton.
 
Snafu in the Void said:
I liked risperidone the most in general because it had the least amount of side effects for me. However it was also the least sedating, which sometimes was desirable. For me it was the most functional and therefore the best for daily use.

Olanzapine made me gain weight (the others didn't) and also made me feel the most zombie like. My least favorite.

Quetiapine is OK but it can give me its own unique side effects like RLS due to it's anticholinergic effects. Hit or miss for me, but the best for occasional use IMO.
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I found risperidone good as well, I was on it for 2 years or so and not only did it help for a while with my bipolar, but then I became non-compliant when it seemed to not have much of an effect. It also helped with my autism symptoms while I was on it so I'm considering asking to be put back on it at some stage.

Quetiapine XR was awful, it turned me into a suicidal zombie. I was put on 900mg when I first got diagnosed with bipolar and I only weighed 65kg or something so it was a bit fucked. I asked to come off it after a couple of weeks. The IR version I don't mind and I take it when I have acute manic episodes because it works to abort the mania really fast. I don't recommend any using it for sleep like it's being commonly prescribed for.

Abilify made me really agitated and I hated that.

Lurasidone has been my favourite antipsychotic because I haven't really noticed many side-effects from it. I'm still on that.
 
I was only (forcefully)given olanzapine, qutiapine and zipdasidone ftom the 2nd gen (daily and depo). I would stay clear from long term use of neuroleptics if there is not an undeniably strong case for it. Unfortunately they fucked me big time as they disgnosed stimulant psychosis as schizophrenia even though itvl was first psychotic episode comming after long binge and sleep deprivation. 5 years they made me take "1st gen + 2nd gen AP + tegretol + prazine + benzos". Never did they bother to test me properly. It was 10 years after when I was off most meds (benzos unfortunately I was never able to stop) is when I went to different shrink who made me do full psychological testing. Result - I don't even have tendency for psychotic brakes if I don't abuse stimulants. I sm sure that inappropriate treatment I recieved makes me averse to this class of medications and I understand that there are instances when they are truly life savers. But when I hear someone is on olanzapine for sleep issues or depression I get very agitated. OP be careful and whatever you and your medical team decide - ise it in a lest amount possibleto achieve therapeutic efect. This are substances that are very hard on the body. I am clearly biased so I will just wish everyone luck and escort myself out from this thread. Take care.
 
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Seroquel was the best of a very very bad class of drugs for me, I guess. I've never been psychotic but have been given them for severe anxiety.

I had one old-school one and after six months my eyeballs were involuntarily rolling back in my head.

Zyprexa fucked my muscles up so badly after a few months I was in Emergency unable to move.

Seroquel made me a big fat cow and ended up making the anxiety worse.
 
I found Latuda the best. Both invega and abilify where horrible i had no motivation and no sex drive but that came back with the latuda
 
Eligiu said:
It also helped with my autism symptoms while I was on it so I'm considering asking to be put back on it at some stage.
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I noticed risperidone seemed to make me less irritable, less sensitive to certain stimuli. But it was difficult to quantify.

Ultimately I stopped taking it because the side effects weren't worth it. I also am not in psychosis anymore or have any related symptoms. Well, some symptoms, but they're manageable and due to permanent serotonergic damage and not psychosis.
 
You can't categorically speak of 'the' best antipsychotic. As with all medications patient's responses to any given drug and therefore its effectiveness for that particular patient are too individualistic.
 
I do know Zyprexa and Halodol were for me the strongest. Geodon is a bit weaker. Abilify had horrible side effects.
 
The UltimateFixx said:
You can't categorically speak of 'the' best antipsychotic. As with all medications patient's responses to any given drug and therefore its effectiveness for that particular patient are too individualistic.
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Yes this is very true. It's like asking which antibiotics are the best. They're all going to be good or not-so-good or horrible from one person to the next.
 
I WILL LITERALLY REP VRAYLAR UNTIL I DIE.

Literally tried every single other anti psychotic.

TRY VRAYLAR (Cariprazine)

It is a new generation anti psychotic!

There’s no generic unfortunately since it’s newer and it is expensive AF! $1680~ out of pocket 0.0

It really sucks cause it’s the only one that works for me without horrid side effects, yet it is SO expensive!

I promise I am not paid to advocate for Vraylar lmfao

However I believe that each person needs their own unique cocktail of psychiatric meds that work for them, so this is just my opinion and experience.
 
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