I have a family member who has been taking Clozapine for about 20 years. I've learned more from this 25 min video than I have from many medical people I've dealt with. Some of what you have outlined I have learned through serious observation and process of elimination. The knowledge is there but not every medical person is forthcoming. Thank you so very much for what you do.
I have several residents who are on clozapine. It really is a miracle drug for some, but the monthly labs, combined with the side effects, are often a deterrent to medication compliance.
Clozapine is related to very high rates of non-compliance. That means it is a bad drug. It's called common sense. Drug-centered psychiatry should die off eventually, shouldn't it?
@@Bambotb When someone thinks that can diagnsos people that they never met, and without any medical background that tells me that the person is one to ignore. 🤡🤡🤡 Reading a book written by a clown is not the same as being an expert in a field. I am not deficient in anything, I eat healthy, ride my bike for up to 60 miles a day and have MI.
@@gianfranco_maldetto_92 Find a non-drug treatment program that is proven to work and then it could happen. Until then, you anti-med people are causing as much harm as the antivaxxers and covidiots.
Starting my wife on this today its been a rough 3 years for us, constant hallucinations wondering the streets, I hope it works as good as it says she hasn't responded well to a long list of other antipsycotics
My son has schizophrenia and has been homeless and in prison throughout his life. Thank you for this amazing video! We are still hoping he gets treatment someday. It may be too late for him but I am so glad you are explaining the details of clozapine treatment.
I hope you and your son can find some relief in this drug. This is the only antipsychotic my brother willingly takes, even with the monthly bloodwork it requires. All the first gen antipsychotics gave him horrible movement side effects. I know it was very important for us to validate him when he complained about the side effects. Some providers didn't take him seriously, like "oh, he's mentally ill, we don't need to take the side effects that seriously bc he's crazy and nothing else will work anyway". Like.. it's important to understand that the side effects of most antipsychotics are terrible, and, a totally understandable reason for "noncompliance". If I don't want to take a medication for my medical condition bc it gives me horrible side effects is that noncompliance? It makes me sad thinking of everyone who stopped taking antipsychotics bc they were gaslit that there were no better options. /Rant lol Just trying to say I hope your son finds something he doesn't hate taking. For my brother that's 100% clozapine and I hope it is for your son too.
On a new referral to a psychiatrist is it acceptable for the patient to say they would like to trial on a particular anti depressant because others are in effective?
My mom recently stopped taking her clozapine.Within 2 days she was admitted due to psychosis after not having one for over 10 years. No other anti psychotics work for her. So sad that without this specific medicine she is in danger to herself and others. It blows my mind that without this pill she is absolutely out of her mind. Schizophrenia is such a fascinating scary confusing mental illness. With this medication she is perfectly normal and fully aware. Ugh so sad
@@junaidsofi760 It is good the clozapine works well for your mothers illness. but coming of clozapine can be horific for some patients with the terrible withdrawal symptoms, it can be impossible for some patients to come of clozapine
Please share the study that shows the 60% effectiveness of clozapine. It is wonderful how effective this medicine is and the fact that it is only used after other medicines have not worked. The effectiveness data would be much higher if it were used before the other medications.
Great Video Syl! One extra thing that would have been good to touch on, is the adverse affect of constipation and the risk of bowel perforation in people on clozapine. Particularly as bowel perforation is actually more common than fatal agranulocytosis in patients on clozapine!
Your very relaxing and have a lovely way about you. Just what patients such as those with severe and enduring mental health illnesses need. Thank you for your service 😊😊😊😊
Awesome video and very informative 🤗 I didn’t realise that antipsychotics can cause cravings for greasy foods. I’ve been on Quetiapine for about a year and my psychiatrist still doesn’t understand how I’ve lost weight. I don’t crave greasy foods and I don’t eat more than what I did before taking Quetiapine, and I exercise moderately but nothing super intense. Just lucky I guess 🤷🏻♀️😅 My pharmacist said that she’s met people who wake up in the night to eat while taking Quetiapine… I actually can’t fathom how it’s even possible to wake up through the sedative effects of it, to be honest 😅 Thank you as always for making such informative videos! You explain all of this stuff really well - much appreciated 🤗😇💖✨
Every patient is different and you don't know how someone will respond to a particular medication until you try it. For example, Zyprexa is notorious for causing severe weight gain, but I have three patients who are actually losing weight on it. I've had plenty of patients lose weight on Abilify or Seroquel. When you manage someone's depression, they start to become more active, participate in their lives, tend to take better care of themselves by eating a healthy diet, etc.
I take 800mg of seroquel and I wake up at night starving. Im almost in a daze it feels like. I lock my bedroom door and it wakes me up enough to stop and go back to bed or my partner grabs me when I start crawling out of bed I gained 50lbs in about a year, I cant say I craved greasy food in particular, I was just eating everything. Ive since lost the weight and kept it off. It wasn't easy losing the weight if that makes sense. Im a very fit guy naturally and worked out routinely. Seemed like it took much more effort to lose the weight. Maybe its just my vanity lool
@@src3360 Thank you for sharing your experience! Funnily enough, in the time since I made that original post I’ve started taking additional long acting seroquel in the mornings (as well as the regular night time dose that I was already on) and even on the lower doses I’m noticing weight gain. I do intense exercise 4 times a week and moderate exercise 2 other days in the week, and I honestly don’t eat poorly or huge quantities or anything (quite the opposite because I’ve had disordered eating in the past; calorie restriction etc). It’s been 3 months now and I’m getting a medication review today, so hopefully there’ll be a solution that I can find with my psych 🤞
@@TheNurseWhoLovedMe89 Yea, the weight gain is kinda insidious. I work out 5 days a week or every day, depends on my mood lol Ive stayed at my normal weight for some time now. I stay within 5 lbs so I have wiggle room. Im able to eat what I want, mostly. Id like to eat pizza everyday but I cant lol I take several meds. I take the seroquel at nice to use the sleepiness to my advantage but im chronic insomniac, it helps but I still wake up every night. Ive been a insomniac since a kid and im 39 so im used to it.🤷🏻♀️👍🏻
For someone who takes ASM, blood checks are a total pain - pure logistics! The same with getting medication. Improvements in these areas would improve compliance. Apps recoding symptoms and workable reminds. Compliance is a big issue in my community. If one's thoughts are disorganised it's going to be a lot harder. My brother has one of those monthly injections to get over this and it is because someone is coming to him once a month that he has independence.
My coworkers and I were just talking about clozapine today! We work with Parkinson’s Disease patients and we occasionally have patients who need clozapine because of psychosis and treatment options are more limited for psychosis with PD. Two of us are in school to be psych nurse practitioners and being in our current role helps us further understand the indications, monitoring, and potential side effects of it. I can’t imagine needing blood draws so often but it has been so helpful for a lot of our patients.
I came back to ask for a future video on Quetiapine, if possible please? It’s difficult to find info online about long term use, stopping the medication, side effects etc without Dr Google making it sound like you’ll die 🙈😅 I’m sure there’s already a long list of things to do videos on and this might already be on the list anyway 🤷🏻♀️🤗
I would love it if you did something on medical ethics and mental illness. I know you're in Australia so you'll have a different lens depending on the standards of care where you are vs. other places, but I follow Lauren from Living Well with Schizophrenia and her experiences with hospitalization have reminded me of the fine line between helping/treating vs. controlling and demeaning in mental health care. I was advised by the emergency department psychologist to not check myself into hospital during a severe depressive/anxiety break down because doing so would hand over all autonomy of my care. I wasn't suicidal at the time, but severely anxious and depressed and desperate for support as the waiting list for a psychiatrist was really long (at least a month - for urgent care). It was terrifying. The medicine my GP prescribed made me so panicked, I couldn't close my eyes without visualizing horrifying images and such. I managed to ask for an SNRI rather than an SSRI simply out of a hope that the medicine that worked for a family member might work for me also. Thankfully, it did, but the fact that I was told I wouldn't be given any choice in my treatment plan if I sought hospital care (something I probably needed) was distressing. Imagine if we did this to other patients. A heart patient loses all control of their medical choices and dignity because they go to the hospital? Should a person who isn't suicidal and is mostly lucid be committed if they came to facility willingly? Even if they are delusional and hallucinating, but realize they are delusional and having hallucinations? It feels like an interesting topic.
Thank you for your share. Great request. I am now 39 but had a suicide attempt at 19 which preceded several others in my early 20’s and subsequently got me “locked up” in mental health in the tiny conservative town I was born in and had been in and out of the hospital on a hand full of occasions due to attempts or ideation. I was misdiagnosed with at least two serious disorders (BPD and schozoaffective disorder) and put on at least 7 meds at a time. I gained 100 pounds, lost my quality of life, was told I’d never finish school, work a job, handle my own finances, volunteer, or be a good mom. Well guess what? I rebelled at 25. I moved two states away with a guy. Got off my meds. Went back to school. And successfully volunteered for hospice. The relationship ended 4 years later but I am now a CASA (I advocate for kiddos in foster care in court) I’m a mom to an amazing 8 year old, I’m a good mom! I handle my own finances, I have a stable support network, I lost all that weight and reversed my nearing diabetes and high blood pressure and sleep apnea and I’m active and happy. You do have to be so careful or you lose all your independence. I took a chance, changed my life, and disproved everyone. I DO struggle with bipolar 2 and GAD, but weekly therapy sessions, regular meditation and exercise and short term meds if needed enable me to manage. I am beyond grateful. I’m so glad you heeded that advice, though sorry it wasn’t a resource that could have been more helpful in your time in need. Im glad the med helped. I hope someone does more research on your topic of interest.
I've been taking Clozapine for over 10 years now. It totally saved my life. I couldn't have made it to all those blood tests without my family's support. Thanks for helping me better understand this medicine I've been on for so long.
I am so thankful for your channel. This is the best explanation of Clozapine. I’m no Dr, or even a nurse, but I really felt like I could follow and understand. Saving this to watch it a few more times, as my niece will likely be on this when she leaves the hospital. Already sent this to the rest of our family so we all understand what to watch for and how to help. Again TY!
Interesting explanation on the cause of agranulocytosis. Makes me wonder why olanzapine (with two CH3 groups) isn't associated more frequently with agranulocytosis compared to clozapine.
I've been on Clozapine for 28 years for anxiety and my anxiety is off the charts half the time. I've tried coming off it four times, but I get horrible. SNAP!!
@@stepho4201 Perhaps, but I knew several psychiatrists who were prescribing Seroquel for insomnia. However, clozapine is tightly controlled through the rems program, so yeah, there is a substantial likelihood of confusion.
Have you ever been tested for Pyrolle Disorder? I have this and have chronic nutritional deficiencies and need to take P5P (active form of B6), zinc, and magnesium as well as some other supplements. I am doing very well. Stop taking them, and after a couple of weeks, my anxiety returns. Getting up to a therapeutic dose is important as well. I am also seriously wheat/gluten grains sensitive. Both are genetic for me.
Thank you so much doctor, I’ve been getting intramuscular injections of olanzapine & it’s been good for the last few years but I feel like I need something like clozapine to take away the auditory hallucinations that I’m currently going through
Thank you for such an informative video. I’m starting Clozapine today after trying (and having zero success) three other antipsychotic medications to manage my schizophrenia symptoms.
Thanks for this episode. I'm starting on Clozapine soon because of the Parkinsonism by Latuda. It has informed me well but still a bit nervous about going on it.
Thank you for your informative videos. I just took psychopharmacology for mental health clinicians and wish I'd known about your channel sooner. You present valuable insight on both mental health diagnoses along with medication protocols in a really approachable way.
You answered everything except your last statement. Once the agranulocytosis is detected what exactly do you do to treat it? If you stop the clozapine what do you replace it with?
also severe constipation, respiratory problems and massive weight gain. nearly impossible to come of for some patients. Makes OCD type symptoms severely worse. A good drug for some but not for others , it has to be monitored carefully. If it is not having a possitive effect it should be discontinued, It has 5 black box warnings, it can be a very dangerous drug. The professionals only tell you the good things but not the problematc side. Some countries will not allow clozapine as it is deemed to dangerous.
I trialled Clozapine, and ended up with (apparently) NMS. They thought I had meningitis but they couldn't conclude as my lumbar puncture didn't work, no spinal fluid came out when they tried twice. I remember being on about 50mg and being sooooo sedated.
@@HughBond-kx7ly I wasn't on it long enough to see an effect. I was in the introductory doses around 12.5mg to 125mg and I developed neuroleptic malignant syndrome. The only downside is the constant blood work you have to do, weekly during the introductory phase and then monthly when you are on a stable dose.
@@HughBond-kx7ly I developed neuroleptic malignant syndrome (the doctors couldn't figure out if it was meningitis or NMS, but NMS seems more likely imo) from clozapine, I wasn't on it long enough to see a benefit/effect. I was in the introductory phase around 12.5mg to 200mg. (I made it to 125mg). I'd say the only downside is that you have to do consistent and constant bloodwork, once a week in the introductory phase then once you are on a stable dose, once a month. It can also be very sedating, but that is expected from antipsychotics.
All of perception is an controlled hallucination. In schizophrenia the hallucination of reality becomes uncontrolled. the brain is a prediction engine that easily becomes haywire when the chemicals are not on track. but the problem with anti psychotics/major tranquilizers they block to much chemical transmission causing massive sedation and metabolism problems and long term ramifications like earlier dementia cardiovascular problems. there still isn't very good solutions to psychiatric problems that don't impede quality of life in the long run.
So I have the treatment resistance schizoaffective. I didn't want to get all of the tests from this medication or else I would have taken it. I asked for something else. So he gave me invega injection every3 weeks. Do you know about that medication?
Dr Syl what are your views relating to Solian? Do you ever prescribe this adjunct with Clozapine particularly for Negative symptoms. Also, interesting to know your views on neuroleptic prescribing for prodrome psychosis? Many thanks
I asked my psychiatrist about Clozapine, but he said with all the blood tests you have to do it's too much. I was put on Abilify for the second time a month ago when I was in the hospital. So far it's fine. I've been on basically everything but Clozapine. So I wonder if eventually I will be on it.
We need to advocate for ourselves. Find another doctor that works well with Clozapine. Search for Dr Laitman protocol. Doctors that worry amount themselves and not the patient should not have our business. The sooner you go on Clozapine the better it works. #endtheclozapinerems
It is not too much. It may be too much work for his office, and to manage some side effects that can be easily managed, so the dr doesn’t seem to want to do any extra work. Typical, very sad. It’s the only antipsychotic that has worked for my son.
Heard of it, but never tried. Get Amisulpride, but wonder if could swap for these? They seem more popular. As for side-effects would obv' have to wait & see. Do sound addictive tbh
I'm interested in the attitude of the medical profession towards weight gain. Why is it that we must just accept sedation but we're not allowed to accept weight gain? This attitude makes patients feel like othered failures over something they cannot control any more than feeling sedated. If they feel sedated they may not feel like exercising!!!
Weight gain leads to a laundry list of health problems and is the main reason why anti-psychotics take off up to 20 years of their life. Gaining weight kills.
Would like to ask if a patient is on sertreline,kwells and cloxipine. The patients personality is placid gentle .before they were admitted the 3 drugs. The visual observations now I see,the patient has no quality of life .2 hours a day awake constantly sleeping. Can you please advise. I've been just dumped with a 😢patient watching all this my heart is broke
Much exercise is not a good advice because 1) the more sy moves the more hungry will become. 2) Too much exercise makes the immunsystem weaker. Some light to moderate exercise is what helpful but for everyone not only for those who take closapine.
Why would a pain specialist prescribe this off label for severe chronic pain? This sounds very dangerous and my GP discontinued it because it wasn't helping and I was having bad muscle stiffness and the flu symptoms you prescribed. I'm so mad at Australian doctors because the know there are things that work well for pain but they are treating pain patients like guinea pigs with this carousel of off label BS. And I was not warned about the severe side effects, they just bin informed consent and we can't afford to keep losing months off our lives every time we wait fr a specialist and keep chucking $450 at them every appointment when they are overtly disinterested and mean and treating us like we have ulterior motives just for them to make us sicker with some other trash. There is a solution and so many of us are good with it and they can supervise all they want and they don't care and prohibition makes it worse and more dangerous for everyone. And they act like they don't know why there is a reason of people self deleting with lo long term pain. for the drool thing just use folded a towel and put it over the pillow, there's no reason to go out and shovel money to more of these a-holes anyone over a scam.
It's all to stop the bs opioid crisis. Which isn't caused by prescriptions it's caused by illicit fentanyl. Oxycodone is the gold standard for pain relief or a fentanyl patch.
Unless you have very severe possitive symptoms of schizophrenia, it should not be prescribed, it ia a very dangerous drug, 5 black box warnings. Horrific withdrawal symptoms for many coming if it and nearly impossible for some patients to come off. You can get clozapine withdrawal catatonia which can be worse than your illness. When this happens it will be blamed on your illness returning not the catatonia, normal practice. Most psychiatrists would be too frightened to try clozapine. as they know the truth about clozapine, Haven said all this it can be effective and the only way for very severe forms of schizophrenia.
Incredibly helpful - my son has been on clozapine the past 4 years. He stopped - (feeling better) relapsed within 10 days. Now being titrated up again - slowly - weekly bloods . ecgs whilst he is in secure section. but its slow slow progress this time. Your video really helped me make sense of many things thank you !!!
it can cause it on larger doses. Strong phychotic medication damages your nervious system over time causing the tardive dystonia. That is something they will not warn you about.
Great Video!! Our son is on Clozapine, and it was probably a life saving drug... But,... he gags when he eats... after only a few mouthfulls... The only time he doesn't is if he is really hungry .... ie hasn't eaten all day, and it is late at night ... Then he can eat an entire meal without gagging... Does anyone have any thoughts ?
Clozapine’s decreases bowel motility and can cause nausea. If he takes the entire dose at bedtime, perhaps the effect on the gut wears off right before the next dose allowing him to feel better.. There are anti nausea meds that are sometimes given and other meds that can increase gut motility. Sorry he’s dealing with this. Can he be seen by a gastroenterologist?
Clozapine is crap! Been taking it for soon 7 years. Haven't helped me sht but probably shortened my life. There's too little research on the long term effects, just focus on the short term effects. It's MAIN goal is to decrease certain hormones, I my case testosterone and dopamine. There shouldn't be a single reason as to why it should effect my genitals. I can't even ejaculate when I take it. Like wtf is this sht? It's clear to me that the Drs don't tell you the exact main goal behind this drug. It is also affects memory, while it's active. There's a reason why they don't give this meds to ppl who have Alzheimer's or similar. It's simply a sht drug (like all the other antipsychotic drugs) and you should stay away from it by all means possible. White blood cells tests every month.. what!?... Why does it even effect your white blood cells in the first place. It can cause problems with your heartbeat rhythm and even cause sudden death. It can be fine for years but one day, you'll never know. Stay away from this crap.
If it is not helping, why continue to take it? Before I got off all psych meds, I gave a medication 6 months to work or I moved to something else. The main goal is to reduce psychotic symptoms. You have to remember that everything you put in or on your body has side effects. You have to weigh the pros with the cons that you are experiencing and see if it is worth continuing. Many, many psych meds affect sexual function. It is not unique to clozapine. Most psych meds are complex, hitting many receptors which can cause all manner of side effects. Look up the complete side effect list for any psych med, they are typically very long and cover the entire body. There are psych meds that can cause deadly rashes. Everything in your body is a chemical reaction and when you introduce anything to it(not just medication), you can change the chemistry which causes side effects. Why would doctors give an antipsychotic to Alzhemeimer's patients?
I have a family member who has been taking Clozapine for about 20 years. I've learned more from this 25 min video than I have from many medical people I've dealt with. Some of what you have outlined I have learned through serious observation and process of elimination. The knowledge is there but not every medical person is forthcoming. Thank you so very much for what you do.
I have several residents who are on clozapine. It really is a miracle drug for some, but the monthly labs, combined with the side effects, are often a deterrent to medication compliance.
Your patients are deficient in niacin, riboflavin and thiamin, Magnesium chloride...you can find book about this deficiencies causing mental illness
Clozapine is related to very high rates of non-compliance.
That means it is a bad drug.
It's called common sense.
Drug-centered psychiatry should die off eventually, shouldn't it?
@@Bambotbb12 deficiency, Methylation factor also cause mental illness
@@Bambotb When someone thinks that can diagnsos people that they never met, and without any medical background that tells me that the person is one to ignore. 🤡🤡🤡
Reading a book written by a clown is not the same as being an expert in a field.
I am not deficient in anything, I eat healthy, ride my bike for up to 60 miles a day and have MI.
@@gianfranco_maldetto_92 Find a non-drug treatment program that is proven to work and then it could happen. Until then, you anti-med people are causing as much harm as the antivaxxers and covidiots.
Starting my wife on this today its been a rough 3 years for us, constant hallucinations wondering the streets, I hope it works as good as it says she hasn't responded well to a long list of other antipsycotics
My son has schizophrenia and has been homeless and in prison throughout his life. Thank you for this amazing video! We are still hoping he gets treatment someday. It may be too late for him but I am so glad you are explaining the details of clozapine treatment.
Why did you allow it to go that far?
I hope you and your son can find some relief in this drug. This is the only antipsychotic my brother willingly takes, even with the monthly bloodwork it requires. All the first gen antipsychotics gave him horrible movement side effects. I know it was very important for us to validate him when he complained about the side effects. Some providers didn't take him seriously, like "oh, he's mentally ill, we don't need to take the side effects that seriously bc he's crazy and nothing else will work anyway". Like.. it's important to understand that the side effects of most antipsychotics are terrible, and, a totally understandable reason for "noncompliance". If I don't want to take a medication for my medical condition bc it gives me horrible side effects is that noncompliance? It makes me sad thinking of everyone who stopped taking antipsychotics bc they were gaslit that there were no better options.
/Rant lol
Just trying to say I hope your son finds something he doesn't hate taking. For my brother that's 100% clozapine and I hope it is for your son too.
On a new referral to a psychiatrist is it acceptable for the patient to say they would like to trial on a particular anti depressant because others are in effective?
My mom recently stopped taking her clozapine.Within 2 days she was admitted due to psychosis after not having one for over 10 years. No other anti psychotics work for her. So sad that without this specific medicine she is in danger to herself and others. It blows my mind that without this pill she is absolutely out of her mind. Schizophrenia is such a fascinating scary confusing mental illness. With this medication she is perfectly normal and fully aware. Ugh so sad
What dosage does she take?
@@junaidsofi760150 mg
@@junaidsofi760
It is good the clozapine works well for your mothers illness.
but coming of clozapine can be horific for some patients with the terrible withdrawal symptoms,
it can be impossible for some patients to come of clozapine
Same issue with my father he is taking this drug from last 35years, without this drug not possible to calm him
@@junaidsofi760 150 mg
Please share the study that shows the 60% effectiveness of clozapine. It is wonderful how effective this medicine is and the fact that it is only used after other medicines have not worked. The effectiveness data would be much higher if it were used before the other medications.
Thank you for geeking out and doing the science with us.
I just wanna say, you have a really relaxing voice 😊
Great Video Syl! One extra thing that would have been good to touch on, is the adverse affect of constipation and the risk of bowel perforation in people on clozapine. Particularly as bowel perforation is actually more common than fatal agranulocytosis in patients on clozapine!
Docusate takes care of that. Or bidacodyl
How about patients who also take methadone?
Your very relaxing and have a lovely way about you. Just what patients such as those with severe and enduring mental health illnesses need. Thank you for your service 😊😊😊😊
Awesome video and very informative 🤗
I didn’t realise that antipsychotics can cause cravings for greasy foods. I’ve been on Quetiapine for about a year and my psychiatrist still doesn’t understand how I’ve lost weight. I don’t crave greasy foods and I don’t eat more than what I did before taking Quetiapine, and I exercise moderately but nothing super intense. Just lucky I guess 🤷🏻♀️😅 My pharmacist said that she’s met people who wake up in the night to eat while taking Quetiapine… I actually can’t fathom how it’s even possible to wake up through the sedative effects of it, to be honest 😅
Thank you as always for making such informative videos! You explain all of this stuff really well - much appreciated 🤗😇💖✨
Every patient is different and you don't know how someone will respond to a particular medication until you try it. For example, Zyprexa is notorious for causing severe weight gain, but I have three patients who are actually losing weight on it. I've had plenty of patients lose weight on Abilify or Seroquel. When you manage someone's depression, they start to become more active, participate in their lives, tend to take better care of themselves by eating a healthy diet, etc.
I take 800mg of seroquel and I wake up at night starving. Im almost in a daze it feels like. I lock my bedroom door and it wakes me up enough to stop and go back to bed or my partner grabs me when I start crawling out of bed
I gained 50lbs in about a year, I cant say I craved greasy food in particular, I was just eating everything. Ive since lost the weight and kept it off. It wasn't easy losing the weight if that makes sense. Im a very fit guy naturally and worked out routinely. Seemed like it took much more effort to lose the weight. Maybe its just my vanity lool
@@src3360 Thank you for sharing your experience! Funnily enough, in the time since I made that original post I’ve started taking additional long acting seroquel in the mornings (as well as the regular night time dose that I was already on) and even on the lower doses I’m noticing weight gain. I do intense exercise 4 times a week and moderate exercise 2 other days in the week, and I honestly don’t eat poorly or huge quantities or anything (quite the opposite because I’ve had disordered eating in the past; calorie restriction etc). It’s been 3 months now and I’m getting a medication review today, so hopefully there’ll be a solution that I can find with my psych 🤞
@@TheNurseWhoLovedMe89
Yea, the weight gain is kinda insidious. I work out 5 days a week or every day, depends on my mood lol Ive stayed at my normal weight for some time now. I stay within 5 lbs so I have wiggle room. Im able to eat what I want, mostly. Id like to eat pizza everyday but I cant lol
I take several meds. I take the seroquel at nice to use the sleepiness to my advantage but im chronic insomniac, it helps but I still wake up every night. Ive been a insomniac since a kid and im 39 so im used to it.🤷🏻♀️👍🏻
@@AllAreStarStuffStop poisoning people!😮
I found out that Ritalin works wonders against the sedation of antipsychotics and it also kills the food cravings and stops the weight gain.
For someone who takes ASM, blood checks are a total pain - pure logistics! The same with getting medication. Improvements in these areas would improve compliance. Apps recoding symptoms and workable reminds. Compliance is a big issue in my community.
If one's thoughts are disorganised it's going to be a lot harder.
My brother has one of those monthly injections to get over this and it is because someone is coming to him once a month that he has independence.
My coworkers and I were just talking about clozapine today! We work with Parkinson’s Disease patients and we occasionally have patients who need clozapine because of psychosis and treatment options are more limited for psychosis with PD. Two of us are in school to be psych nurse practitioners and being in our current role helps us further understand the indications, monitoring, and potential side effects of it. I can’t imagine needing blood draws so often but it has been so helpful for a lot of our patients.
I came back to ask for a future video on Quetiapine, if possible please? It’s difficult to find info online about long term use, stopping the medication, side effects etc without Dr Google making it sound like you’ll die 🙈😅 I’m sure there’s already a long list of things to do videos on and this might already be on the list anyway 🤷🏻♀️🤗
I would love it if you did something on medical ethics and mental illness. I know you're in Australia so you'll have a different lens depending on the standards of care where you are vs. other places, but I follow Lauren from Living Well with Schizophrenia and her experiences with hospitalization have reminded me of the fine line between helping/treating vs. controlling and demeaning in mental health care. I was advised by the emergency department psychologist to not check myself into hospital during a severe depressive/anxiety break down because doing so would hand over all autonomy of my care. I wasn't suicidal at the time, but severely anxious and depressed and desperate for support as the waiting list for a psychiatrist was really long (at least a month - for urgent care). It was terrifying. The medicine my GP prescribed made me so panicked, I couldn't close my eyes without visualizing horrifying images and such. I managed to ask for an SNRI rather than an SSRI simply out of a hope that the medicine that worked for a family member might work for me also. Thankfully, it did, but the fact that I was told I wouldn't be given any choice in my treatment plan if I sought hospital care (something I probably needed) was distressing. Imagine if we did this to other patients. A heart patient loses all control of their medical choices and dignity because they go to the hospital? Should a person who isn't suicidal and is mostly lucid be committed if they came to facility willingly? Even if they are delusional and hallucinating, but realize they are delusional and having hallucinations? It feels like an interesting topic.
Thank you for your share. Great request.
I am now 39 but had a suicide attempt at 19 which preceded several others in my early 20’s and subsequently got me “locked up” in mental health in the tiny conservative town I was born in and had been in and out of the hospital on a hand full of occasions due to attempts or ideation.
I was misdiagnosed with at least two serious disorders (BPD and schozoaffective disorder) and put on at least 7 meds at a time. I gained 100 pounds, lost my quality of life, was told I’d never finish school, work a job, handle my own finances, volunteer, or be a good mom.
Well guess what? I rebelled at 25. I moved two states away with a guy. Got off my meds. Went back to school. And successfully volunteered for hospice.
The relationship ended 4 years later but I am now a CASA (I advocate for kiddos in foster care in court) I’m a mom to an amazing 8 year old, I’m a good mom! I handle my own finances, I have a stable support network, I lost all that weight and reversed my nearing diabetes and high blood pressure and sleep apnea and I’m active and happy.
You do have to be so careful or you lose all your independence. I took a chance, changed my life, and disproved everyone.
I DO struggle with bipolar 2 and GAD, but weekly therapy sessions, regular meditation and exercise and short term meds if needed enable me to manage. I am beyond grateful.
I’m so glad you heeded that advice, though sorry it wasn’t a resource that could have been more helpful in your time in need.
Im glad the med helped.
I hope someone does more research on your topic of interest.
I've been taking Clozapine for over 10 years now. It totally saved my life. I couldn't have made it to all those blood tests without my family's support. Thanks for helping me better understand this medicine I've been on for so long.
@jeffreybeck7895 Are you able to have a normal life - work, family, etc?
Can you tell me how you were health wise before taking Clozapine and where it greatly improved your life?
I am so thankful for your channel. This is the best explanation of Clozapine. I’m no Dr, or even a nurse, but I really felt like I could follow and understand. Saving this to watch it a few more times, as my niece will likely be on this when she leaves the hospital. Already sent this to the rest of our family so we all understand what to watch for and how to help. Again TY!
Interesting explanation on the cause of agranulocytosis. Makes me wonder why olanzapine (with two CH3 groups) isn't associated more frequently with agranulocytosis compared to clozapine.
Yea good point! No idea 🤷♀️
#stoptheclozapinerems
Amazing presentation
I like the historical overview....I use it when i talk about Clozapine to newly registered professionals
I've been on Clozapine for 28 years for anxiety and my anxiety is off the charts half the time. I've tried coming off it four times, but I get horrible. SNAP!!
Clozapine isn't used as an antianxiety medication; try xanax ... much safer.
@barneyronnie they are likely talking about clonazepam - people often mix these two up
@stepho4201 you called it! I got them confused. Thanks for catching that for me. 🤓
@@stepho4201 Perhaps, but I knew several psychiatrists who were prescribing Seroquel for insomnia. However, clozapine is tightly controlled through the rems program, so yeah, there is a substantial likelihood of confusion.
Have you ever been tested for Pyrolle Disorder? I have this and have chronic nutritional deficiencies and need to take P5P (active form of B6), zinc, and magnesium as well as some other supplements. I am doing very well. Stop taking them, and after a couple of weeks, my anxiety returns. Getting up to a therapeutic dose is important as well. I am also seriously wheat/gluten grains sensitive. Both are genetic for me.
Im an RN
GREAT JOB
Thank you so much doctor, I’ve been getting intramuscular injections of olanzapine & it’s been good for the last few years but I feel like I need something like clozapine to take away the auditory hallucinations that I’m currently going through
Thank you for such an informative video. I’m starting Clozapine today after trying (and having zero success) three other antipsychotic medications to manage my schizophrenia symptoms.
Great to learn from you Sir. I think you forgot constipation side effects
Thanks for this episode. I'm starting on Clozapine soon because of the Parkinsonism by Latuda. It has informed me well but still a bit nervous about going on it.
Can you describe that condition you have to take clozapine because I haven't heard of it before?
The antipsychotic causes Parkinson's like symptoms. That is why I'm changing to Clozapine.
Thank you for your informative videos. I just took psychopharmacology for mental health clinicians and wish I'd known about your channel sooner. You present valuable insight on both mental health diagnoses along with medication protocols in a really approachable way.
You answered everything except your last statement. Once the agranulocytosis is detected what exactly do you do to treat it? If you stop the clozapine what do you replace it with?
I might also add that adjustments in diet can be helpful too as Clozapine can accelerate diabetes and cardiac toxicity as well as obesity.
also severe constipation, respiratory problems and massive weight gain. nearly impossible to come of for some patients. Makes OCD type symptoms severely worse. A good drug for some but not for others , it has to be monitored carefully. If it is not having a possitive effect it should be discontinued, It has 5 black box warnings, it can be a very dangerous drug. The professionals only tell you the good things but not the problematc side. Some countries will not allow clozapine as it is deemed to dangerous.
I trialled Clozapine, and ended up with (apparently) NMS. They thought I had meningitis but they couldn't conclude as my lumbar puncture didn't work, no spinal fluid came out when they tried twice.
I remember being on about 50mg and being sooooo sedated.
Then I really want to know what helped you eventually after clozapine failed?
I want to trial clozapine because others aren't working for me now .Did you find it effective or detrimental?
@@HughBond-kx7ly
I wasn't on it long enough to see an effect. I was in the introductory doses around 12.5mg to 125mg and I developed neuroleptic malignant syndrome.
The only downside is the constant blood work you have to do, weekly during the introductory phase and then monthly when you are on a stable dose.
@@HughBond-kx7ly
I developed neuroleptic malignant syndrome (the doctors couldn't figure out if it was meningitis or NMS, but NMS seems more likely imo) from clozapine, I wasn't on it long enough to see a benefit/effect. I was in the introductory phase around 12.5mg to 200mg. (I made it to 125mg).
I'd say the only downside is that you have to do consistent and constant bloodwork, once a week in the introductory phase then once you are on a stable dose, once a month. It can also be very sedating, but that is expected from antipsychotics.
All of perception is an controlled hallucination. In schizophrenia the hallucination of reality becomes uncontrolled. the brain is a prediction engine that easily becomes haywire when the chemicals are not on track. but the problem with anti psychotics/major tranquilizers they block to much chemical transmission causing massive sedation and metabolism problems and long term ramifications like earlier dementia cardiovascular problems. there still isn't very good solutions to psychiatric problems that
don't impede quality of life in the long run.
My boyfriend helped me stop it after my psychosis.
So I have the treatment resistance schizoaffective. I didn't want to get all of the tests from this medication or else I would have taken it. I asked for something else. So he gave me invega injection every3 weeks. Do you know about that medication?
Dr Syl what are your views relating to Solian? Do you ever prescribe this adjunct with Clozapine particularly for Negative symptoms. Also, interesting to know your views on neuroleptic prescribing for prodrome psychosis? Many thanks
I found solian the only drug to greatly help with negative symptoms
I asked my psychiatrist about Clozapine, but he said with all the blood tests you have to do it's too much. I was put on Abilify for the second time a month ago when I was in the hospital. So far it's fine. I've been on basically everything but Clozapine. So I wonder if eventually I will be on it.
What country do you live in if you don’t mind sharing?
@@DrSyl I’m in the US
We need to advocate for ourselves. Find another doctor that works well with Clozapine. Search for Dr Laitman protocol. Doctors that worry amount themselves and not the patient should not have our business. The sooner you go on Clozapine the better it works. #endtheclozapinerems
It is not too much. It may be too much work for his office, and to manage some side effects that can be easily managed, so the dr doesn’t seem to want to do any extra work. Typical, very sad. It’s the only antipsychotic that has worked for my son.
You should do ASMR doctor:) thanks for the infos, I have psychiatry exam on Tuesday.
That was brilliant. Thanks
Heard of it, but never tried. Get Amisulpride, but wonder if could swap for these? They seem more popular. As for side-effects would obv' have to wait & see. Do sound addictive tbh
good video thank you
Can you make a video on quetiapine please?
Thanks!
Thank you!
Can you pretty please cover zoloft and Propranolol.
I'm interested in the attitude of the medical profession towards weight gain. Why is it that we must just accept sedation but we're not allowed to accept weight gain? This attitude makes patients feel like othered failures over something they cannot control any more than feeling sedated. If they feel sedated they may not feel like exercising!!!
Weight gain leads to a laundry list of health problems and is the main reason why anti-psychotics take off up to 20 years of their life.
Gaining weight kills.
You didn't mention constipation which can be deadly.
I doubt in America you could get all these medical or lab test with the cost of insurance.
I bet you could because it is cheaper than treating these deadly side effects.
Would like to ask if a patient is on sertreline,kwells and cloxipine. The patients personality is placid gentle .before they were admitted the 3 drugs. The visual observations now I see,the patient has no quality of life .2 hours a day awake constantly sleeping. Can you please advise. I've been just dumped with a 😢patient watching all this my heart is broke
Isn't Clozapine an antipsychotic that affects dopamine in a much different way than the other standard SGAs?
If you ask a medical practitioner if you could trial on clozapine would you be out of order or considered a doctor shopper ?
I answered this question in an upcoming video. :)
What happens if this drug goes against a patient what's the next port of call.
How about Quitiapine 150 mg
Much exercise is not a good advice because 1) the more sy moves the more hungry will become. 2) Too much exercise makes the immunsystem weaker. Some light to moderate exercise is what helpful but for everyone not only for those who take closapine.
Why would a pain specialist prescribe this off label for severe chronic pain? This sounds very dangerous and my GP discontinued it because it wasn't helping and I was having bad muscle stiffness and the flu symptoms you prescribed. I'm so mad at Australian doctors because the know there are things that work well for pain but they are treating pain patients like guinea pigs with this carousel of off label BS. And I was not warned about the severe side effects, they just bin informed consent and we can't afford to keep losing months off our lives every time we wait fr a specialist and keep chucking $450 at them every appointment when they are overtly disinterested and mean and treating us like we have ulterior motives just for them to make us sicker with some other trash. There is a solution and so many of us are good with it and they can supervise all they want and they don't care and prohibition makes it worse and more dangerous for everyone. And they act like they don't know why there is a reason of people self deleting with lo long term pain.
for the drool thing just use folded a towel and put it over the pillow, there's no reason to go out and shovel money to more of these a-holes anyone over a scam.
It's all to stop the bs opioid crisis. Which isn't caused by prescriptions it's caused by illicit fentanyl. Oxycodone is the gold standard for pain relief or a fentanyl patch.
Clozapine for chronic pain. That's BEYOND INCOMPETENT. RUN!!!
I challenge psychiatrists to take it.
Unless you have very severe possitive symptoms of schizophrenia, it should not be prescribed, it ia a very dangerous drug, 5 black box warnings. Horrific withdrawal symptoms for many coming if it and nearly impossible for some patients to come off. You can get clozapine withdrawal catatonia which can be worse than your illness. When this happens it will be blamed on your illness returning not the catatonia, normal practice. Most psychiatrists would be too frightened to try clozapine. as they know the truth about clozapine,
Haven said all this it can be effective and the only way for very severe forms of schizophrenia.
Incredibly helpful - my son has been on clozapine the past 4 years. He stopped - (feeling better) relapsed within 10 days. Now being titrated up again - slowly - weekly bloods . ecgs whilst he is in secure section. but its slow slow progress this time. Your video really helped me make sense of many things thank you !!!
I have schizophrenia 😢
😋
Hi dear sister
Hello sir, Does clozapine help in drug induced tardive dystonia?? Please respond
No.
it can cause it on larger doses. Strong phychotic medication damages your nervious system over time causing the tardive dystonia. That is something they will not warn you about.
Coming off clozapine distonia@@robertrowan8738
Great Video!! Our son is on Clozapine, and it was probably a life saving drug... But,... he gags when he eats... after only a few mouthfulls... The only time he doesn't is if he is really hungry .... ie hasn't eaten all day, and it is late at night ... Then he can eat an entire meal without gagging... Does anyone have any thoughts ?
Clozapine’s decreases bowel motility and can cause nausea. If he takes the entire dose at bedtime, perhaps the effect on the gut wears off right before the next dose allowing him to feel better.. There are anti nausea meds that are sometimes given and other meds that can increase gut motility. Sorry he’s dealing with this. Can he be seen by a gastroenterologist?
@@Lauren-fj2dm its hietal hernia consult gastroentrologist or GS
Clozapine is crap! Been taking it for soon 7 years. Haven't helped me sht but probably shortened my life. There's too little research on the long term effects, just focus on the short term effects. It's MAIN goal is to decrease certain hormones, I my case testosterone and dopamine. There shouldn't be a single reason as to why it should effect my genitals. I can't even ejaculate when I take it. Like wtf is this sht? It's clear to me that the Drs don't tell you the exact main goal behind this drug. It is also affects memory, while it's active. There's a reason why they don't give this meds to ppl who have Alzheimer's or similar.
It's simply a sht drug (like all the other antipsychotic drugs) and you should stay away from it by all means possible. White blood cells tests every month.. what!?... Why does it even effect your white blood cells in the first place. It can cause problems with your heartbeat rhythm and even cause sudden death. It can be fine for years but one day, you'll never know. Stay away from this crap.
If it is not helping, why continue to take it? Before I got off all psych meds, I gave a medication 6 months to work or I moved to something else.
The main goal is to reduce psychotic symptoms. You have to remember that everything you put in or on your body has side effects. You have to weigh the pros with the cons that you are experiencing and see if it is worth continuing.
Many, many psych meds affect sexual function. It is not unique to clozapine.
Most psych meds are complex, hitting many receptors which can cause all manner of side effects. Look up the complete side effect list for any psych med, they are typically very long and cover the entire body. There are psych meds that can cause deadly rashes. Everything in your body is a chemical reaction and when you introduce anything to it(not just medication), you can change the chemistry which causes side effects.
Why would doctors give an antipsychotic to Alzhemeimer's patients?
it is a gold bar drug very lucrative for the pharmacautica companies.
Galanin maybe?