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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by baseball55 on November 27, 2015, at 19:21:20
My nephew is schizophrenic. He has taken a number of drugs without much success. He did best on clozaril, but had to stop because of blood issues.
He is now on 40mg latuda and 16mg perphenizine. When I saw him yesterday at Thanksgiving, I was shocked. He has gained a ton of weight, his face is terribly bloated and his eyes have this dull look. He just didn't seem his usual sweet self. I know that he has serious problems. He has been in and out of hospitals constantly. He sometimes loses insight into his condition. I addition, he has had two severe traumatic brain injuries and has mild cognitive impairment.
Is latuda knows for this level of weight gain?
Posted by rjlockhart37 on November 27, 2015, at 22:50:40
In reply to latuda and perphenizene, posted by baseball55 on November 27, 2015, at 19:21:20
not sure, but when i started zyprexa i didnt gain weight, but after time....at 20mg, it made me gain weight and im trying to get off through liquid diets and excersise, but for some reason i got lucky and stopped weight gain around 240lbs
but latuda may can have some effect, adding geodon or topamax are known to cause weight loss....
this is a article i found on losing weight on anti-psychosis medications
Posted by herpills on November 28, 2015, at 0:36:53
In reply to latuda and perphenizene, posted by baseball55 on November 27, 2015, at 19:21:20
> My nephew is schizophrenic. He has taken a number of drugs without much success. He did best on clozaril, but had to stop because of blood issues.
>
> He is now on 40mg latuda and 16mg perphenizine. When I saw him yesterday at Thanksgiving, I was shocked. He has gained a ton of weight, his face is terribly bloated and his eyes have this dull look. He just didn't seem his usual sweet self. I know that he has serious problems. He has been in and out of hospitals constantly. He sometimes loses insight into his condition. I addition, he has had two severe traumatic brain injuries and has mild cognitive impairment.
>
> Is latuda knows for this level of weight gain?How long was he on the Clonazpine? The wight gain could have come from that, I'm not sure how bad weight gain is from Latuda
Posted by Lamdage22 on November 28, 2015, at 6:00:43
In reply to Re: latuda and perphenizene » baseball55, posted by herpills on November 28, 2015, at 0:36:53
Metformin could be tremendously helpful with no mental side effects.
Posted by Christ_empowered on November 28, 2015, at 11:33:23
In reply to Re: latuda and perphenizene, posted by Lamdage22 on November 28, 2015, at 6:00:43
Perphenazine can cause some weight gain...its my understanding that most tranquilizers can, except molindone and ziprasidone. Latuda is more weight neutral than a lot of other atypicals. Sounds to me like he may be over-tranquilized.Metformin, amantidine, alpha lipoic acid, and phentermine have all been studied w/ varying degrees of success in preventing and reversing AP/AAP-induced weight gain. There's that new wellbutrin thing out...Contrave...its naltrexone plus bupropion. Its supposed to help shed pounds w/o any potential for addiction or anything. Wellbutrin can also help people w/ psychotic and mood disorders, as long as the psychosis is well-controlled. I take 400mgs/day in SR form, and I"m slowly shedding some weight.
Why Latuda? Why perphenazine? From what very little I've read on AP+AAP combos (this from a Cochrane Review I skimmed briefly), there can be an increase in risk of TD and other side effects w/o much of a clear benefit, at least at the aggregate level.
Have they ever used anticonvulsants, benzos, antidepressants with him? I'm diagnosed as Bipolar I, but my psychosis didn't really die down until I added 2 anticonvulsants and Wellbutrin. From what I've read, there's often a strong mood component in Schizophrenia, but treatment providers see "Schizophrenia" as the diagnosis and they just keep piling on the antipsychotics.
Hope things work out well for him. Please keep us posted.
Posted by baseball55 on November 28, 2015, at 20:24:25
In reply to Re: latuda and perphenizene, posted by Christ_empowered on November 28, 2015, at 11:33:23
He did gain weight on clozaril, but has been off it for over a year and the weight gain has been noticeable over the past year. I don't know why they are using the drugs they're using. He lives in a group home and is on disability, Medicaid and Medicare. It's in a small town and I doubt they have him seeing the most innovative p-docs.
As far as why APs - he is definitely schizophrenic, not bipolar or depressed. He is plagued with aural hallucinations.
I don't want to recommend anything to him, because he has limited insight and is not someone who will stand up for himself. I will mention metformin to his father, my brother.
Posted by Christ_empowered on November 29, 2015, at 10:00:28
In reply to latuda and perphenizene, posted by baseball55 on November 27, 2015, at 19:21:20
hey again. I looked it up and the Latuda dose and the perphenazine dose are both fairly low to moderate.
Latuda can apparently cause some metabolic issues--increases in fasting glucose and weight gain, although the information I found seems to indicate a lower risk of serious weight gain for patients as a whole. Individual results may vary, of course. Personally, I packed on the pounds with high dose (30mgs/day) Abilify and docs are still telling me "its not the Abilify!" Riiiight.
Perphenazine can cause weight gain and blood sugar abnormalities. As best I can tell by consulting The Google, perphenazine is one of the better-tolerated conventional APs.
I dunno what to tell you. Its rough, being severely mentally ill...maybe suggest blood sugar testing and appropriate treatment, like metformin or something?
I dunno what to tell you about the cognitive problems. My best guess would be to blame the perphenazine, but...that's sort of assuming that all old school APs cause cognitive problems. From what little I've read on the subject, using 2+ AP/AAP drugs for long term treatment isn't ideal. Risks go up, benefits aren't clear. Maybe he'd be better off on a higher dose of Latuda or on a higher dose of Perphenazine, but not both, combined.
Sorry this is happening.
Posted by baseball55 on November 29, 2015, at 19:28:14
In reply to Re: latuda and perphenizene, posted by Christ_empowered on November 29, 2015, at 10:00:28
The cognitive problems predate the psychosis and meds. He had two very serious brain injuries, including one when he was 10 that required 18 hours of neuro-surgery. He lacks what they call executive function.
> I dunno what to tell you about the cognitive problems. My best guess would be to blame the perphenazine, but...that's sort of assuming that all old school APs cause cognitive problems. From what little I've read on the subject, using 2+ AP/AAP drugs for long term treatment isn't ideal. Risks go up, benefits aren't clear. Maybe he'd be better off on a higher dose of Latuda or on a higher dose of Perphenazine, but not both, combined.
>
> Sorry this is happening.
This is the end of the thread.
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