Current Events > Need medical advice from one of the docs on CE

(+) Yeah! (+)

@Soviet_Poland you were in that one topic about the guy about to go to the psych ward or whatever

right now i'm on invega but it's not really making me 'care' about things or giving me the energy i need, it mostly just handles my positive schizo symptoms. i know i should talk to my doctor about it, but can you think of a good medication to try instead? ideally, something that doesn't raise prolactin. my doctors are more concerned with managing my positive symptoms but ever since i stopped smoking pot i don't think it's as much of an issue.
---

This is something your doctor will know way more than me, mostly because I'm still in med school, and they know your history.

It would be irresponsible for me to recommend a different med because I don't know your history, what you've tried, or other considerations your doctor has had to put you on invega vs something else.

As a general rule of thumb, the positive symptoms are much easier to treat than the negative. In some ways, the negative symptoms of schizophrenia are considered somewhat treatment resistant. There are some studies showing adding an antidepressant like mirtazapine might help, but again that's something that your doctor would know if it would be helpful or appropriate for you specifically.

And as another rule of thumb, all of the meds in the same class as invega are pretty minimal about prolactin, except for risperidone. But again, everybody's different and can respond differently, so that can be hard to predict sometimes.
---

Soviet_Poland posted...

This is something your doctor will know way more than me, mostly because I'm still in med school, and they know your history.

It would be irresponsible for me to recommend a different med because I don't know your history, what you've tried, or other considerations your doctor has had to put you on invega vs something else.

As a general rule of thumb, the positive symptoms are much easier to treat than the negative. In some ways, the negative symptoms of schizophrenia are considered somewhat treatment resistant. There are some studies showing adding an antidepressant like mirtazapine might help, but again that's something that your doctor would know if it would be helpful or appropriate for you specifically.

And as another rule of thumb, all of the meds in the same class as invega are pretty minimal about prolactin, except for risperidone. But again, everybody's different and can respond differently, so that can be hard to predict sometimes.

Okay, thanks.
---

Psychiatry really isn't something that can be adequately diagnosed and discussed on the internet, sorry. You should bring this up with your psychiatrist. Generally speaking, most antipsychotics induce prolactin production by shutting down the dopamine-inhibition pathway.
---

Coffeebeanz posted...

Psychiatry really isn't something that can be adequately diagnosed and discussed on the internet, sorry. You should bring this up with your psychiatrist. Generally speaking, most antipsychotics induce prolactin production by shutting down the dopamine-inhibition pathway.

I don't really have a psychiatrist right now, there is one available but usually, I just go to my family doctor for this stuff. She's not really keen on experimenting with different drugs because the Invega has overall been good for me and I think she is more concerned with making sure I'm stable more than vibrantly healthy, idk.
---

LysistrataMedea posted...

I don't really have a psychiatrist right now, there is one available but usually, I just go to my family doctor for this stuff. She's not really keen on experimenting with different drugs because the Invega has overall been good for me and I think she is more concerned with making sure I'm stable more than vibrantly healthy, idk.

I'd do your best to see a psychiatrist. The other specialties tend to not really know much about psych meds. It's like you said, the family medicine doc doesn't want to rock the boat. A psychiatrist will know how to handle your case a lot more efficiently. But generally speaking, finding the perfect combo of meds usually takes a few follow up visits to fine tune.
---