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Has anyone tried Ritalin to combat clozapine sedation?
My son is 30 and has had schizophrenia for 8 years. He is treatment resistant. We tried many antipsychotics until we came up on the combination of LAI Abilify and clozapine. This combo came controls his anger, but makes him sleep 14 to 16 hours a day, with much sedation for the hours that he is awake. I have read about the stimulant "Ritalin" being studied and used to combat the sedative effects of clozapine and it also helps with cognition and executive functioning. My psychiatrist gave us only 10 pills to try out then after very good results he will not prescribe it for my son. Has anyone's doctor prescribed Ritalin for a treatment resistant schizophrenic's clozapine sedation and cognition problem?
My son showed improvement....,...
# 1 he showered for the first time in six months (literally).
#2 he put other peoples desires ahead of his own.
#3 he went to an open house for 3 hours AND enjoyed it
#4 he asked me to floss his teeth ( they are falling out of his head because he won't do self care)
Yet the doctor refuses to prescribe with out explaining why . Frustrated and heart broken.
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@swhitman410 that is awfully frustrating! The doctor is downright cruel for letting him go through that process only to let him and you down.
Can you find another Psychiatrist that can help you?
@swhitman410 it is heart wrenching to see our kids suffer (even if /especially when they are grown up)! Perhaps there is an age related hold up underneath the Dr’s reluctance to prescribe? Before dumping the present psychiatrist and switching consider these things:
Has he been your son’s Dr. this whole time? Is he the one who came up with the current medication regimen? Since it has been awhile maybe an adjustment is necessary? Can you ask him to explain the rationale behind the 10 pill trial (benefits, risks, med interactions, alternatives etc.) and why he doesn’t want to prescribe? You mentioned “your psychiatrist”. Does your son have a different one? That could be a problem. If there’s more than one, they need to collaborate. Is it possible that your son has expressed different desires to the Dr. than what you want for your son? With your son’s permission a consultation between the 3 - 4 of you may be in order.
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2 ReactionsThank you for replying. Sorry to be unclear it is my son's psychiatrist. I am his guardian and mom and go to every appt. So it feels like MY psychiatrist but it really is Seans.
He is one of the only doctors I can find that prescribes clozapine in our area. So we switched to him for that 2 years ago. After a stay in a hospital Sean came up with the idea of Abilify Maintaina. He said it worked better While he was in the hospital. The doctor implemented his idea.
I have asked the doctor 3 times thru email why he won't prescribe ritalin. Giving him ample opportunity to explain he has not elaborated beyond saying ... " Because of his diagnosis and medicine given I will not prescribe Ritalin."
I went to a pharmacist and asked if he knew if any reason the doctor might have. And his take was that it raises the chance of a seizure. The doctor hasn't said that though. And for the Sean's continued compliance with taking clozapine and being non violent and having a better quality of life (cognitively) perhaps the risk is worth all the reward. Especially when you consider that there is anti seizure medicine.
But I have found thru online info on PUBMED many articles and studies that mention Ritalin or other stimulants are given to combat clozapine sedation and to enhance cognition. I sent that Info to the doctor and am waiting for a reply.
Clozapine sedation is the number one reason for dropping clozapine. This combination of LAI Abilify and clozapine is the only combination that has kept him from being violent.
Thanks for talking to me and giving me your ideas. Can anyone confirm that they have taken Ritalin and clozapine without problems?
It IS frustrating! Since day one eight years ago it has been an uphill battle.
Thanks for caring. I have found 2 more doctors that prescribe clozapine in my area. Waiting to see if I can convince my son doctor to help us first. I just realized since we got those 10 pills that Sean could have medicinal help with cognition and sedation. So I am educating myself on the options of medicine out there since my doctor doesn't offer alternatives voluntarily .
My loved one has been on 400 mg of clozapine. He sleeps 12-14 hours a day for best performance during the day. We have not tried Ritalin, however, I have found great support and advice on the support group for clozapine called “Team Daniel,” if you are not already a member. They have an effective protocol lead by Dr. Laitman and other experts in an active chat group. I’m sure you can find wonderful insight there.
Thank you for your response. I have had a cursory look at the website. It is new to me thank you for the resource. Did clozapine take away your loved ones symptoms? My son is treatment resistant and is on a long acting injection too of Abilify. He still continues to have hallucinations but he is not aggressive or violent with this combination. Thank you for telling me about Team Daniel.
Thank you again for telling me about " Team Daniel ".
I read the book "Meaningful recovery from serious mental illness". Like Dr Laitman's protocol I got our doctor to prescribe modafinil 100 mg. this is my son's third day on it. Hopefully it helps like the Ritalin did. It was wonderful to have another resource for information.