What are the ways to wean off psychotropics and continue Clonazepam?

Question

Hello doctor,

I need an opinion about weaning off psychotropics to go on only Clozapine for a diagnosis of schizoaffective disorder. Please help.

Thank you.

Answer 1

Hello

welcome to icliniq.com.

I understand your concern.

As you are on multiple medicines, it will be difficult to withdraw all medicine. You are currently taking a combination of anti-psychotics and mood stabilizers. So, if you want to be on Clozapine, you can add it in a low dose of 12.5 mg. Stop Olanzepine and Clonazepam immediately once you add Clozapine.

If you do not have any extrapyramidal side effects, then you can stop Trihexyphenidyl. Asenapine is anti-psychotic, so you can reduce the dosage once you increase the dosage of Clozapine gradually. Lamictal and Topamax are mood stabilizers, so you can increase the dosage of any one and gradually discontinue the other. But one thing to keep in mind is that Clozapine may cause weight gain, and also metabolic changes are common with it. So, start it after all the discussion about Clozapine. Regular blood checkups are required with Clozapine.

I hope this helps.

Thank you.

Regards.