Posted by LouisianaSportsman on April 12, 2014, at 19:59:49
In reply to replace Abilify with perphenazine?, posted by Christ_empowered on April 10, 2014, at 16:54:55
Greet topic! I'll approach it as a theoretical topic like this is: What typical antipsychotic would be best if you were to choose one?
I would choose Pimozide (Orap). That and Perphenazine are your only true options IMO. Not sure why Orap isn't more popular. It's just missing perhenazine's very important more potent 5-HT2a affinity (5.6), but it still has some moderate affinity and you can't tell me it's not enough to make some sort of difference (48.4). Pimozide is also not likely going to cause much sedation because it does effect H1 as much as much (692 vs. 8) and it shares perphenazine's coolness with binding to the 5-HT7 Scott loves to rave about even stronger (0.5 vs. 23). And of course they're both antipsychotics so they're going to have dopamine antagonism.
I think pimozide is better because it shouldn't cause much sedation, has even more significant binding at 5-HT7 and even has moderate binding at 5-HT2A.
I always told myself it would be the typical I would choose for myself.
Well, let's look at our other typical antipsychotic choices, shall we? Many of these may be hard to get (including perphenazine and pimozide).
We have approved and not discontinued right now in the USA:
Not to Mess With:
Fluphenazine
Haloperidol
ChlorpromazineProchlorperazine: This is mostly for dizziness, migraines and vertigo. Etc.
Thiothixene: Didn't know much about this one coming, had a bad image but not any basis behind it, admittedly. Looks like you shouldn't mess with it. Lots of side effects and one conclusion on one study: "Patients with borderline and schizotypal disorder without the foregoing symptoms probably would not profit from thiothixene and might needlessly be placed at risk for adverse drug effects."
This leaves us with:
Loxapine (kinda sucks)I think you should still stick with an atypical, however.
poster:LouisianaSportsman
thread:1063976
URL: http://www.dr-bob.org/babble/20140328/msgs/1064141.html