Episode 18 - Rethinking Clozapine: Should it be the First Resort to Treat Schizophrenia?
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- เผยแพร่เมื่อ 2 มิ.ย. 2021
- In this episode, we talk meds with an MD. Specifically: Clozapine. Many of us are told that it’s the “last resort” medication, “when nothing else works”. Is that really true?
Guest : Robert S Laitman, MD, is an internal medicine physician at Bronx Westchester Medical Group in New York. Over the last 10 years, he has developed a practice taking care of people with psychotic disorders after his son, Daniel, received a diagnosis of schizophrenia in 2006.
Dr Laitman, his family, and his colleague authored the book, "Clozapine: Meaningful Recovery from Schizophrenia."
He has been named Congratulations for being named Clinician Extraordinaire by SARDAA (now called: Schizophrenia and Psychosis Action Alliance)
We talk about:
1. Why do you say clozapine should be the drug used first? Why isn’t it?
2. Why is clozapine used more in other countries compared to the United States? Why isn’t it marketed more here?
3. Why does clozapine take so long to fully kick in (a year in some cases) compared to other antipsychotics? Your son continues to improve, even after being on it for 9 years. In what ways does he improve?
4. How does clozapine can benefit patients, besides addressing the classic symptoms of schizophrenia, e.g., suicidality, illicit drug use, smoking.
5. Mitigating predictable side effects - e.g., weight gain, salivation, sedation. (Med therapy management and how it works)
6. We need Engagement, Access, Treatment, Support
7. What can families do, to advocate for their loved ones to get best treatment? What should practitioners know, and do? What can families do? Educate yourself about clozapine and talk with your loved one’s psychiatrist.
Links and explanations:
TeamDanielRunningForRecovery.org
Clozapine facebook page
Team Daniel facebook page
SZ 3 Moms Facebook page
Get on the mailing list:
rslaitman@aol.com
Dr. Laitman’s Book:
www.amazon.com/MEANINGFUL-REC...
A nephrologist is a type of doctor that specializes in treating diseases of the kidney
New finger-prick Point-of-service test
Psychiatrists were once referred to as Alienists - Psych. Today article
Clozapine facebook page
Team Daniel facebook page
SZ 3 Moms Facebook page
Get on the mailing list:
rslaitman@aol.com
Dr. Laitman’s Book:
www.amazon.com/MEANINGFUL-REC...
A nephrologist is a type of doctor that specializes in treating diseases of the kidney
New finger-prick Point-of-service test
Psychiatrists were once referred to as Alienists - Psych. Today article
Deborah Levy was director of the Psychology Research Laboratory at McLean Hospital and an associate professor of psychology in the Department of Psychiatry at Harvard Medical School,
“Dr. Levy’s work had a major impact on our understanding of schizophrenia. In a landmark study based on her dissertation, she examined vestibular responsivity (manifested as an individual’s functional awareness of the position and motion of their body’s parts) in patients with schizophrenia.”
Nuplazid
Gene at risk for schizophrenia:
“The gene, called C4 (complement component 4), sits in by far the tallest tower on schizophrenia’s genomic “skyline” (see graph below) of more than 100 chromosomal sites harboring known genetic risk for the disorder”
NICE :National Institute of health Care Excellence (UK)
Treatment Advocacy Center
Cure SZ
Quotes:
“Dr. Laitman...basically returned my son to me.” - Mimi
“I would revise the HIPAA laws to where they would be liable if they did NOT cooperate and talk to the parent. I always talk to the parent.” - Dr. Laitman
“Why not use the best available medicine, give the best support - the wraparound services that you need - and voila, a lot of these kids get dramatically better - and the longer you stay at it, the better that they will get.” - Dr. Laitman
“We’re trying to ‘stop the insanity’ in the system, so we can stop the psychosis in our loved ones, and there’s a lot of work to do” - Randye
Who are the 3 moms?
Randye Kaye -Broadcaster, Actress, Voice Talent, Speaker, and Author (“Ben Behind his Voices”)
Miriam Feldman - Artist, Mom, Author “He Came in With It”
Mindy Greiling - member of the Minnesota House of Representatives for twenty years. Activist, Legislator, Author (“Fix What You Can“)
We spent fortunately only one horrific year of suicide attemts, broken neck, broken hips. And constantly telling each hospital these drugs are not working. They kept increasing the antipsychotics, and changing them. We get saying what about clozapine. Eventually he was put on clozapine. But it still makes me so angry that it was not used much early and could have saved my son so much pain and suffering, Thank you Dr. Laitman and thank you for this podcast. He has now been on clozapine for the last 4 years and is doing well.
So glad you are all doing better….and that you find the
Podcast helpful!
Does it work for negative symptoms
I'm on clozipine since 2009 it has worked for years have had no hospital stay in 12 years it has been blessing to me and also I have been able to get job and be productive
That’s wonderful! Congrats and thank you for sharing that
@@SZ3MomsTrenches welcome
I hope this is a true statement
My son will be starting Clozapine for the first time today. Wish us luck!!
Good luck! Give it time to work, and hopefully you have some one prescribing who will keep an eye on possible side effects like Dr. Laitman does. Fingers crossed!
@@SZ3MomsTrenches As a matter of fact he just started seeing Dr Mandel , Dr Laitman’s wife. So, I have high hopes.
@@irenep8242 ya be careful of Dr. Mandel. She forced my brother on abilify in conjunction with clozapine. He had suffered from terrible akathisia years before from abilify but she still convinced him into taking it again. What a nightmare that was, we will never know if clozapine actually works for my brother because he was suffering so immensely from akathisia, he associated both meds with pain and suffering. After I called her with my brother and explained the situation, she would not give any advice on how to taper off the abilify and said that I was “sick like my brother”. I was the one with him 24/7 when he was pacing all day and night, and zombified. I hope she helped you though.
@@AA-cl2oq I am so sorry your brother did not have a good experience with Dr Mandel. My son has been under her care for six months now and has done a complete 180. We are very happy with her and Clozapine. I do pray your brother is getting the help he needs with another provider.
@@irenep8242 I’ve talked to multiple other families she has helped. I know that she’s changed the lives of many. Im glad she has helped you get out of the anguish and hell that psychosis causes. If anything it gives me more comfort and faith in giving her another chance if his current route fails. Thank you for the prayers and care.
This podcast has been so helpful. I,ve ordered the 2 books and am reading them. For 3 years my 30 yr old daughter with sz has had 2 psychiatrists and tried 3 medications. I’m now just realizing she has not gone a single day without voices dogging her. And I’m the only one who knows it. I’m now, this very day beginning my search for a clozapine prescriber. Thank you for opening my eyes, as I’m hearing your stories I’m realizing there is more to my daughter and the shift in my attitude towards her is a great improvement. I’m so thankful for your podcasts.
Thank you! We are so glad! New episodes coming in September . Hang in there :)
I met Dr. Laitman in Virginia at a SAARDA/LEAP training conference. He guided me via email to help my son get AOT in the state of NY. I am so grateful. My next hope is that my son, now 24, will get to try Clozapine. Unfortunately, he is not med compliant yet and still suffers with Anosognosia. I am hoping that one more year on AOT will help with that. Clozapine is not available in the injectable form...
That would be so great....
I wish there were more psychiatrists like this.
We do too!
Dr Rob is the best! My don too is back with us! So blessed!!
so happy to hear that!
Dr. Laitman is a hero and THE BEST DOCTOR IN THE WORLD!!!
Very helpful
Grateful for your podcast! I am a Mom.
…in the trenches too, I assume. Welcome!
This was a wonderful talk my son has Pariona scfroriena with agitation I just started colazapine I t would if be nice if he talked what's a good mix for agitation I think he said lithium doses and one know
thanks so much! Glad you found it informative. We can't answer all questions in a podcast, but I think you would find many answers in Dr. Laitman's book, a.co/d/67gU8Kg
Dr Laitman, can you recommend someone in the west tn area that would prescribe Clozapine and work with their patients as you do?
Hi Savannah! you can reach him at rslaitman@aol.com - or the website www.teamdanielrunningforrecovery.org/ -- all links are in the description. thanks!
My son Joel is 28 he has been on antipsychotics for seven years he has been diagnosed now schizophrenia he is on ivega . None of his medications work clozapine is now recommended too him . But I’m wanting to get this process done right for him .he has struggled everyday for seven years I live in Australia . How can I no where he can receive this treatment and no where to find a doctor who can overcome these obstacles. . Or will his best chance be in with this doctor Laitman
Hi Neale, Dr. Laitman is in the US, so you might be better off staying with an Australian Doctor. Do you have any support groups etc. you can ask?
There is SANE Australia as a place to start
Arrrgh! The interruptions are exasperating! So many times the doctor was mid-sentence with information I was desperate to know, when he was interrupted and sidetracked ☹️.
If Clozapine and Lithium were combined into one slow release pill, could it be patented and therefore, made more lucrative for a company to produce? Or if a long acting injection of a combo, wouldn’t that be considered new enough to patent? The Clozapine management fee is a great idea.
One important side effect omitted here(at least for men) are the sexuel ones.Despite psychiatrist protestations to the contrary,many if not the majority of men experience ED and even total absence of any sex drive while on neuroleptics.This goes a long way to explaining non compliance.
Yes side effects are a major issue. The right physician will prescribe with that in mind.
@@SZ3MomsTrenches Yes but for whatever reason, this specific side effect is rarely mentioned.We are all adults here.
My son may be starting clozapine but has a hard time working out/running due to hardware in hi feet. What else can be used to combat weight gain? Thanks.
My son’s doctor prescribed Metformin. Yes, the medication used for diabetes. This will hopefully curb his appetite. It has only been 2 weeks so I can’t tell yet. Maybe you can discuss this with his doctor. Good luck!
@@irenep8242 thanks. I believe Dr. Laitman talks about that in this episode. We are not doctors and can't prescribe, but the combo of meds given is what can make all the difference
Where can I get the Clozapine handbook?
I think this is it....www.amazon.com/Clozapine-Handbook-Handbooks-Essential-Psychopharmacology/dp/1108447465/ref=sr_1_1?dchild=1&keywords=clozapine+handbook&qid=1622749439&sr=8-1
What about negative symptoms ? Does clozapine work for it
In our experience, it’s the only medication that does. My son, on clozapine, got enough of his charm and ambition back to work full time as a restaurant server. Amazing. Sadly, he now refuses to take it. Says it makes him too tired. If he’d had a doctor like Dr. Laitman things might be different. We are still hoping he will rethink his refusal to take it. He is now on Haldol and it quiets the positive symptoms but not the negative.
@@SZ3MomsTrenches my negative symptoms make me tired without medication already I think I am doomed
@@SZ3MomsTrenches and abuse from my mam aswdll and family it's annoying
@@Slidehhy oh no! different medication could make a huge difference. Worth a try!
Thanks 3 moms! You guys are awesome! So, Dr laitman has a son with schizophrenia? Or he treats patients like his children?
His son Daniel has SZ, and is a stand-up comedian :)
@@SZ3MomsTrenches wow! That’s amazing! By the way I just finished reading Ben Behind Voices, I’m so touched! I admire your courage to write abd share your story! It’s very well written!
@@janeliu5237 thank you so much!
So I just got back from MY therapist appt and was talking to her about trying to get my son on Clozapine. She just gasped. And begged me not too. To which I begged her to research more and to watch these videos. The system is so messed up!!!
Let us know if she does watch, and if it changed her mind at all
Clozapine kills.
I don’t think it should be the first med tried at all. The side effect profile makes it very risky. That being said, I have seen this med work wonders on those who can tolerate it.
What can I do if my son refuses help? He has suffered for so long that he has lost hope😪
Oh Karina, wish there were an easy answer here. Have you read I Am Not Sick, I Don’t Need Help? It can help you understand why your son refuses, and introduce a method that might help.
Gamblers at the extremes of dare I say degenerate scale.
Your own words are terrifying,no mention of an enlarged heart ,the inability to comprehend and respond to basic communication and I’ll leave it with the most frightening words you used more or less “ if you don’t need it ,it won’t do shit”.
I’m on sertraline now and lately because of anxiety I’ve been clear of all antipsychotics and I had to go on the run like a criminal to escape the grips of my psychiatric team.
I ended up on epilem chrono because of seizures I could go on ,I saved myself and I’m not presenting a great argument but I could ,4 weekly blood tests it was a life changing experience most definitely.
I have just within the last couple of months heard about Clozapine thanks to SARDAA zoom calls. Dr Laitman's nurse Rachel is on one and she is wonderful!! My son was diagnosed 15 yrs ago! I asked his most recent Dr to try him on it and his response was "I cant help your son". My son is currently refusing his 3rd invega shot.
How’s it going now?
Glad he is refusing that shot. It nearly killed my brother! Has he started growing breast yet? is he pacing back and forth zombified? Did he develop the brain itch yet? You are poisoning your son miss.