If you were stuck on an island with Fanapt, Latuda & Saphris...

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firedoor

firedoor

let it bleed
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If you had only these 3 newest antipsychotics to choose from, which would you choose and why?
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its got to be Latuda. Has to be. Unless you can strictly follow an Atkins diet, you have to stay away from all the -apines.

Can't I send a message in a bottle requesting aripiprazole and/or an analyst?
 
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9point75 said:
its got to be Latuda. Has to be. Unless you can strictly follow an Atkins diet, you have to stay away from all the -apines.

Can't I send a message in a bottle requesting aripiprazole and/or an analyst?
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huh? a diet of fresh island berries and monkey jerky is probably a well balanced low fat diet as well :D
 
No good, it has to be very low carb diet if your on an -apine or else you're killing your patients
 
9point75 said:
No good, it has to be very low carb diet if your on an -apine or else you're killing your patients
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Dude you have no idea what you are talking about! sad this is the kind of thing someone is practicing!
 
Dude, have you ever heard of supplementing a low carb diet with sugar? It's called the western diet and it kills. Perhaps you have some interesting ideas why antipsychotics cause weight gain and perhaps you'll try and sound scholarly and talk about receptor antagonism. That might fly with your inpatient attending...maybe even on PRITE, but the real answer lies in the fact that whilst ingesting antipsychotics (especially -apines) you're body starts relying on ketones in the face of readily available glucose. You're activating both the fed state and the starvation state at the same time and this equals an extraordinary increase in weight, fasting glucose, blood pressure...the good old fashioned syndrome X, which you whippersnappers call the metabolic syndrome. Let me know if that was too jargon laden, I can always dumb it down
 
Wallstreet said:
Dude you have no idea what you are talking about! sad this is the kind of thing someone is practicing!
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I think it's sad when a supposed professional resorts to the sort of ad hominem attack above.

Atypicals may cause some of their metabolic dysregulation by shifting energy metabolism toward fat utilization at the expense of carbohydrate metabolism (http://thelastpsychiatrist.com/2010/10/zyprexa_and_fat.html). A low-carbohydrate diet (and/or a less metabolically burdensome medication) may be beneficial in minimizing the negative glycemic and related metabolic-physiologic consequences of this derangement.
 
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fire door, you seem to have a handle on the subtle nuances of being a psychiatrist. I wish you well.
 
firedoor said:
I think it's sad when a supposed professional resorts to the sort of ad hominem attack above.

Atypicals may cause some of their metabolic dysregulation by shifting energy metabolism toward fat utilization at the expense of carbohydrate metabolism (http://thelastpsychiatrist.com/2010/10/zyprexa_and_fat.html). A low-carbohydrate diet (and/or a less metabolically burdensome medication) may be beneficial in minimizing the negative glycemic and related metabolic-physiologic consequences of this derangement.
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This is one theory and by no means substantiated. If you are reccomending things to your patients based on this quality of evidence (or huge lack thereof) that is the danger in what you speak. Anything you read you reccomend? that is what is scary. Keeping your weight down by intake of less calories is the most tried and true way to prevent complications with anti-psychotics as far as we know at this point. No matter how, low calories and weight loss. That is what you should be reccomending, not a atkins diet that is not even accepted as healthy in the medical literature.
 
I guess if you have to wait for a large pool of research from primary literature on these rare and nuanced conditions, you will forever be a sheep following your shePharr and continually putting your patients at risk. Seriously, it's like arguing with a candybar
 
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One of the proposed mechanisms of Metabolic Syndrome with antipsychotics is that they alter glucose transport. In other words there is an increased uptake of glucose into the cell which then gets converted to fat (i.e, weight gain) and a decrease in glucose outside the cell (i.e., hypoglycemia). In response there is a prolonged abnormal release of insulin and therefore insulin resistance....which as we all know worsens this cycle.
In simple words, you will gain weight on antipsychotics even on a diet...

PS: Ergo...candy bars are not good for you
 
If you were stuck on an island with Fanapt, Latuda & Saphris...

firedoor said:
If you had only these 3 newest antipsychotics to choose from, which would you choose and why?
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Why has noone questioned that they actually need to be taking antipsychotics? I am not taking antipsychotics. The voices in my head tell me not to take them and that they are poison.

Except Zydis. It freshens breath while you do dishes.
 
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Ok, since noone seems to want to take this thread seriously, I will divulge the fact that I actually AM on a deserted island at this moment with only Latuda, Fanapt and Saphris at my disposal.

So please, your thoughtful comments are crucial!!!
 
Way to reclaim your thread. I choose Latuda.
 
to the above poster bashing atkins - you sound like a smart guy but obviously are up on the psych literature but not medical. low carb is HUGELY accepted as healthy - and has been shown almost across the board to be the best diet with the best results ESPECIALLY when adapted as a way of life -- with associated improvement in lipid profiles -- hyperinsulinemia is the root of all evil. :)
 
CRLD said:
low carb is HUGELY accepted as healthy - and has been shown almost across the board to be the best diet with the best results ESPECIALLY when adapted as a way of life :)
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I'm not sure what you are reading. I haven't seen good data showing low carb diets maintain weight loss in the long term. Do you have good long-term studies you can share with us? How many patients can stick to that diet long term anyway? Some of my patients do not know what a carb is. :scared:
 
TexasPhysician said:
I'm not sure what you are reading. I haven't seen good data showing low carb diets maintain weight loss in the long term. Do you have good long-term studies you can share with us? How many patients can stick to that diet long term anyway? Some of my patients do not know what a carb is. :scared:
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Honestly, how many people can stick to a low-fat, low-calorie diet either? In general, lifestyle modification is only modestly successful even among the most functional members of society. I don't hold out much hope for those with enough functional impairment and severity of illness to require an antipsychotic.

All that aside, following a low-carb diet will give the patient a better chance of avoiding unnecessary simple carbohydrates. Since insulin resistance is implicated in the metabolic changes in patients taking atypicals, why not try a diet that will have the best chance of lowering the glycemic load? It at least seems rational when considering the pathophysiology of the problem.
 
Ok, since noone seems to want to take this thread seriously, I will divulge the fact that I actually AM on a deserted island at this moment with only Latuda, Fanapt and Saphris at my disposal.

So please, your thoughtful comments are crucial!!!
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Then you have no patients since the island is deserted.

If this is a problem, use the internet (which you clearly have) to better use and get yourself off the island. If the island is a paradise, stay there and enjoy.

If the medications are for personal use, I can't give advice over the internet.
 
TexasPhysician said:
I'm not sure what you are reading. I haven't seen good data showing low carb diets maintain weight loss in the long term. Do you have good long-term studies you can share with us? How many patients can stick to that diet long term anyway? Some of my patients do not know what a carb is. :scared:
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There is tons of data on this--it's just that low-carb diets aren't popular, there's a lot of animosity surrounding them, and it's been hard for them to break into the mainstream. They're starting to garner more attention, however. Check out Good Calories, Bad Calories by Gary Taube. Or, if you'd like a shorter read, Why We Get Fat by the same author.

Hell, homo sapiens would have never even evolved if we hadn't shifted our diets from plant material to meat. Check out this http://references.260mb.com/Paleontologia/Aiello1995.pdf article. If you're interested, I have a ton more links.

Here's another: http://www.scientificamerican.com/article.cfm?id=carbs-against-cardio
 
CaptainSSO said:
There is tons of data on this--it's just that low-carb diets aren't popular, there's a lot of animosity surrounding them, and it's been hard for them to break into the mainstream. They're starting to garner more attention, however.
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I think if you took everything you just said and said the opposite, then I would agree with you.

There is not tons of data. Low Carb diets are immensely popular because people like the idea that they are going to lose weight by eating like tyrannosaurs. The general public thinks they're magic. They were mainstream for several years and sparked a jillion dollar run at Barnes and Nobles everywhere. And they're now declining in popularity, because, like every other diet, they only work for a few weeks before people realize that a) sugar tastes good, and b) any diet without motivational support will, on average, fail.
 
billypilgrim37 said:
I think if you took everything you just said and said the opposite, then I would agree with you.

There is not tons of data. Low Carb diets are immensely popular because people like the idea that they are going to lose weight by eating like tyrannosaurs. The general public thinks they're magic. They were mainstream for several years and sparked a jillion dollar run at Barnes and Nobles everywhere. And they're now declining in popularity, because, like every other diet, they only work for a few weeks before people realize that a) sugar tastes good, and b) any diet without motivational support will, on average, fail.
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:thumbup:
 
Manicsleep said:
Then you have no patients since the island is deserted.

If this is a problem, use the internet (which you clearly have) to better use and get yourself off the island. If the island is a paradise, stay there and enjoy.

If the medications are for personal use, I can't give advice over the internet.
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Oh, if only I could match your wit. But I will remember to at least try by posting meaningless nonsense the next time you attempt to start a meaningful discussion ;).
 
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billypilgrim37 said:
I think if you took everything you just said and said the opposite, then I would agree with you.

There is not tons of data. Low Carb diets are immensely popular because people like the idea that they are going to lose weight by eating like tyrannosaurs. The general public thinks they're magic. They were mainstream for several years and sparked a jillion dollar run at Barnes and Nobles everywhere. And they're now declining in popularity, because, like every other diet, they only work for a few weeks before people realize that a) sugar tastes good, and b) any diet without motivational support will, on average, fail.
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Oh, I agree--compliance can be extremely difficult. But if someone can remain on the diet (and I think it helps to think of it more as a lifestyle choice, rather than a diet per se), it's great. Our bodies can synthesize all the glucose we need without ever consuming even a gram of carbohydrates. That's the problem with sugar--it tastes so delicious to us because we evolved in environments where carbohydrates were difficult to obtain in large amounts, so anytime humans could get them (it was usually honey), it benefited them to eat all they could. Please, check out one of Gary Taubes's books I suggested. If you still disagree after reading one of those, then that's fine, but I think you may be surprised by some of his findings.

Edit: There's a lot of literature online, as well, if you don't feel like reading a whole book. Believe me, I was completely skeptical of low-carb diets, since I'm a fairly fit/active guy, and I've been eating bread my whole life, but after reading tons about it, I started to understand where these ideas were coming from. (And it's mainly the processed food we eat in America that's the culprit--the chips, cookies, chocolate, etc.) There are actually hunter-gatherer societies that subsist largely on carbohydrates (things like tubers), who are quite fit and healthy, since their metabolisms never get screwed up in the first place from all the quick hits of sugar like we get here in America.
 
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CRLD said:
hyperinsulinemia is the root of all evil. :)
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:thumbup: And don't forget his similarly evil sibling, hyperglycemia, and cousin, hyperomega-6!
 
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