Invega Monthly Injection

Hello everyone.

First time poster and would really appreciate some feedback.

I was diagnosed with schizophrenia and after relapsing the first time the second time around I started with the highest dose of 234mg monthly injection of Invega Sustenna which was 4 years ago. Throughout the entire time my mind was constantly racing and I was having all types of thoughts. I wasn't hearing any voices and was not delusional but every few days I would end up in a state of euphoria, stay up all night and felt that everything was going to work out for me but then I would crash down and become depressed the next day. I also developed PTSD and insomnia and would have nightmares throughout the night and wake up frequently. My sex drive completely shut down and I also became impotent. I wouldn't masturbate for months. My mind was constantly racing, it was hard for me to concentrate, loss of focus and memory problems as well. I thought that since I had just stabilized that these were symptoms of the illness and was hoping that it would eventually go away or get better with time.

I hung in there and after 9 months with the approval of my psychiatrist I got the dose successfully lowered to the 156 mg monthly injection and stayed on that dose for about 2 years. My symptoms weren't completely gone but they improved somewhat. But the most important thing is that I was stable and started to function pretty well. I could focus better, concentration improved a little bit. My racing thoughts were still persistent but I was managing them pretty well. The problem was that I was eating a lot of junk food and gained 10 lbs. I decided to go for blood work and the results were not good so I started to diet and exercise to take care of my health. I also had high prolactin levels.

After 2 years with the approval of my psychiatrist I went a little lower again. Now I'm on 117 mg monthly injection of Invega Sustenna. I was actually on 3 other medications (2 for sleep and 1 anti-depressant but I slowly tapered down from them until I quit them completely). The side-effects greatly improved and I feel that my brain is returning to normal again. My racing thoughts are almost completely gone, my concentration and focus has improved as well. I'm not impotent anymore and my sex drive has returned a little bit but I can tell that it has not completely returned. I spoke to the nurse that administers my injection whether or not any of her patients have gone lower than 117mg and she said yes. The next dose below is 78mg and she doesn't recommend going lower than that. This medication has done wonders for me but I believe for the past 3 years that I was overly medicated. The problem I'm having right now is muscle stiffness in my upper back. Again the most important thing is that I am stable and functioning but my belief is that a person should be on the least amount of medication but still be stable and functioning. I know it's a trial and error process with antipsychotic's especially when you have an illness such as schizophrenia but I wanted to get some feedback from others that are successfully functioning on this medication on lower doses or attempted to lower the dose and how did there brain respond. If you want more information please let me know. I appreciate anyone who reads all this. Thanks once again.

Hello, and welcome to the forums!

I appreciate your wanting to be on the lowest dose possible. Not just from your story, but out of general principles. And hopefully without too much trial and error- I had an extended family member with Schizophrenia- a rather bad case of it (and to be honest I'm surprised I'm not Schizophrenic, myself but that's another story) and he was heavily medicated which wore on him badly. Mind you- this started in the late 1950s or early 1960s for him so we're talking some really old-school daily meds- some of which had rather unpleasant long-term deleterious effects- and he was in the public mental health system, so every time he'd get a new case worker or doctor they'd try adjusting his meds and often just wound up knocking him off balance. They'd mess with his meds, then next thing you know he'd be spending a week or a month in a psych ward. But as I say, he was a pretty severe case.

But thinking of the old-school stuff he was on just pushes home the point that with mental health drugs you want the minimum. I wish I didn't take what little I do but I'm glad for the edge to be taken off, anyway.

As a freshly-minted member here it seems to me that your search abilities will be sharply curtailed for a while- I did a perusal through this forum for Invega Sustenna and didn't find anyone talking about dosages except here

schizophrenia/topic137764.html#p1420159

They mention they're on 100mg- I wonder if they actually could have meant the 117 you're on- but maybe not. Seems to me being an injection unless it's prepackaged surely they can tweak it in smaller gradations than dropping all the way to 78- but what do I know. Web MD doesn't show any dosing information but they do have photos of prepackaged doses and besides the 78 I see one that goes all the way down to 39mg! Someone- a lot of someones- must use that dose, why else would they go to the expense of packaging them?

Snaga wrote:Hello, and welcome to the forums!

I appreciate your wanting to be on the lowest dose possible. Not just from your story, but out of general principles. And hopefully without too much trial and error- I had an extended family member with Schizophrenia- a rather bad case of it (and to be honest I'm surprised I'm not Schizophrenic, myself but that's another story) and he was heavily medicated which wore on him badly. Mind you- this started in the late 1950s or early 1960s for him so we're talking some really old-school daily meds- some of which had rather unpleasant long-term deleterious effects- and he was in the public mental health system, so every time he'd get a new case worker or doctor they'd try adjusting his meds and often just wound up knocking him off balance. They'd mess with his meds, then next thing you know he'd be spending a week or a month in a psych ward. But as I say, he was a pretty severe case.

But thinking of the old-school stuff he was on just pushes home the point that with mental health drugs you want the minimum. I wish I didn't take what little I do but I'm glad for the edge to be taken off, anyway.

As a freshly-minted member here it seems to me that your search abilities will be sharply curtailed for a while- I did a perusal through this forum for Invega Sustenna and didn't find anyone talking about dosages except here

schizophrenia/topic137764.html#p1420159

They mention they're on 100mg- I wonder if they actually could have meant the 117 you're on- but maybe not. Seems to me being an injection unless it's prepackaged surely they can tweak it in smaller gradations than dropping all the way to 78- but what do I know. Web MD doesn't show any dosing information but they do have photos of prepackaged doses and besides the 78 I see one that goes all the way down to 39mg! Someone- a lot of someones- must use that dose, why else would they go to the expense of packaging them?

Hey Snaga thank you very much for your reply. I appreciate it.

I've been searching discussion forums and other websites to find out information about people's stability on the 78mg dose. Yes the lowest possible dose is 39 mg but my nurse told me that at that dose it's as if you aren't even taking the medication. I have to continue to take medication for the rest of my life and so far this medication has helped me the most. I'm grateful to be stable and functioning at the level that I am. The problem with this illness and the medications is... just as you mentioned it's a trail and error process because everyone responds to these medications differently, has there own individual symptoms, and have there own screwed up brain chemistry. I understand that there will be side effects because you are putting a substance in your body that is technically not supposed to be there. To top it all off these medications shut down certain parts of your brain and can effect creativity, memory etc. I also realized that a lot of psychiatrists don't discuss the side-effects with there patients because then no one would take any of these medications. There main goal is to make sure that you are stable and not a harm to others or yourself so I understand there dilemma.

Just like your extended family member I was in a psych ward as well. I've been baker acted 4 times and the last time I was baker acted I was locked up in the ward for a week. That was 4 years ago and I plan to never go back. That is my main goal. Another great thing about living in this day and age rather than in the 1950's or 60's or even in the past is that medicine has advanced leaps and bounds and medications have gotten better and better and can definitely improve a person's quality of life. Illnesses that people have died from in the past can be treated and allow a longer life span for a person. Anyway I'll check out the link that you posted but thank you again for your reply.

My pleasure.

I appreciate what you mean about other deleterious side effects. From what I can see, folks Dx'd with Schizophrenia are rather more imaginative than average- and I mean that in a good way. I could well understand not wanting to take meds that dull creativity. It's a sucky trade-off, but you do what you have to do. And yes at least things have advanced- I know in the 60s my family member got things like electric shock treatment and stuff like that. And not just that the drugs were nastier- wayyy back in the day, we had a state hospital for the mentally ill that was pretty damn squalid (literally) until some major reform was enacted, & it was just not a good place to be and I remember us checking him out for the day one time when I was a child in the late 60s, and it just really didn't look like a place you'd want to be. They finally revamped the place in the late 70s but you didn't want to have to go there before that. I mean he'd had himself put there he knew he needed help, but still... just was a sad place.

I was on and off Invega Paliperidone tablet form a few years ago. The reason I omitted it from my medication regime was because of its potential to have major interactions with another medication I was on. Now I am just on 30mg Olanzapine ODT and 20mg Escitalopram. They seem to be working well for me. I am just a little dubious about whether I should tweak the dose a little; not in the way of reduction, but maybe increase one of my meds just a little to see if it helps. I have been feeling pretty on and off. But for the most part I have been feeling fine.

I'm not positive, but if I recall I've been told 20mg is pretty much the top end already for the escitalopram. Which I am prescribed (10mg- and 'prescribed' isn't the same as taking it, I've been weaning myself off it, if by 'weaning' you mean, 'just stopped taking it and powered through the SSRI withdrawal'). I was taking it for general anxiety, and one time I was still complaining about the anxiety and the doc was like 'well we could only go up to 20 on the lexapro'.