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Paranoia, irritability. Currently taking Saphris, cymbalata. Prevent psychosis?

Currently taking Saphris(5mg daily for 4 days) tapered from .5 for 3 days then up. Also taking cymbalata(30mg) tapered down withing the 3 day period of starting saphris. Also taking Clonazepan (.5mg) usually 1-x daily. Questionable paranoia and irritability since I ve started the Saphris. Don t know how to take it, is it a side effect or just a delusion . I have not felt so irritable as to where i felt a lack of control since starting this and feel it is alarming especially since the medication should prevent psychosis like symptoms...I am concerned.
Asked On : Tue, 12 Mar 2013
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Psychiatrist 's  Response
Dec 2014
Welcome to Health Care Magic

Saphris or asenapine is a newer drug and it is very useful in psychosis and bipolar disorder. Cymbalata is duloxetine and is used in depression, anxiety and fibromyalgia etc.
When ever any drug like duloxetine is started a rebound increase in anxiety occurs along with irritability. But these side effects go after 1-2 weeks.
Your complaints like paranoid, irritability etc. may occur with asenapine as during initial phase of therapy with antipsychotic drug, subjective and objective restlessness, irritability occur, which is also called akathesia. Although this type of side effect is common with typical older antipsychotic drugs and newer drugs are devoid of such type of side effects. Still there is a risk and we can assume that the symptoms are due to asenapine. I advise you to visit your psychiatrist and take opinion regarding the problem. Proper dose adjustments will help.


Dr. Seikhoo Bishnoi
Answered: Tue, 12 Mar 2013
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