Posted by SLS on July 4, 2000, at 7:41:01
In reply to Re: Question for Cam » Oddzilla, posted by Cam W. on July 3, 2000, at 21:27:06
Dear Cam,
I am unclear as to whether or not applying a neuroleptic antipsychotic can *unmask* tardive-dyskinesia (TD).
> > Another variable that could be factored into this equation is that the Zyprexa could "unmask" EPS or TD caused by previous traditional antipsychotic use. I have seen this on a number of occasions where Zyprexa has been blamed for causing TD (tardive dyskinesia) within the first week of it's use. This seems to occur rarely when a person is taken off a traditional antipsychotic and an anticholinergic (for the EPS) and placed on one of the atypical antipsychotics.
Cam - You indicated that TD showed up when someone was switched from a combination of a traditional antipsychotic with an anticholinergic to Zyprexa.1. If the anticholinergic were kept on-board, would TD symptoms have appeared? Was it simply the withdrawal of the anticholinergic drug that was responsible for the emergence of symptoms?
2. In the absence of an anticholinergic, can the switch from a traditional neuroleptic to Zyprexa (or other atypical neuroleptic) unmask the TD that had been previously masked by the traditional one?
3. Can atypical neuroleptics fail to mask TD in patients for whom a typical neuroleptic had accomplished this?
4.Zyprexa and Clozaril are sometimes used to "treat" TD. Are these drugs added to the offending neuroleptic or substituted for it?
5. Do atypical neuroleptics act pharmacologically to reduce TD symptoms in a way dissimilar to typical neuroleptics, or is it that they simply lack an offending mechanism? What would such an offending mechanism be?
6. Can the acute application of a neuroleptic immediately exacerbate TD symptoms, or does it always reduce them?
7. Does 5-HT2 receptor antagonism act to reduce TD symptoms? If so, have any other drugs with this property been used to treat TD - nefazodone for instance? Has ritanserin ever been played with for this indication?
This is a test. You have 7 minutes to complete it and submit your answers. Open book is O.K. Good luck.
Thanks.
- Scott
poster:SLS
thread:38901
URL: http://www.dr-bob.org/babble/20000630/msgs/39308.html