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Re: Meds and brain damage

Posted by Oddzilla on August 24, 2000, at 22:11:24

In reply to Re: Meds and brain damage » Steve, posted by Cam W. on August 24, 2000, at 21:56:40

Hi Steve Here is an excerpt from the June 21 online chat with Dr. Glenmullen,a Harvard professor of Psychiatry. It is on abc.com. You have an unusual doctor to be concerned and knowledgeable about the possibility of brain damage. I urge you to discuss your concerns with him directly. Good luck! Oddzilla

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Brandon593 asks: Do you know what percent of people get a movement disorder like that lady on 20/20?
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Dr. Joseph Glenmullen
We know a great deal about these movement disorders from an earlier class of medications called major tranquilizers. These movement disorders typically occur after patients have been on medication for some time. In the case of major tranquilizers, it took 30 years for the FDA to require that a warning be added to the information on the major tranquilizers. It was found that about 50 percent of patients got the kind of tick disorders that you could see on 20/20. Unfortunately, in about 50 percent of those cases, the ticks were permanent.
We do not know enough about how many patients on Prozac-type antidepressants might get these kind of tick disorders. Prozac-type antidepressants have been on the market for a little over 10 years. When major tranquilizers had been on the market for about 10 years and some psychiatrists were trying to raise the alert about these ticks, many psychiatrists said that they were "rare" and that patients shouldn't be warned about them.
Some psychiatrists insisted that the drugs weren't causing them, but later research showed this was not true. But, with many drugs, there is what we call a 10-20-30 year pattern, where it's at about 10 years after a new class of drugs is introduced that one starts to see what will be the most serious side effects of the drug. But we lack a systematic program for monitoring long-term side effects in this country.
Only four percent of the FDA budget goes to monitoring long-term side effects. A recent commissioner of the FDA, Dr. David Kessler, wrote in a medical journal that only about one percent of serious long-term side effects come to the attention of the FDA. So because we lack systematic monitoring, it takes about 20 years for enough cases to accumulate for people to be really concerned.
Unfortunately, it can take still another 10 years before slow bureaucratic regulatory agencies and professional organizations step in to change prescribing patterns. The tick disorders with major tranquilizers are a very good example of this 10-20-30 year pattern.
We are at the 10 year mark with Prozac-type antidepressants. We have patients complaining of neck and jaw stiffness, teeth-grinding, muscle spasms, tremors, ticks and other movement disorders. Unfortunately, as was the case with major tranquilizers when they had been on the market for 10 years, we do not have good information on how many patients are suffering these movement disorders or how many might eventually get the tick disorders like you saw on 20/20.
So the important point here is that all patients should know that psychiatrists are concerned about these movement disorders. It's important to comment that the tick disorder seen on tonight's show apparently originally appeared when the patient was put on Prozac.
In Prozac Backlash I describe a patient who had been on Prozac for two years and developed a very different type of tick. She developed facial ticks — uncontrollable sticking out of her tongue. We stopped the drug and the worst of these ticks took months to disappear. But she is still left with permanent twitching around her mouth.
There are many patients with much more mild muscle spasms and twitches. Patients will describe their legs being very restless while they are sleeping in bed, and perhaps their spouse is awoken by it. Other patients say their arms or legs will jump a little bit while they are reading or doing activities like that. Other patients describe stiffness in the muscles of their neck or jaws.
Because we lack adequate studies of these movement disorders, we have no way of knowing how many patients are affected by just mild versions of these ticks or twitches, or how many patients have or may get the more severe ones, like the ones that were seen on 20/20.
I think the important thing for patients to know is that this is an important concern about Prozac-type antidepressants, and this is one of the reasons why one should have regular reevaluations of whether or not one still needs the drug. If you have any concerns about ticks, twitches, muscle spasms, teeth grinding, or jaw stiffness or tremors on your antidepressant, you should ask your


> > Hi everyone.
> >
> > I have treatment-resistant depression, and have been tried on more than 20 meds by doctors who simply didn't know what to do. Now my doctor says that I have brain damage from all the different meds. Does anyone know anything about the damages meds would cause, and how they would manifest themselves?
>
>
> Steve - What were the meds and their dosages, length of therapy of each med and particular combinations. Tardive dyskinesia and neuroleptic malignant syndrome are two forms of brain damage that come to mind, but, if you look at the percentages, very, very few people who are treated with psychotropic medication ever develop any form of brain damage (but it does happen), What form of brain damage has occured to you? What are your symptoms, so we may be able to determine where the damage has occurred? - CAm


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