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Re: Zombie on Neuroleptics- I'm just not here

Posted by SLS on May 25, 2001, at 21:10:06

In reply to Zombie on Neuroleptics- I'm just not here, posted by Paul W on May 24, 2001, at 12:55:53

> Oh Jesus (sorry to offend out there) but this upsets me terribly. To put a patient in an AP that is NOT experiencing psychotic symptoms amounts to malpractice to me. Of course you are feeling like a zombie, that's what APs do- it's like a chemical lobotomy. Been there too. The atypicals aren't as bad and apparently some people have had success here augmenting their AD's with zyprexa, etc. You need to get off this stuff- go get a second opinion (sometimes you have to taper, but not always) Please, before you have permanent brain damage- I've seen it first hand and it's not pretty. Write back and let me know how it goes, I care- judy

Dear Judy,

I am a bit surprised by your feelings in this matter. I truly don't know you well enough, but it doesn't sound like you to take such a position. I think we can both agree that it is counterproductive to pigeon-hole drugs and confine their usage to the first label that man has placed on them. Were these labels to be applied rigidly, no one with bipolar disorder who is not also suffering from epilepsy would ever see Depakote or Lamictal; two drugs that have undoubtedly saved some of their lives. An antipsychotic is simply a compound observed to ameliorate the psychotic symptoms of schizophrenia and bipolar mania. It is not a drug with an assigned mission exclusive of all others. Some drugs that exert antipsychotic properties (neuroleptics particularly) have also demonstrated efficacy in depression, nausea and emesis, and hiccups. Hiccups are no laughing matter. For some, it makes for good medical judgment to use Thorazine (chlorpromazine), one of the "ancient" typical neuroleptic antipsychotics to treat them.

I am definitely not stating that Paul should remain on his medication. His doctor might want to discontinue it were Paul to report to him his experiences. I also do not fail to recognize the magnitude of the side effects that are possible with these drugs. I began taking Zyprexa a few days ago with the hope that it would help as a bridge during the washout period following MAOI discontinuation. I have been taking it for three days, and I have experienced a perceptible improvement in clarity of thought rather than an obfuscation of it. Some people suffering from depression report Risperdal to be activating rather than sedating. Geodon seems to produce insomnia rather than somnolence. These are hardly similar to the popular notion of what results from a lobotomy.

In my case, it seems that Zypexa and Risperdal can produce a noticeable antidepressant effect when combined with other medications. Other people have experienced a robust antidepressant response to another antipsychotic, amisulpride, as monotherapy. Of course, all three carry with them the risk of serious side effects, including some that can be irreversible; each drug displaying different frequencies of their occurrences. However, I think there comes a time in an individual's pursuit of relief from pain the necessity to weigh the risk versus benefit of any available drug. I have read posts here on Psycho-Babble for which the withholding of an antipsychotic to treat depression could be viewed as grounds for malpractice.

I am curious about the choice of Fluanxol (flupenthixol). Usually, one of the newer atypical antipsychotics is chosen to augment antidepressants. However, my own doctor has mentioned Moban (molindone), a more typical neuroleptic, to fill that role, so I am reluctant to second-guess the doctor here. With regard to the type of cognitive disturbance that is being described by Paul of flupenthixol, its unmitigated persistence beyond two weeks after a medication change probably indicates that it will not resolve.

Oh yeah...

Hi Paul! I didn't mean to be writing about you behind your monitor. :-) I hope things begin to head in a more positive direction for you soon. I think I know exactly what you are describing. I began to experience the same things at relatively low dosages of both Zyprexa and Risperdal. I am hoping that this was the result of an interaction with Parnate, an MAOI that I have just discontinued. Everything seemed distant, or perhaps better said, I felt distant from everything around me. I could not learn or remember new things. I could not remember easily old things. I could not even "feel" what I already knew. My knowledge did not feel accessible to me (not that there is a whole lot of it to feel). If you have not told your doctor about your cognitive side effects, you should probably do so right away. Good luck.

Oh yeah...

I love you, Judy.

- Scott




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