Posted by OldSchool on January 1, 2002, at 18:26:30
In reply to Re: Cam:antipsychotic question, posted by jimmygold70 on January 1, 2002, at 17:56:40
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> I know they use risperdal to treat TD !They do? I never heard that. Doesnt make much sense as Risperdal can cause TD in itself.
> The best treatment for TD is to increase the dose of the AP you take.
LOL This is the "old" way of dealing with TD, primarily if you are classic schizophrenic. Increasing the dosage of the neuroleptic merely masks and covers up the TD symptoms for awhile, only to let the TD symptoms arise again later even worse. Increasing the neuroleptic dosage to mask over TD symptoms is an extremely poor method of dealing with TD (incompetent actually).
The best way to deal with TD is to get off the TD inducing drug entirely. In time, the TD will probably get better if the offending drug is removed. In the case of schizophrenia, obviously taking someone off their neuroleptic permanently is simply not possible. In which case a switch to Clozapine is probably indicated.
Clozapine has the lowest incidence of TD and EPS of all anti-psychotic medications.
>Since Risperdal is less likely to cause TD than the typical ones, I would recommend you to try this. There is no well documented uses for sqroquel concerning paranoid ideation.
HUH? Where do you get your information from? Seroquel is very well intended for paranoid ideation. Paranoid ideation is a classic reason to take a drug like Seroquel.
>The fact it works for paranoid schizophrenia doesn't imply it is good for paranoid ideation as well.
Um...I dont agree with this. Seroquel is used for a wide spectrum of mental disorders and I can guarantee you that paranoid ideation is one of them.
One of the better things about Seroquel is that its one of the handful of neuroleptics which doesnt use the 2D6 enzyme for drug metabolism. Which means Seroquel is less likely to create pharmacokinetic drug/drug interactions compared to other neuroleptics. This in my opinion, is the greatest thing about Seroquel. Seroquel uses 3A4 for metabolism, not 2D6.
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> > At least the Mellaril didn't give me EPS, but I am sure in time I would develop more advanced TD.
> > Is there any other way to manage paranioa and distorted thinking without AP's??? Are there any other major tranquilizers that don't block dopamine???
>
> No. The definition of a major tranquilizer that it should block D2 receptors. I would stick to an antipsychotic with well proven history of treating paranoid ideation - i.e. Risperdal. Play with the dose of risperdal + Benadryl/cogentin. Zyprexa is also an option. Yes, SSRIs might help too. I would combine high dose Paxil with whatever antipsychotic you take. It might bring more favorable results. Just my intuition.
Seroquel is just as effective an anti-psychotic as is Risperdal. All these atypical anti-psychotics are basically the same drugs, variations on a theme. That variation on a theme is "antagonize 5HT2 receptors while simultaneously antagonizing D2 receptors." All of them basically do the same thing.You can avoid neuroleptics by going back to the basics of psychiatry and having ECT instead.
Bilateral ECT has powerful dual antidepressant/anti-psychotic effects, which can come in handy with mood disordered folks who have psychotic features such as "distorted thinking." ECT does not carry with it the danger of inducing movement disorders like EPS and TD.
Bilateral ECT is the single most effective treatment for mood disorders with psychotic features and all the literature you will read will back that up.
Old School
poster:OldSchool
thread:87920
URL: http://www.dr-bob.org/babble/20011222/msgs/88476.html