Posted by ed_uk on February 10, 2006, at 15:57:57
In reply to Re: TA etc., posted by the kindling effect on February 9, 2006, at 19:35:21
>......years ago to attempt to replace the loraz.......was having panic attacks on it so I insisted on raising dose and frequency and seemed like akathisia......
Perhaps you felt worse due to decreasing your dose of lorazepam, rather that due to the diazepam itself?
>I would try Librium even though Valium is a metabolite.
Chlordiazepoxide (Librium) is not metabolised to diazepam (Valium). Chlordiazepoxide and diazepam are both metabolised to desmethyldiazepam however - their most important metabolite.
>Haven't done well with trycyclics.
What about other ADs? Have you tried low-dose mirtazapine (Remeron)?
>Anti-cholinergic are apparently a big no-no with TA and can worsen it quite a bit(even if it masks it at first.) No doc has suggested them.
I wouldn't say there are any definite no-no's in TA because its treatment has been so poorly researched. Some patients may benefit from anticholinergics whereas other may find them detrimental. Pro-cholinergic drugs (such as donepezil, Aricept) might be useful for some, particularly for those who find that anticholinergics aggravate their symptoms.
A patient with TA responded to benztropine (Cogentin), an anticholinergic.......
>Cypro I tried to get but couldn't find it anymore here in Canada.
Cyproheptadine 4mg tablets are available without a prescription in Canada. I doubt many pharmacies will stock it but I imagine they could order it in for you if you ask. Tell them you find it a good antihistamine for your allergies. Cyproheptadine is inexpensive.
Cyproheptadine is an OTC (over-the-counter) drug in Canada......
>This i have not heard (RE moclobemide). Do you have the report?
Only the abstract.....
When I tried Moclobimide about 5 years ago, pre-Efxr and pre-APs I was slow and shaky and drowsy with a bad startle response and weird anxiety/insecurity. I was so-out-of it but jumpy.Stiffness wasn't that bad.(besides usual serotonin side efxs which I don't count.
>10mg propran. a day. i go higher and run into problems
What sort of problems?
I wonder what the combined alpha/beta blocker carvedilol might do for you?
>Any suggestions welcome, including vitamin suggestions.
Have you tried vitamin B6 (pyridoxine)? It seems helpful in acute akathisia at least........
B6 in TD.......