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Re: web info on TD...you guys are freaking me out heaven help me

Posted by yxibow on June 1, 2006, at 0:11:37

In reply to web info on TD...you guys are freaking me out, posted by heaven help me on May 31, 2006, at 21:00:51

> I take 120mg Geodon a day and I am starting to get feaked out about it but I found this info today, here is part of it:
>
> If neuroleptic drugs have been used, or are being used, there is substantial evidence (at least seven studies) which show that tardive dyskinesia can be avoided and/or treated, through the use of certain nutrients, especially vitamin E. One professional suggests the following to prevent or treat tardive dyskinesia:
>
> Vitamin E, 400-800 units/day
> Vitamin B6, 100-200 mg./day
> Vitamin C, 1000 mg./day
> Vitamin B3, 100-200 mg./day (niacinamide)
> Multiple mineral tablet containing about 3-5 mg. of manganese
> AND, here is the link it came from:
> http://www.autism.org/tardiv.html


That is not, by the way, the official Autism society's web page -- it is a private research group.

But, yes, Vitamin E has been recommended as a neuroprotective, and despite no double blind studies, I do take 400 IU a day, the maximum one should really take as there are issues of internal bleeding. For treatment of TD, 1600 IU has been used successfully in some cases, but again, there have been little double blind studies illustrating it.

The thing about TD is that it can remit during treatment, thus one never knows whether it was the Vitamin E or not without a double blind study. It can also remit with a switch to a different neuroleptic. It can be exacerbated also in some studies by abrupt discontinuation of any neuroleptic. The only neuroleptic to date that has not caused more than a few isolated TD cases is Clozaril, which carries a 2% mandatory discontinuation if mandatory blood tests determine agranulocytosis (low white blood cell count.) Clozaril has also been shown to help those with TD. To this date, we have no conclusive studies on the potential of TD, and naturally that leaves the patient with the decision of "informed consent" to take a neuroleptic.

I do worry at times about my use of Seroquel, though it is the least powerful at D2 of all antipsychotics other than Clozaril which has nearly no affinity (Clozaril is more powerful in other ways as a "gold standard" for treatment resistant schizophreniform spectrum disorders.)

There was a study by the British Journal of Pharmacology, if I recall, on a rather substantial number of patients on Zyprexa. It was determined that the average annual rate of TD was 1/2% per year -- theoretically if you lived 100 years, you could say that could be up to 50% cumulative, although that is not exactly how TD manifests, nor how statistics work. Seroquel is even weaker than Zyprexa which has a fair affinity for D2, so I suppose I could extrapolate to 1/4%, but its in the "we don't know department."

Geodon has a fairly strong affinity for D2 and thus if one is exhibiting strong EPS on Geodon, there is a greater likelyhood of developing TD at some undetermined, but definately tardive (late) period. This would be based on the theory that strong EPS is an indicator of a possibility of strong TD, again, not conclusively proven either.

What one should do, under their own "informed consent" while taking an antipsychotic is have a regular AIMS exam -- typically every 6 months, by your trained psychiatrist. If a psychiatrist is prescribing antipsychotics, they should know how to perform an AIMS exam which is a subjective level of TD. There are other things out there that may mimic TD, but fall below the standard of actually calling it TD, such as fasciculations, pseudoparkinsonism, and other EPS manifestations.

 

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poster:yxibow thread:650453
URL: http://www.dr-bob.org/babble/20060530/msgs/651309.html