Posted by yxibow on September 9, 2006, at 17:30:43
In reply to tardive dyskinesia, posted by Jeroen on September 9, 2006, at 1:47:34
> be carefull, it gave me TD in 3 weeks usage, never went away
While your experiences are awful, the leading experts on Tardive Dyskinesia (Drs. Wirshing and Wirshing, Veterans Administration) say the following: that it a) is tardive (that means late in treatment, not 3 weeks) and b) that the patient is unaware of the movements of it.
I have had various movements over the course of my treatment Seroquel but they all have been classified as EPS and not TD, by several examinations.
The part about the patient being aware is important -- though patient knowledge is taken into account in AIMS examinations, it is not a significant part of them. If one is aware of a particular movement occurring, the chances are greater than lesser that it is a (guaranteed uncomfortable) form of EPS and not TD.
Now to minimize risk of TD, if one is worried, the choice of neuroleptic should be kept to both the MED (minimum effective dose) and the chosen atypical neuroleptic that has the least activity at D2 that causes EPS movements (high to low) [Risperdal->(Geodon, Abilify)->Zyprexa->Seroquel->Clozaril(None, but other unpleasant effects)]. In your country (not the US), you may also have the Sulprides, which would be around Zyprexa/Seroquel. The most conservative estimate for Seroquel is 1% per year, but that is over estimation, the actual cases are far below that as of today's measurement.
Also, this choice is important for those who do not suffer from a psychotic/schizophreniform disorder but rather affective (mood, e.g. severe depression, anxiety, OCD, etc.) disorder, where EPS and possibly TD have greater impacts.
The doctors prescribing an atypical neuroleptic should be aware of their risks, give you informed consent (knowledge of risks and that you agree to them), and know to give AIMS (subjective examination for TD -- Abnormal Involuntary Movement Scale) exams every 6 months or if the patient requests them earlier (they don't take very long to perform, measuring various aspects of musculature of the patient.)
-- tidingsJay
poster:yxibow
thread:682684
URL: http://www.dr-bob.org/babble/20060909/msgs/684539.html