Posted by yxibow on December 6, 2006, at 0:29:44
In reply to What is TD??, posted by maryhelen on December 5, 2006, at 16:36:57
> After all of my years of med trials it seems to me that I should know what TD means, but I don't. I am so confused about medications I don't know if I am coming or going half the time. I had a hospitalization for 2 months earlier this year ( about my 8th time as well as 4 treatment centres) and ended up having 13 ECT treatments (third time, ineffective) and was sent home on the following meds:
>
> 50 mg. clomipramine
> 150 mg. trazadone
> 100 mg. seroquel
> 15.0 zopiclone
>
> I still do not sleep well. I am so tired after 25 years of battling this depression. I use to research every med I was ever on ..... I cannot even remember all of them. Now I feel so hopeless as to ever being helped I don't even have the energy to be proactive in my care. I also have a problem with pain medications .... have a lot of physical disabilities. Percocett, for example, or other types of opiates, is the only relief I get from the depression. Of course I have to take too much to be effective and they are not easily available. My psych is working on me going on buprenorphine and a higher than normal dose of an antidepressant. My system metabolizes drugs at an alarming rate. He seems to indicate Effexor something like 600 mg. I am just waiting, as the bupe has not been available in Canada and special permission has been required for approval from the government. However, I understand now that bupe was made available in November here. I read other sites, and there is an indication for bupe being used for refractory depression. My doc told me that it is just indicated for pain management and to stop taking the other opiates. I just do not know anymore. The depression is devastating and I do know that I cannot continue much longer living such a useless and pointless life. Sorry to go off topic. Just got carried away. I don't even know why I continue to take these meds as they are obviously not working or I would not be so depressed. They were prescribed by the psych doc at the hospital whom I do not see anymore. I guess I am just waiting to see what my own doc puts me on. Thanks for listening.
>
> maryhelen
TD is Tardive Dyskinesia, a movement disorder caused by primarily neuroleptic (antipsychotic) medications. It is characterized in severity by the AIMS scale and can consist of stereotypy such as orofacial movements, limb jerks, cogwheel rotation, and other displays. To have definite TD, contradictory to intuition, one generally is not aware (at first) that they even have the motions and generally have to be pointed out. Awareness is included in AIMS exams but is not a primary part of diagnosis necessarily. TD and EPS (a fancy name for side effects of neuroleptic and other agents) are sort of on a sliding scale, TD being a more permanent result and EPS being various ongoing side effects as a result of treatment.
Tricyclics such as clomipramine are slightly more common in rareness than SSRIs to cause TD but this is not a major issue in their usage; side effects such as sedation, sweating and other characteristics of that drug class are far more common side effects.
The Seroquel you are taking, while there have been cases of TD, atypical (new) antipsychotics have varyingly been assigned about a 2% per year risk rate across the board by various studies, and Seroquel itself is probably even below that. It unfortunately is the most sedating of all antipsychotics, new or old.
TD can also be caused by extreme alcoholism, although this is also a rare event, and use of benzodiazepines such as Xanax, which is probably even more rare. Generally TD is most common in old line antipsychotics such as haloperidol.Roughly 30% of patients remit, 30% go no further, and 30% develop further problems. There is ongoing research in attempts to tackle TD but it remains an unfortunate part of treatment for BP and Schizophreniform disorders as well as other conditions with antipsychotics. At least a dozen agents have been tried against it, with some minor results with high dose Vitamin E and high dose BuSpar (which itself is a weak antipsychotic in disguise at high doses). Tetrabenazine has had some luck in some cases at the expense of pseudoparkinsonism (handshaking, etc.)
-- Jay
poster:yxibow
thread:703921
URL: http://www.dr-bob.org/babble/20061129/msgs/710761.html