Posted by yxibow on January 15, 2007, at 0:37:32
In reply to Re: ABILIFY + EPS--alanjacobs, posted by Honore on January 14, 2007, at 11:33:20
> Hi, Alanjacobs.
>
> I'm not an expert, by any means, but personally I'm concerned about the experiment your pdoc is running.
>
> I completely understand your (and his) desire to stay with the abilify-- and maybe the risk is worth it.
>
> My concern would be that if you suppress the symptoms, they might not manifest themselves even as the condition actually persisted. Then it might become harder to treat, when and if it did reemerge.
>
> My suggestion is that you get a second opinion, in this. There must be pdocs who specialize in TD and someone like that, who has an expertise in that particular area, would be able to say if it's safe (or worth the risk) to continue. S/he might also be able to give you much better guidance on what to look for, and how to monitor the possible underlying condition.
>
> I would strongly recommend that, under the circumstances, given the difficulty of treating TD, if you're considering continuing abilify.
>
> HonoreThe general guidance of using any neuroleptic is using the MED (minimum effective dose.) Abilify is dosed up to 30mg and beyond, we are talking about a 2.5mg dose if I am correct here. This is a rather small dose, and while the akathisia is noticeable, it is an EPS that is probably noticeable at any dose of Abilify. Regardless of the effectiveness of Zyprexa, pseudoparkinsonism was a noticeable effect at any level of zyprexa for me including a split of the smallest available dose.
Neuroleptic use, myself included, is and should be an informed consent. As long as the doctor has given a general description of what really EPS is and what really TD is, and is prepared to give AIMS exams, then the tradeoff is between feeling better for whatever period of time, or going down the path of what BP can manifest and I needn't describe. Akathisia is probably among the most noticeable effects of any neuroleptic, new or old. I had horrible akathisia from the phenothiazine Compazine in the ER. They didn't give me oral Benadryl or anything similar to take home and it wore off and I could barely tell the taxi driver how to get back home let alone cogitate any coherent thought. But phenothiazines are many times stronger than atypicals. Still, Abilify and to some extent Geodon had me crawling on the carpet. But at least I was lucid. There will always be tradeoffs.
At any rate, I hope your treatment goes well and do discuss your concerns about what I have mentioned above in your own words and take things as they go.
One side comment, you may experience some bright or blurry vision with Cogentin, being the most atropine like anticholinergic. This is to be expected and may or may not dissapear as things progress. It is presumably dosal related.
-- tidings
poster:yxibow
thread:721839
URL: http://www.dr-bob.org/babble/20070113/msgs/722416.html