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Re: large dose, reverse the muscle problem? » Jeroen

Posted by yxibow on January 19, 2007, at 18:55:42

In reply to large dose, reverse the muscle problem?, posted by Jeroen on January 19, 2007, at 14:53:48

> large dose, reverse the muscle problem in my eyes? possible?

I wouldn't raise the dose -- I know you want to get rid of the blepharospasms, but if any treatment for TD is to work, it should be at the minimum effective dose. Because you don't want to raise the chance of getting TD from another antipsychotic. Now, the risk of TD from Seroquel is much lower -- you can discuss this with your doctor, but unless he's in favor of a sky high dose, which they used to try in the old days with old antipsychotics, I don't think it would be recommended. In any case, with all of these things, follow it with your doctors advise, tell him how you feel, and the two of you can work together to find something that may eventually do something for you.


There are still other options you can try, other medications have been tried against TD, as you noted Vitamin E -- but please do this with your doctors approval.


The one thing that should still be compared though, is when you start an experimental treatment, you should get an AIMS score, and do another AIMS exam, say 6 weeks into the experiment. Otherwise you will not know how much has been improved.


The second thing you have to remember is that you have at least 33% chance on your side that it will remit at some point anyhow which could take a year, and any treatment you do may merely be a placebo to the remission of TD.


The best successes, non double blind so far, have been with different atypical antipsychotics, tetrabenazine (Nitoman), and Clozaril.


If you try Clozaril, you have to be prepared for weekly blood tests for several months at least because it can cause up to 2.5% of patients to have low blood cell counts, which could seriously endanger you if you got any infection. Also, while it has never been conclusively proven to have any TD of its own, it does cause a certain amount of drooling in some patients which you may have to control with an anticholinergic, probably Artane or Cogentin. This presents a dilemma, because you already have TD, and anticholinergics make TD worse almost 100%. Your only other choice in reducing drooling is Clonidine, an alpha blocker, which must be taken on schedule, or you could have rebound blood pressure. Certain antihistamines may also be drying, but they will have a percentage of anticholinergic effect too.


But most of all, focusing on it, while I know it is impossible to forget, only makes it more distressing for you. People are cruel, whether online or offline and I understand that you have been mocked in school, but you have to let it roll off as much as possible. Stress theoretically could increase TD I suppose, though I can't say that for sure. Mental illness carries a horrible burden, and treatments have their own consequences. Be well and you have a community here who cares. Babblemail some of your friends.


Be well

-- Jay

 

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URL: http://www.dr-bob.org/babble/20070119/msgs/724160.html