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Re: Atypicals for anxiety?

Posted by yxibow on January 31, 2007, at 20:29:18

In reply to Re: Atypicals for anxiety? » Bob, posted by Phillipa on January 30, 2007, at 20:22:19

> Well I for one have taken benzos for over 30years and have varied the ones and the doses a lot without any problems at all. If anxiety in life is down so is my use of benzos. And the or some of the atypicals cause diabetes especially zyprexa. Lawsuit being taken I think And I've seen the vidoe of Jeroen very scarey from geodon. Love Phillipa


You have to realize that the video posted is a rare but unfortunate effect. Also we don't know the complete history of how many typicals or atypicals Jeroen has tried before Geodon, as there is some evidence of cumulative drug dosage, although TD to this date is still not completely understood. Also, while I can completely believe that the video is TD, especially when described as being noticeable by other peers around him, I have yet to hear of any AIMS monitoring of any choices offered to attempt to mitigate the circumstances. At least 1/3 of people lose their TD over time and a significant number never get worse. So it is important to do an AIMS monitoring, baseline and followup any time one makes changes or you'll never actually say, yes, this did something to alleviate it, however little or great. A surprisingly low number of doctors do AIMS tests on patients regularly prescribed neuroleptics. It may seem pointless, but there is a point to it. Its to see that things don't get worse and have a mitigation plan in mind to try different medications like Clozaril and tetrabenazine and sky high doses of BuSpar and other things that have had some positive effects on TD.


Yes, Geodon is a stronger atypical but there are other choices.


The lawsuits in my mind, while may be warranted in some cases, are a typical reaction to the downsides of medication. I'm not speaking for the makers of Zyprexa or Seroquel (which I take), but I think it behooves anyone to have regular physicals and blood tests on any new medications.


Clozaril has been around a lot longer and we know the side effect profile of it, so its not surprising that newer medications have their own issues. To not monitor simple things like kidney, liver, and blood sugar functions during a physical does a disservice to the patient.


At the end of the day, while there are outright damaging things that have been done by medication, such as Thalidomide (which is actually being reintroduced) and the SSRI that preceded Prozac, we are always stuck between wanting the next best thing, yet remembering that the next best thing may have hidden side effects that may not be discovered until later on. Geodon was re-released to the market after extensive QTc assessment, yet Mellaril still remains, albeit a black box, prescribed.


I don't like to be a guinea pig any more than anybody else, but there is always this dichotomy that I hear and that I think too -- gee, what is in Phase III, and then the trials and tribulations of recently approved medications, such as my experience with Lyrica which I unfortunately had to discontinue because it does cause blurry vision in some patients.


Would I choose an atypical as a first line for anxiety -- no, probably not. SSRIs have been out much longer, and benzodiazepines even more and we know the side effects of each (about 15-20 years and 50 years respectively). But some complex disorders may need more than just an SSRI, they may need augmentation with something else.


Still, at the end of the day, its informed consent, and that means knowing the effects, and being informed by your doctor and consenting to treatment, not being passively handed prescriptions. It is and should be a partnership.

-- tidings

 

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