Posted by yxibow on June 5, 2008, at 2:43:02
In reply to Re: swallowing excessive from clozapine TD » Jeroen, posted by SLS on June 2, 2008, at 7:16:44
> > swallowing excessive from clozapine
> >
> > day 3 :(
> >
> > also my pillow is wet and the feeling to swallow is strange,
> >
> > is this TD
>
> It is not TD because it is not latent (tardive). Clozapine will usually hide these dyskinesias, anyway. It occurs much later in treatment. It may be some initial startup EPS that will disappear in a week or two. However, if you have had true TD in the past, you may have to take a second look at the swallowing problem.
>
> It is rare (0.5%), but trouble swallowing is a symptom of neuroleptic malignant symdrome (NMS). It could happen at any time during treatment with antipsychotics. There are reports in the medical literature of NMS occurring with clozapine. Check your temperature. If it is significantly elevated, please call your doctor.
>
> I guess what I am trying to say is that you have very little to worry about. If you have any doubts, I recommend that you speak to your doctor rather than rely on PB to act as a physician for you. You might suggest to him that you would like him to administer an Abbreviated Dyskinesia Rating Scale (ADRS).
>
>
> - Scott(I hadn't heard of the ADRS, generally the NIMH AIMS scale is used)
Drooling is unfortunately a common reported side effect with clozapine and with what you have described as your previous TD makes it difficult to treat with anticholinergics because they would exacerbate any previous TD symptoms in general.
But you are only on day 3 and that isn't quite a fair trial of any psychotropic medication because there is a lag time of several weeks to find out what will or will not go away or reduce over time.
I have requested frequent medication changes myself because of the length of my illness and looking for relief and my doctor though understanding, wants me to appreciate each change, because changing medications every week or changing two medications at a time doesn't fit the standard of practice.
NMS is very rare actually with atypicals, one would not be aware of it sometimes, except for as noted a very high fever -- the disorientation that frequently goes along is often missed by the patient from what I understand.
As for the swallowing thing -- I know with Trazodone and possibly Seroquel in the past, if I take them and stay up and start to raid the kitchen because of the antihistaminic and other related effects, I find myself having difficulty swallowing the food that I probably shouldn't be eating at that point.
So what I would say is a) don't give up after 3 days, as these can be common effects and.......b) obviously keep following the pretty much worldwide standards of blood draws, that's vital -- it won't be dispensed otherwise, certainly here in the states and most "western" countries with clozapine registries. Anyhow I doubt it is being dispensed otherwise.
...and as mentioned before it is not TD as it that is a future, very latent.... 0.5%-5% with most atypicals and few cases have been heard with clozapine at all.
It could be some other form of dyskinetic effect, an ID (initial dyskinesia).
Don't lose hope, hope comes from within.
-- best wishes
-- tidings
-- Jay
poster:yxibow
thread:832467
URL: http://www.dr-bob.org/babble/20080528/msgs/833024.html