Posted by yxibow on January 28, 2009, at 2:37:46
In reply to Re: Have you tired perphenazine yet????? » Jeroen, posted by Zyprexa on January 27, 2009, at 20:08:14
> How do you know it will give you TD? I take it and don't have that problem. You can take cogentin to get rid of TD. I take a little of that with it, not even sure I need it.
I hate to edge in here, but Artane and Cogentin and the discontinued Akineton are a set of possible things to cover EPS, which may include pseudoparkinsonism (tremors), stiffness, akathisia (intense feeling to move) and other such effects, and propranolol and sometimes amantadine.
EPS is another way of describing a cluster of side-effects, not -late- forming -possibly- long lasting or permanent effects such as TD and TDy (tardive dyskinesia and tardive dystonia).
To this date there has been no proven solution for TD, other than taking the MED (minimum effective dose) of a AP, taking a new generation atypical which reduces the risk about 5 fold theoretically, or discontinuing a medication that shows signs of possible movement disorders on an AIMS exam.There has been a limited study with tetrabenazine, which did show some promise at the expense of possible lasting or permanent iatrogenic pseudoparkisonism.
Other things have been tried, such as Vitamin E at large doses, Buspar at incredible doses, and a variety of things. There haven't been double blind trials and it unfortunately still remains inconclusive.
Still, there is a chance that Clozaril (with all its problems) can cover, reverse, alter changes while on the medication, and that lower risk atypicals such as Seroquel may be a better choice if treatment has to continue anyhow.
Sometimes treatment still has to continue though because the medication keeps a patient in a stable state.
Tardive like symptoms can also prevent as a manifestation of schizophrenic spectrum disorders, and TD generally remits at least in 30% of the cases of discontinuation, stays about the same in 30% and may possibly become worse in the other 30%.
I didn't want to make a heavy response, but this is unfortunately still the case and it is something that is in the back of my mind for the use of Seroquel (for an unrelated, unknown orphan condition) that I take.
Taking anticholinergics such as Cogentin with TD (not TDy) generally aggravates the symptoms of TD and does not stop the manifestations.
-- Jay
poster:yxibow
thread:876147
URL: http://www.dr-bob.org/babble/20090104/msgs/876702.html