![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 44. This is the beginning of the thread.
Posted by janejj on December 26, 2001, at 23:29:50
Hello everyone,
Hope you had a good holiday !Ok i'm wondering if Wellbutrin can induce paranoia ? Is it connected to too much Dopamine ?
Thankyou,
jane
Posted by jimmygold70 on December 27, 2001, at 2:10:20
In reply to Paranoia and Dopamine CamW or anyone ?, posted by janejj on December 26, 2001, at 23:29:50
Well, I haven't heard about this particular effect. It is known that some TCAs can induce paranoia, and this might be true for Wellbutrin too.
Jimmy
Posted by Cam W. on December 27, 2001, at 13:09:59
In reply to Paranoia and Dopamine CamW or anyone ?, posted by janejj on December 26, 2001, at 23:29:50
Jane - My holidays are going well; as well as they can for a secular humanist-type of guy. Santa sent a pile of philosophy books (I think he/she thinks that I am collecting too much information about psychopharmacology without internalizing it (ie. collecting the knowledge, but not integrating it into wisdom). Guess I gotta become more selective in what I learn, and finally realize that I can't know it all! (Sure Santa, wanna bet!)
Anyway, I have seen someone who did develop paranoid ideation about 3 or 4 weeks after starting Wellbutrin™ (bupropion). I had seen this person in outside the clinic (at a mall) and he/she had said that they were feeling very "anxious and jittery". Since it was about three weeks into therapy, I had chalked it up to start-up side effects. I told this person to hang on and these would go away.
I went back to work and had a conversation with the therapist about this individual and she gave a call. I guess this person had deteriorated and the therapist went to the apartment. This person had progressed to the point where the neighbors were plotting to "get them" (the whole family). This person was sent to hospital for a couple of days, the Wellbutrin was stopped, and the ideation faded.
It should be noted that this person had been taking Haldol™ (haloperidol) for a number of years, and had a few breakthrough psychotic episodes (usually delusions, rather than overt paranoia, though). This person had experienced paranoia during the occasional cocaine binge (which was denied, at this time - also, had previously told me that coke wasn't a favorite escape because of the paranoia). Also, this person had been known to occationally binge on other recreational chemicals, but had never mentioned (to me) of any paranoia.
The pdoc, therapist, and I had chalked up the paranoia to either extreme agitation &/or nervousness. In any case, whatever had caused the paranoia, it did resolve within a couple of days of stopping the Wellbutrin. I do believe that I had read somewhere that Wellbutrin had caused paranoid ideation in a person taking Wellbutrin, but I cannot remember the particulars.
I hope that this is of some help. - Cam
Posted by Cam W. on December 27, 2001, at 13:16:57
In reply to Paranoia and Dopamine CamW or anyone ?, posted by janejj on December 26, 2001, at 23:29:50
Jane - As for the cause of the paranoia; it may be due to excess dopamine. I am still not convinced that Wellbutrin, at therapeutic doses, really has any significant effect on dopamine (in most people). It may be that you have sensitive dopamine receptors in your limbic system (esp. the connections to the prefrontal cortex), but this is a guess.
Since the person, who story that I related in the previous post was taking an irreversible dopamine-2 blocking agent (haloperidol) and experienced a sort of paranoia, I am not sure that dopamine changes by the Wellbutrin were to blame; but I am also not positive that it wasn't due to dopamine.
- Cam
Posted by dreamer on December 27, 2001, at 15:27:45
In reply to P.S. » janejj, posted by Cam W. on December 27, 2001, at 13:16:57
> Jane - As for the cause of the paranoia; it may be due to excess dopamine. I am still not convinced that Wellbutrin, at therapeutic doses, really has any significant effect on dopamine (in most people). It may be that you have sensitive dopamine receptors in your limbic system (esp. the connections to the prefrontal cortex), but this is a guess.
>
> Since the person, who story that I related in the previous post was taking an irreversible dopamine-2 blocking agent (haloperidol) and experienced a sort of paranoia, I am not sure that dopamine changes by the Wellbutrin were to blame; but I am also not positive that it wasn't due to dopamine.
>
> - CamI may be wrong but it is said that paranoid shizophrenia may be due to excessive dopamine also hash ( i may be wrong again) raises dopamine levels.
Smoking a joint for me = xtreme paranoia hallucinations etc.
If the med I pop affects seretonin maybe it depletes dopamine over time hense less paranioa xcept when crazy manic , too complex , my head hurts.
Posted by Chloe on December 27, 2001, at 17:18:57
In reply to Re: P.S., posted by dreamer on December 27, 2001, at 15:27:45
This is related to dopamine, so I hope you don't mind me jumping in.
Cam,
I HAVE to be on an AP for the at least a few months or much longer. I already have MILD vermicular movements of the tongue from long term use of Melleril several years ago.
A well know pharmacologist that was consulted said I should go back on a typical AP and take 10 mgs of Melatonin to conteract tongue movements.
This was too scary for me, so I opted to go with the more safe AP, seroquel(much less effective, though!).
Do you think the seroquel could turn my mild tongue movements into TD?
And is there any merit to the use of Melatonin? The RDA for TD prevention in this pdocs mind is 10 mgs. This seems like a very high dose, and possibly depressogic, I would persume.
Do you have any thoughts on this???
TIA
Chloe
Posted by Willow on December 27, 2001, at 18:40:50
In reply to Re: Cam:antipsychotic question, posted by Chloe on December 27, 2001, at 17:18:57
Chloe
My father has severe TD caused by antipsycotics. He is now on zyprexa and it hasn't worsened the movements so far. He is seeing a psychiatrist who specializes in TD and she put him on a high dose of vitamin E, 800i.u., apparently this works better the less severe the TD or newer it is. You may want to ask your doctor or pharmascist about this.
How does Melatonin work considering TD?
Willow
Posted by Willow on December 27, 2001, at 18:58:19
In reply to Paranoia and Dopamine CamW or anyone ?, posted by janejj on December 26, 2001, at 23:29:50
> Ok i'm wondering if Wellbutrin can induce paranoia ? Is it connected to too much Dopamine ?Jane
I was on Mirapex which has something to do with dopamine and it confused my thought processes. The older ADs and some of the newer ones have done this to me to, whenever I stop them the confusion goes away fairly quickly.
It wasn't until I found this site and heard from other with symptoms caused by ads that my previous doctors discounted that I was able to trust my own judgement. If you suspect a medication is making you worse and stopping it makes the symptom go away then in my opinion the drug does cause it.
BEST WISHES
Willow
Posted by Chloe on December 27, 2001, at 20:17:44
In reply to Re: Cam:antipsychotic question » Chloe, posted by Willow on December 27, 2001, at 18:40:50
Hi Willow,
So glad to hear that your dad is doing well on Zyprexa. My pdoc assures me that the risk of increased tongue movements is minimal. But 24 hours after I start taking Seroquel, or Zyprexa or Geodon, I get increased tongue stuff (maybe just EPS???). It's not too disturbing and is not noticable to anyone else. So if it doesn't get worse, I belief it is worth taking the med. I am having severe difficultly functioning without an ap.Per my pdoc, I take 1600 iu's of E, half in the am, half in the pm, and have for years, since the tongue stuff started. It helps marginally. By that I mean, if I forget the vita E, I notice more activity in my mouth.
In terms of Melatonin, it's supposed to have some antioxidant properties like vita E has. But I can find very little info on the net about it. But a consulting pdoc swears by it...(I just don't know if I could tolerate 10 mgs of melatonin. It seems like a lot, and has it's own affects on mood.)
Thanks so much for your encouraging words about your dad's response to Zyprexa. Does his pdoc know about melatonin for TD?
Chloe
> My father has severe TD caused by antipsycotics. He is now on zyprexa and it hasn't worsened the movements so far. He is seeing a psychiatrist who specializes in TD and she put him on a high dose of vitamin E, 800i.u., apparently this works better the less severe the TD or newer it is. You may want to ask your doctor or pharmascist about this.
>
> How does Melatonin work considering TD?
>
> Willow
Posted by Cam W. on December 27, 2001, at 20:44:17
In reply to Re: Cam:antipsychotic question, posted by Chloe on December 27, 2001, at 17:18:57
Chloe - I haven't heard of using melatonin successfully for EPS or TD. I have seen vitamin E used successfully...once. The Seroquel™ (quetiapine), while it may not stop these movements, will, in all probability, not worsen them (unless, by stopping the Mellaril™ - thioridazine - "unmasks" more severe tardive symptoms). I have never seen Seroquel cause any kind of EPS symptoms (let alone TD), but then again, I seldom see Seroquel used as a sole agent.
The worse case of TD that I had ever seen (the person could not even keep a hat of their head) was basically "cured" using Clozaril™ (clozapine). It did take over 8 months for the effects to kick in, but now this person is riding a bike, and if you did know that this person had TD, you couldn't tell. The transformation was absolutely amazing.
I have heard a similar story with Zyprexa™ (olanzapine), but I have personally only seen the unmasking of Orap™ (pimozide) induced TD with Zyprexa. This could be due to the short time that the person was taking the Zyprexa before stopping it.
- Cam
Posted by Chloe on December 27, 2001, at 21:11:32
In reply to Re: Cam:antipsychotic question » Chloe, posted by Cam W. on December 27, 2001, at 20:44:17
Cam,
I have been off of Mellaril for 4 or more years because I was developing tongue movements. After about a year, the tongue movements settled down so it only come back with an anxiety producing situation, or activating meds like Celexa. Seems strange an SSRI would cause the same mouth movements as an AAP.
My Pdoc is wondering if I just have an "oversensitive" tongue and mouth since the d/c of Mellaril. Does this sound plausible? That agents that might touch on dopamine would *reactivate* an already irritable tongue? And maybe Seroquel won't cause additional *permanent* damage? The damage is already done?BTW, I was on Clozeril for about 3 month several years ago. I had a wonderful response to it. Best I think I have every functioned. My emotional pain for once, was really being managed. But my WBC bottomed out. Very upsetting.
I think I am going to wait on this Melatonin "cure" for the moment. It seems like it might add more problems at the moment.
Thanks so much Cam.
Chloe- I haven't heard of using melatonin successfully for EPS or TD. I have seen vitamin E used successfully...once. The Seroquel™ (quetiapine), while it may not stop these movements, will, in all probability, not worsen them (unless, by stopping the Mellaril™ - thioridazine - "unmasks" more severe tardive symptoms). I have never seen Seroquel cause any kind of EPS symptoms (let alone TD), but then again, I seldom see Seroquel used as a sole agent.
>
> The worse case of TD that I had ever seen (the person could not even keep a hat of their head) was basically "cured" using Clozaril™ (clozapine). It did take over 8 months for the effects to kick in, but now this person is riding a bike, and if you did know that this person had TD, you couldn't tell. The transformation was absolutely amazing.
>
> I have heard a similar story with Zyprexa™ (olanzapine), but I have personally only seen the unmasking of Orap™ (pimozide) induced TD with Zyprexa. This could be due to the short time that the person was taking the Zyprexa before stopping it.
>
> - Cam
Posted by Cam W. on December 27, 2001, at 23:14:49
In reply to Re: Cam:antipsychotic question » Cam W., posted by Chloe on December 27, 2001, at 21:11:32
Chloe - Yes, unfortunately the damage is done. The good news is that it is highly unlikely that Seroquel will add any more problems. It is thought that the loose binding of dopamine-D2 receptors by the atypical antipsychotics (like Seroquel), rather than the irreversible binding of dopamine-D2 receptors to the traditional antipsychotics (like Mellaril) helps to avoid EPS and TD.
With the atypicals, at any one time the D2 receptors are less than 79% blocked. Above this level is when one starts seeing EPS symptoms (and ultimately TD symptoms). I think that I read somewhere that with most of the atypicals you can obtain greater than 80% blockage of D2 receptors if you raise the dose high enough (Risperdal™ [risperidone] >6mg; Zyprexa™ [olanzapine] >35mg - approximately), except with Clozaril™ (clozapine) and Seroquel. I am fairly sure that they have tried, but have been unable to get Seroquel to block the D2 receptors at a level greater than 80%.
Yeah, SSRIs do seem to exacerbate TD and can even cause EPS in a minority of people. I don't really know why. It could be because when you increase serotonergic tone, you (in a roundabout way) decrease dopaminergic transmission. This is just a guess, though.
As for the use of Clozaril, has your doc ever considered a rechallenge, with a close watch on your blood cells? I have seen a few rechallenges where the second time around there has been no blood problems (so far). The downside to the cases that I know about is that the docs are a little jumpy about Clozaril rechallenges and keep the people on weekly blood tests forever (so far). That can be a real pain (where I wouldn't put a window).
- Cam
Posted by Chloe on December 28, 2001, at 9:31:41
In reply to Re: Cam:antipsychotic question » Chloe, posted by Cam W. on December 27, 2001, at 23:14:49
Cam,
That info is so helpful and reassuring. Especially when you throw in the statistics! I am also glad Seroquel seems to even "more" safe in that it doesn't seem to bind over 80% at any dose.
> > Chloe - Yes, unfortunately the damage is done. The good news is that it is highly unlikely that Seroquel will add any more problems. It is thought that the loose binding of dopamine-D2 receptors by the atypical antipsychotics (like Seroquel), rather than the irreversible binding of dopamine-D2 receptors to the traditional antipsychotics (like Mellaril) helps to avoid EPS and TD.> > With the atypicals, at any one time the D2 receptors are less than 79% blocked. Above this level is when one starts seeing EPS symptoms (and ultimately TD symptoms). I think that I read somewhere that with most of the atypicals you can obtain greater than 80% blockage of D2 receptors if you raise the dose high enough (Risperdal™ [risperidone] >6mg; Zyprexa™ [olanzapine] >35mg - approximately), except with Clozaril™ (clozapine) and Seroquel. I am fairly sure that they have tried, but have been unable to get Seroquel to block the D2 receptors at a level greater than 80%.
> > Yeah, SSRIs do seem to exacerbate TD and can even cause EPS in a minority of people. I don't really know why. It could be because when you increase serotonergic tone, you (in a roundabout way) decrease dopaminergic transmission. This is just a guess, though.
> > As for the use of Clozaril, has your doc ever considered a rechallenge, with a close watch on your blood cells? I have seen a few rechallenges where the second time around there has been no blood problems (so far). The downside to the cases that I know about is that the docs are a little jumpy about Clozaril rechallenges and keep the people on weekly blood tests forever (so far). That can be a real pain (where I wouldn't put a window).In terms of a rechallenge, I am under the impression that it is illegal to take Clozaril again after one has had agranulocytosis. Is my info incorrect? Perhaps it's allowed in Cananda, but not here in the US? Or my pdoc is just too scared! But I don't think so.
After two days of Seroquel, my thinking is really clearing up and I am feeling a bit better. I think I am just going to have to accept my tongue movements and get on with my life. It is quite reassuring that it shouldn't get worse. Unfortunately, this tongue stuff was created a long time ago.
Thank you so much, again, Cam. It is such a gift that you are willing to share your expertise and experience with us. Happy 2002!
Chloe
Posted by janejj on December 28, 2001, at 10:43:05
In reply to Re: Paranoia and Dopamine CamW or anyone ? » janejj, posted by Cam W. on December 27, 2001, at 13:09:59
Hi Cam,
Thankyou for your reply ! How are those philosophy books going !?
OK I suspect then that it is the Wellbutrin. Perhaps just exacebating what was already there! Although its very specific paranoia, just that i think people are staring at me when i go shopping at the mall. I hate those places !!!
Janejj
Jane - My holidays are going well; as well as they can for a secular humanist-type of guy. Santa sent a pile of philosophy books (I think he/she thinks that I am collecting too much information about psychopharmacology without internalizing it (ie. collecting the knowledge, but not integrating it into wisdom). Guess I gotta become more selective in what I learn, and finally realize that I can't know it all! (Sure Santa, wanna bet!)
>
> Anyway, I have seen someone who did develop paranoid ideation about 3 or 4 weeks after starting Wellbutrin™ (bupropion). I had seen this person in outside the clinic (at a mall) and he/she had said that they were feeling very "anxious and jittery". Since it was about three weeks into therapy, I had chalked it up to start-up side effects. I told this person to hang on and these would go away.
>
> I went back to work and had a conversation with the therapist about this individual and she gave a call. I guess this person had deteriorated and the therapist went to the apartment. This person had progressed to the point where the neighbors were plotting to "get them" (the whole family). This person was sent to hospital for a couple of days, the Wellbutrin was stopped, and the ideation faded.
>
> It should be noted that this person had been taking Haldol™ (haloperidol) for a number of years, and had a few breakthrough psychotic episodes (usually delusions, rather than overt paranoia, though). This person had experienced paranoia during the occasional cocaine binge (which was denied, at this time - also, had previously told me that coke wasn't a favorite escape because of the paranoia). Also, this person had been known to occationally binge on other recreational chemicals, but had never mentioned (to me) of any paranoia.
>
> The pdoc, therapist, and I had chalked up the paranoia to either extreme agitation &/or nervousness. In any case, whatever had caused the paranoia, it did resolve within a couple of days of stopping the Wellbutrin. I do believe that I had read somewhere that Wellbutrin had caused paranoid ideation in a person taking Wellbutrin, but I cannot remember the particulars.
>
> I hope that this is of some help. - Cam
Posted by Willow on December 28, 2001, at 16:32:24
In reply to CamW, posted by janejj on December 28, 2001, at 10:43:05
Posted by IsoM on December 28, 2001, at 17:03:50
In reply to What is EPS? (nm), posted by Willow on December 28, 2001, at 16:32:24
It means extrapyramidal symptoms - muscle disturbances & movements such as restlessness, tremors, & muscle stiffness that are side effects of some antipsychotic medications. They're generally more common with older medications than the newer ones.
Posted by Cam W. on December 28, 2001, at 18:02:44
In reply to Re: What is EPS? » Willow, posted by IsoM on December 28, 2001, at 17:03:50
> It means extrapyramidal symptoms - muscle disturbances & movements such as restlessness, tremors, & muscle stiffness that are side effects of some antipsychotic medications. They're generally more common with older medications than the newer ones.
....or Edmonton Police Service (damn, busted again).
Willow - EPS can be treated with anticholinergic drugs (which many times cause more perturbing side effects than some EPS), like Cogentin™ (benztropine), Artane™ (trihexyphenidyl), Kemadrin™ (procyclidine), Disipal™ (orphenadrine),
Akineton™ (biperiden), and Parsitan™ (ethoproprazine). I have listed them in order of most commonly used to least commonly used in our area.All have good points and bad points. Doses are highly individualized. Some people taking high doses of older antipsychotics don't need any or small doses (1mg of Cogentin daily), but I have seen someone taking 1mg of Haldol a day need 2mg of Cogentin three times daily. It's all how one's body is affected by D2 blockade.
- Cam
Posted by Willow on December 28, 2001, at 22:15:13
In reply to Re: What is EPS? - Willow, posted by Cam W. on December 28, 2001, at 18:02:44
EPS can be treated with anticholinergic drugs (which many times cause more perturbing side effects than some EPS), like Cogentin™ (benztropine), Artane™ (trihexyphenidyl), Kemadrin™ (procyclidine), Disipal™ (orphenadrine),
> Akineton™ (biperiden), and Parsitan™ (ethoproprazine). I have listed them in order of most commonly used to least commonly used in our area.So EPS is the constant movement of legs and arms that my father has? And if so, his doctor hasn't tried him on any of these meds, is there a reason for this?
The effexor gives me muscle twitches and sudden jerks. I've been reassured by the doctors that this isn't related to the TD in anyway. Are they correct? Is it safe to say that they aren't related to EPS either?
Chloe
If you're still here I have a question for you regarding the TD, more so the tongue. Do you ever get an irrating tickle running along a nerve in your tongue? I've just always wondered what this is.
Answers just lead to more questions.
Willow
Posted by Willow on December 28, 2001, at 22:16:42
In reply to Re: What is EPS? - Willow, posted by Cam W. on December 28, 2001, at 18:02:44
> ....or Edmonton Police Service (damn, busted again).Now what would the Edmonton Police Service want with you?
Wondering Willow
Posted by Cam W. on December 28, 2001, at 23:58:52
In reply to EPS Cam, posted by Willow on December 28, 2001, at 22:16:42
>
> > ....or Edmonton Police Service (damn, busted again).
>
> Now what would the Edmonton Police Service want with you?
>
> Wondering WillowWillow - Just hangin' with my homeys on the drug squad. =^P
Posted by Cam W. on December 29, 2001, at 0:11:19
In reply to Re: What is EPS? » Cam W., posted by Willow on December 28, 2001, at 22:15:13
Willow - There are several reasons that your father hasn't been given these drugs. First and foremost, I believe that your dad has tardive dyskinesia (TD), and these meds do little in the way of stopping those movements. The anticholinergics I mentioned are usually used for the extrapyramidal movements and muscle pains associated with EPS.
Secondly, these drugs cause a fair bit of cognitive impairment in the elderly population, especially those prone to Alzheimers, which anticholinergics with significantly worsen. They actually use anticholinesterase inhibitors for Alzheimers patients, which increase acetylcholine concentrations in the body. Blocking acetylcholine receptors would significantly enhance Alzheimers symptoms.
Also, anticholinergics can cause hallucinations in people who are more sensitive to their effects, and they cause lovely side effects like extreme dry mouth, sedation, urinary flow problems, and coordination problems (leading to falls). These side effects are most pronounced in the elderly.
Muscle twitches probably aren't EPS, although some people have reportedly got EPS symptoms from SSRIs and Effexor. It isn't that common. I believe that muscle aches and pains are an early sign. Your doc can do a simple test to determine if you do have EPS (I doubt it, though).
- Cam
> The effexor gives me muscle twitches and sudden jerks. I've been reassured by the doctors that this isn't related to the TD in anyway. Are they correct? Is it safe to say that they aren't related to EPS either?
Posted by Chloe on December 29, 2001, at 9:45:56
In reply to Re: What is EPS? » Cam W., posted by Willow on December 28, 2001, at 22:15:13
> >Do you ever get an irrating tickle running along a nerve in your tongue? I've just always wondered what this is.
Willow,
I have never experienced an irritating tickle. My tongue can get awfully sore and irritated at the tip where is rubs back and forth on my lower teeth. But no nerve problems. That is an interesting one. Does your father experience this?
> > Answers just lead to more questions.Isnt that the truth!
Best,
chloe
Posted by Willow on December 29, 2001, at 15:16:06
In reply to Re: What is EPS? » Willow, posted by Chloe on December 29, 2001, at 9:45:56
Chloe
I asked my dad if he has any problems besides the obvious with the TD because of the tongue movements. He said that just his neck gets sore. The scariest part of it is that he often swallows down the wrong tube and chokes.
Fortunately the zyprexa doesn't give him such a dry mouth and the need to gozzle water isn't as strong. Now this may also be because he substituted his beer for Ativan, he claims the no-name brands don't help the same way.
The question regarding the tickle was for myself. Thankfully it is very infrequent but quite obtrusive as it has wakened me from my sleep which not much can. I've also on separate occassions lost all sense of smell and taste. The taste came back to parts of my tongue in portions, the back first. I don't know if this is related to the tickle.
But from this experience I do believe that these senses affect our mood. Whenever I notice it fading I make a point to eat strong foods and sniff strong odours to try and revive it and to give my mood a kick start.
I do hope your holidays are going well!
BEST WISHES
Willow
Posted by Chloe on December 29, 2001, at 15:55:59
In reply to TD » Chloe, posted by Willow on December 29, 2001, at 15:16:06
Hi Willow,
I am glad your dad is better on Zyprexa and avoiding beer! The inability to swallow stuff is very scary for me. I felt I might have had that when I took Geodon. All foods just seemed so dry, and I had such a hard time forcing down my throat. It was strange, because I did not experience dry mouth with Geodon. So I was too scared to continue with that med.Your tongue phenomenon sounds uncomfortable. Esp. if it's waking you from a sound sleep. Are you taking any antipsychotics? Do you think this is some form of TD that I am unfamilar with? I wonder if it's neurological in some way. In that you are losing sensation, and taste, and then it will return with strong smell. Have you talked to an MD about this? Does it worry you?
I am barely holding it together with the addition of Seroquel. I find it doesn't work as well as the traditional antipsychotics, and I do get exaggerated tongue wiggling/teeth clenching, which is very annoying. But I guess it's better than being "crazy", ie, angry, distorted thinking, paranoid, anxious all the time. But I am still extremely depressed. I just wish there were a cure for what I got. But I really don't have much hope. Esp. when all meds seem to be giving me major side effects. I am *trying* to stay upbeat as possible. I hate to drag people arouond me down with my lousy mood!
Thanks for the holiday good wishes. Same to you.
Chloe
>
> I asked my dad if he has any problems besides the obvious with the TD because of the tongue movements. He said that just his neck gets sore. The scariest part of it is that he often swallows down the wrong tube and chokes.
>
> Fortunately the zyprexa doesn't give him such a dry mouth and the need to gozzle water isn't as strong. Now this may also be because he substituted his beer for Ativan, he claims the no-name brands don't help the same way.
>
> The question regarding the tickle was for myself. Thankfully it is very infrequent but quite obtrusive as it has wakened me from my sleep which not much can. I've also on separate occassions lost all sense of smell and taste. The taste came back to parts of my tongue in portions, the back first. I don't know if this is related to the tickle.
>
> But from this experience I do believe that these senses affect our mood. Whenever I notice it fading I make a point to eat strong foods and sniff strong odours to try and revive it and to give my mood a kick start.
>
> I do hope your holidays are going well!
>
> BEST WISHES
> Willow
Posted by OldSchool on December 30, 2001, at 11:59:48
In reply to What is EPS? (nm), posted by Willow on December 28, 2001, at 16:32:24
I was recently diagnosed with EPS this past fall. Im still battling it actually. It occurred after I took low dose Seroquel for slightly over one a month, just 50 mg!. I was adding the seroquel to an SSRI for "augmentation" for refractory depression...didnt help in fact it made me feel more depressed. After I went off the Seroquel, my muscles got super sore and tight feeling and my tongue got real numb. I felt super weak, but my mood wasnt affected that much. I also had mild weakness on my right side. I also had a lot of small muscle twitches at rest, "twitch, twitch, twitch."
It feels like a very mild, sustained muscle contraction all over my body, with a numb tongue.
I went to my family doctor and he quickly informed me I was suffering from side effects of the Seroquel and he told me to contact my psychiatrist immediately, which I did. I then went and saw my psychiatrist, who informed me after doing some tests that my right side was mildly weak. He told me I had EPS, and that EPS oftentimes affects one side of the body more than the other.
Right now Im just waiting things out to see if things will go back to normal on its own. Its gotten a bit better but the EPS is still there. Only thing Ive tried so far that helps it is OTC Benadryl. Its also started affecting my breathing some I hate to say, like my chest gets tight, all my muscles get tight. Tongue is numb a lot. I cant open my mouth as far as I used to before all this EPS started.
The best way to deal with EPS is to never get it in the first place. When it comes to neuroleptic induced movement disorders, prevention is the best cure. That means avoid taking anti-psychotics unless you are bona fide psychotic or manic. Dont use atypical anti-psychotics for things that oftentimes are a integral part of severe depression like anxiety, insomnia, agitation, irritability and "rumination."
Use anti-psychotics for what they were originally intended for...psychosis. IE; schizophrenia or manic psychosis.
I have kind of come to the conclusion on my own that for people whose primary dx is a mood disorder and if they have psychotic symptoms the best thing might be old fashioned bilateral ECT. Or maybe bifrontal ECT. Instead of anti-psychotics plus antidepressants. Because with ECT there is no danger of movement disorders. Id trade some memory loss for this EPS crap anyday.
In short, if your problem is primarily a severe mood disorder, you might be better off getting shocked than taking anti-psychotics.
Here is a link that describes EPS from the Merck manual website:
http://www.merck.com/pubs/mmanual/section14/chapter179/179d.htm
Old School
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.