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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by ed_uk on November 3, 2004, at 9:22:11
Hello....
Some of you may have read my post about my experience with chlorpromazine. Conclusion: Ed needs his dopamine :) It was very long so I think I might have scared you all off.
At the moment my anxiety/depression is well controlled, I hope it stays that way!Just wanted to ask.....
What are your experiences with taking typical antipsychotics, how did they affect you psychologically? How did they make you feel? Were they given by mouth or by injection? Were you forced to take the drug or was it voluntary?I'm very interested in experiences with old fashioned antipsychotics such as: haloperidol(Haldol), chlorpromazine, fluphenazine, prochlorperazine,perphenazine,trifluoperazine, flupenthixol etc.
Ed.
I'd also like to hear from anyone who has suffered from akathisia on atypical APs such as Risperdal.
Posted by linkadge on November 3, 2004, at 10:33:27
In reply to Classical Neuroleptics: Dysphoria in pill form!, posted by ed_uk on November 3, 2004, at 9:22:11
I experienced terrible akathesia on risperdal. I also took thioridazine (called melleral here in canada) which left me feeling just plane weird.
Absolutely no motivation to do anything. Nothing had any meaning or any importance.
Linkadge
Posted by ed_uk on November 3, 2004, at 10:58:13
In reply to Re: Classical Neuroleptics: Dysphoria in pill form!, posted by linkadge on November 3, 2004, at 10:33:27
Linkadge, I found this report in the 'vault of erowid'. It's about Risperdal, I think you might find it interesting. I don't know who wrote it BUT IT'S NOT ME!!...................
This antipsychotic drug is given mostly to people suffering schizophrenia and is most likely given to someone relating to any psychotic symptoms, auditory (or visual) hallucinations, etc. Anyone with these symptoms taken into an emergency room is most likely to get a shot of Haloperidol or Risperidone and some sedative substance - I advise you to stay clear away off these experiences and make sure you have a safe haven to stay until the end of any psychedelic experiences. These substances are no fun in any way, when given to anyone, care should be taken not to experiment with large doses as they are real brain killers in even very small doses.
T+0:00 As innocent I was, felt an urge to find out the effects this substance has upon mind and mood of my existence. I advise anyone with the least sanity and appreciation of life's beauty not to have similar concepts or inclinations with these materials. I should point out that I took the first pill with a good intent and could not imagine that they might do any harm to my brain and/or mental and emotional functioning.
T+0:20 I was pondering that it is 3 milligrams that I just had taken and did some research previously on recommended dosages, so I learned that the range is between 1-12 mg per day. I wanted to go for sure to learn the effects, so I felt an urge to take another 3 mg pill, which I did after a short hesitation, reassuring my thoughts that this is a very small dose, nothing bad should come out of this.
T+0:35 Another 3 mg tablet found its way down my throat, and to make sure I'd experience any effects I took a fourth one with some mineral water in a short while. I would never ever do such a thing again.
T+1:00 No effects noticed and had no fears whatsoever.
T+1:30 No effects. I was still expecting some experience of an interesting sort of nature. Looking back, it is evident that I did not really care for the whole process. I decided to go and take a visit to my mother's place to see her, it was Friday afternoon. I walked 200 meters to a nearby tram stop, things started to quiver in me. Nothing serious to realize, though at some point during the walk, I noticed that my bright and airy mood started to become really earth grounded and my thoughts started to take on a strict approach or point of view to judge my decisions in life in general.
T+1:40 I was waiting for the tram, I could not see it coming in the far distance of its straight line. I was wondering whether to take another route, but decided to stay and wait. My mind was clear and my thoughts were positive all the way so far.
T+1:45 At some point a sudden rush of despair came to me out of nowhere with strong fear which very soon lead to a panic state of mind seeking rescue and a safe place to hide. I cannot really describe the feeling and the mind set, nothing similar felt before. It is like the breath of death itself not trying to kill me but revealing its power. The key word is imbalance. I had to walk in confusion. No way is right. Up and down. It all happened so fast, this is just a fraction that I can describe to you. I looked around trying to evaluate my situation, there were like 4 everyday people waiting for the tram with a long face. They definitely could not represent any source of hope or safety in regard to an emergency situation. My heartbeat became very fast, I had to decide what to do. Either go back to my apartment, there I'd be alone, waiting for the effects to calm down, or trying to get to my mother, undertaking the situation and trying to tell her what was happening to me. Uhh. With this and that option in my mind I decided that I would take the tram and try to go to her place. Being alone didn’t seem to be a reasonable option at all in this state.
I still have to say I cannot describe the feeling. I felt that I must take a helico or something a supersonic plane or otherwise I break down with the fear and panic. The tram arrived. It seemed all so slow. The doors opened, I got inside, it was spacious, all people with the usual faces, but so strange. I felt it is an evil planet, and I am another sort of being in the wrong place. god, get me out of here, please. Could not look at people's faces, they all frightened me, I couldn’t realize anything nice, attractive or just fine in my surroundings. When the tram doors closed and the vehicle started off, I felt more panic, each stop took an eternity for I had no way to escape the closed compartment. Ahh. I had to calm myself down very much, looking at my own face in the glass - it was dark already- - but it frightened me too, as I was scary and frightened. My heart pumped but my system was calm at one level. This duality was with me all the way throughout.
I had to take off at the second stop. I don’t know why I felt that walking is more secure. it was fXXXng cold. I was walking all the long straight road with cars and trucks fasting rushing down at me by the road. I took off my jacket and sweater. all I had on was a t-shirt with lady diana and prince charles on it with London in the background. ahh. This was too much to realize. they were smiling at me with a hint of pain in their eyes. I felt the smile is fake and nothing can be safe or victorious in this world. I had to walk 10 steps then turn around to see that there's nobody attacking me from behind. I passed a hospital but I had no intention to walk in on my own I was so afraid of everything in there. I kept on walking and keeping my panic down - it was a great effort.
I must take note that it is clear for me that the panic was not from the situation but must have occurred on a chemical intervention in my nervous system. I could handle very well the situation and wished to persist until the effects would clear away. But I felt that they were just setting in.
Anyway I took the tram as I reached the bridge in the city. Mom's place seemed so far away, like another lifetime. I was thinking of my room and bed over there, which felt safe from here. The tram ride was more panic. Between each stop, I was unsure whether I could make the next one, or break down in heart attack or something. When the tram started to go real fast I felt that I need to escape immediately to feel safe. It took more than an hour and a half to reach home.T+3:00 I find that I cannot describe what is happening to me, I cannot talk to mom or to people. I even find myself so desperate that I feel that no one can help me at all. I cannot explain the situation, my feelings, my state, and no one would understand it anyway. HELL. I tried to explain my mother that I took some pills and I might need some help. Of course she got frightened which made me feel more insecure and desperate. God. I went to bed but could not stay there. I had to get out and walk in the apartment. It was scary. I felt my heart beating in irregular rhythms, and noticed that once it started to beat faster, build up, then down its rhythm, like a trance beat up and down. When it went up, no one could tell if it was ever going to stop at all. Ahh. So walking, and walking. My head started to ache. I cannot describe how and where. It was bad. I felt my body is struggling big time, I could hardly breathe enough with my heart beats changing all the time.
I tried to keep a 'low profile' not to make it an emergency situation. I expected the whole thing to calm down in a few hours - but it did not. Mom wanted to call the emergency many times, she didn't know how to help. I was so afraid. Even to see her being frightened and desperate too. We had a psychiatrist in the family also, he might help I thought. I still expected the effects to wear off and disappear in a while. It was late 11 pm somehow I managed to get to sleep. Don’t ask me how. my heart bumped. but I could find a position in my bed that felt comfortable enough to fall asleep being exhausted very much.
The next day I woke up with a clearer mind, but soon the effects become evident again. This panicked me. It was like turning on the radio, which cannot get the stations only much noise. An hour later muscle cramps in my leg. Later my neck started to get really stiff. I could not move my head.
An hour more later my head was turned on either the left the right, or pushed to the back. I looked quite strange and this was the time when I realized I really need help here. This ain’t no fun. It was strange because I also had to smile and laugh in my desperation. Mom also was laughing with some tears. Ahh. I needed her to keep my head straight. An hour later this force was so strong that she could only hold my head straight for 5 seconds, then release for a while to gain enough strength.Anyway I finally found my way to a hospital where they immediately understood the situation, gave me Akineton [biperiden, an anticholinergic] to ease muscle stiffness. It ain't fun. It took 30 minutes to release the force and the pain.
I won't go more into this, but I missed many things on the mindset. Psychedelics probably boost serotonin and dopamine levels in the brain. Risperidone is deadly effective in diminishing their level and effects, I wouldn’t give it to any healthy man in any quantities. I felt like a zombie. No emotions, no attractions, I could not be enthusiastic about anything, feeling empty, and desperate, hopeless, the only way out seems to be suicide. Any kind of music is disturbing, I feel it is a strange, alien world with hostility, uncaring people, selfishness. Very much on the dark side.
Scientists don't know the exact mechanism of its action. It is synthetic, artificial. Prescribed to humans. Legal. It might kill while keeping you alive. POOR RATS. Surely, it might be useful for treating real schizophrenia. Don’t ever try it unless you are physically ill.
Few things are harder to put up with than a good example.
Posted by linkadge on November 3, 2004, at 11:40:28
In reply to Re: Classical Neuroleptics: Dysphoria in pill form!, posted by ed_uk on November 3, 2004, at 10:58:13
Many of the psychadelics act on the 5-ht2a recetpor, being agonists.
THe only problems is that strong 5-ht2a agonism by LSD and others leads to a very rapid downregulation in the 5-ht2a receptors.
If you suddenly introduce a 5-ht2a antagonist (risperidone strong 5-ht2a antagonist) into the picture, the 5ht-2a receptor gets virtually no serotonin, which can create severe states of panic.
Potent 5-ht2a agonism creates feelings of empowerment and "universal understanding"
even a "cosmic contiousness" if you will.But potent 5-ht2a antagonism can lead to feelings of being nonexistant. (often happens at the end of a LSD trip) creating sudden and severe panic.
This is not to even mention messing with the dopamine system.
Linkadge
Posted by ed_uk on November 3, 2004, at 12:03:33
In reply to Re: Classical Neuroleptics: Dysphoria in pill form!, posted by linkadge on November 3, 2004, at 11:40:28
Linkadge, can you describe the psychological effects that Risperdal caused in you. Did you experience the feelings described in your last post?
Thanks, Ed.PS. Thioridazine is available in England too. We call it Melleril. It's annoying how pharmaceutical companies spell their drug's brand names differently in different countries. eg.
Venlafaxine.... uk=efexor. elsewhere=effexor.
Thioridazine....uk=melleril. elsewhere=mellaril.
Cetirizine......uk=zirtec. elsewhere=zyrtec.
Posted by lostforwards on November 3, 2004, at 13:47:17
In reply to Re: Classical Neuroleptics: Dysphoria in pill form!, posted by linkadge on November 3, 2004, at 11:40:28
> Many of the psychadelics act on the 5-ht2a recetpor, being agonists.
>
> THe only problems is that strong 5-ht2a agonism by LSD and others leads to a very rapid downregulation in the 5-ht2a receptors.
>
> If you suddenly introduce a 5-ht2a antagonist (risperidone strong 5-ht2a antagonist) into the picture, the 5ht-2a receptor gets virtually no serotonin, which can create severe states of panic.
>
> Potent 5-ht2a agonism creates feelings of empowerment and "universal understanding"
> even a "cosmic contiousness" if you will.
>
> But potent 5-ht2a antagonism can lead to feelings of being nonexistant. (often happens at the end of a LSD trip) creating sudden and severe panic.
>
> This is not to even mention messing with the dopamine system.
>
>
> Linkadge
>
>
>I might be wrong but I think antagonism of the 5-ht2a receptor leads to an increase in striatal dopamine..I think that's part of the reason why atypicals that block that receptor have less chance of causing TD.
Posted by linkadge on November 3, 2004, at 14:00:58
In reply to Re: Classical Neuroleptics: Dysphoria in pill form! » linkadge, posted by lostforwards on November 3, 2004, at 13:47:17
You are right, the atypicals are less likely to cause TD based on the fact that they block the 5-ht2a receptor.
It is kind of a mixed bag however since, some of the dopamine released from the blocakde of the 5-ht2a receptors is again blocked by the d1/d2 bockade actions of the drugs.
Linkadge
Posted by Lazarus on November 3, 2004, at 21:48:15
In reply to Classical Neuroleptics: Dysphoria in pill form!, posted by ed_uk on November 3, 2004, at 9:22:11
I took a very small dose of Risperdal once, 0.25 mg, and experienced terrible akathesia. As tired as the medication made me I couldn't lie down and sleep; I had to keep moving. I felt like I was in hell.
During a second trial at the same dosage I experienced the same thing again.
My pdoc explained that what I experienced is similar to what I would have experienced had I been given a shot of Haldol.
I'm now on Zyprexa, Seroquel and Abilify. Only the Abilify gives me SOME akathesia at doses higher than 5 mg.
Lazarus
Posted by Chairman_MAO on November 4, 2004, at 4:29:03
In reply to Re: Classical Neuroleptics: Dysphoria in pill form!, posted by linkadge on November 3, 2004, at 14:00:58
Atypicals are less likely to cause TD primarily because they aren't nearly as potent DA blockers as the typicals in the doses usually prescribed of each. Also, there is something beyond my understanding called the "dissociation constant" that comes into play, also. Atypicals, IIRC, do not bind as "tightly" to the receptors as the typicals do, or something like that.
I don't have any sources in front of me, but I'd be willing to bet lunch at a nice restaurant that there are at least a few typicals with some meaningful degree of 5ht2a blockade.
--cm
Posted by jboud24 on November 4, 2004, at 9:47:15
In reply to Re: Classical Neuroleptics: Dysphoria in pill form!, posted by linkadge on November 3, 2004, at 11:40:28
Linkage,
The main reason LSD works to produce creativity is due to the fact that through stimulation of the 2a/c receptors, a very powerful tonic control is forced upon the DA system. In other words LSD and related agonists drastically reduce the release of dopamine in the mPFC region of the brain. This effect induces creative thought processes by reducing the stereotypical nature of dopamine and allowing the user to 'think outside the usual box that dopamine pkaces on our creativity circuits. Additionally, while some people feel a sense of inner peace and creativity, many, many people panic when exposed to LSD proposed to be related to increased 2c agonism and enhanced glutamatergic transmission at the metabotropic glu receptor mGlu5. As for Risperdal, it antagonizes the 2a and 2c receptors thereby provoking anxiolysis, sedation, and relaxation.
The dysphoria this user felt was no doubt due to the rapid and fairly complete inactivation of the 5-HT2a/c, dopamine D2/D3 receptors to an extent that the neurons were not yet ready for. Risperdal is the strongest neuroleptic on the US market IIRC, and the highest recommened dose is 12mg for psych in-patients, again IIRC. But to a drug-naive mind, such a profound and instant shift in brain function no doubtedly caused these trip-like, weakening, and dysphoric characteristic.
Moral of Story: Don't mess around with doses of neuroleptics unless you are both familiar with the effects or are very well versed in dose titration for the specific drug you are taking,
Justin
Posted by jboud24 on November 4, 2004, at 9:54:32
In reply to Re: Classical Neuroleptics: Dysphoria in pill form!, posted by Chairman_MAO on November 4, 2004, at 4:29:03
You are right on with the difference in typical versus atypical dissociation constants. I read somewhere in an old University neurobiology text of mine where they were singing the praises of these two 'new and improved' neuroleptics called atypicals. The book went on to discuss different equations on how to calc. dissociation constants, but said that atypicals reduce side-effects by 3 known methods: 2a antagonism, better binding to the limbic vs. striatal brain structures, and in the case of clozapine a weaker dissociation constant.
Later guys,
Justin
Posted by linkadge on November 4, 2004, at 11:11:19
In reply to Re: Classical Neuroleptics: Dysphoria in pill for » linkadge, posted by jboud24 on November 4, 2004, at 9:47:15
I think we are agreeing in most sences.
There is only one thing. 5ht2a receptor activation *can* be actually anxiolitic in some sences. Activation of the 5-ht2a receptor can cause psyical anxity by increasing cortisol release, but that sence of enlightenment can in reality pull pull people out of their daily lives. Ie the antiobsessive qualities of ssris are presumably due to 5-ht2a/c receptor activation.
Just as 5-ht2a/c activation can help someone *pull out* (making the world seem surreal), its blocade can exasperate OCD thoughts and make things seem *super real*.
Some people attribute some of the SSRI's effect
to the general lowering of dopamine caused by 2a/c receptor activation.Another thing, is that blocade of the 5-ht2a receptors can impair short term memory,
see www.nootropics.com
Whenever I add periactin (a potent 2a/c) blocker to citalopram for sleep, it helps sleep but the next day I feel paniky, confused, and a little blue. I have heard this from others as well. It helps the psysical anxiety, but can actually be anxiogenic in the sence that it can promote thought frenzied hypercholinergic states.
Anyhow the point I am getting to is this. 2a/c receptor activation/blocade can have varying effects on anxiety dependant on the state that the individual is in.
Linkadge
Posted by jboud24 on November 5, 2004, at 13:26:59
In reply to Re: Classical Neuroleptics: Dysphoria in pill for, posted by linkadge on November 4, 2004, at 11:11:19
I'd agree with you linkage. Back in my LSD/mushroom days, I recall alot of times where the hallucinogens would ease my aniety because they would allow the worry of the day to slip out of focus and I'd be in this novel new creative state of mind for hours. But there were also a few times when LSD/mushrooms induced a state of panic. It always happened on large doses of the two, and I contribute those instances to super-hyper-activation of the 2a or 2c receptors (probably 2c since it is the one involved in anxiogenic states ala mCPP, TFMPP).
Justin
Posted by anxiety_free on November 6, 2004, at 0:02:50
In reply to Classical Neuroleptics: Dysphoria in pill form!, posted by ed_uk on November 3, 2004, at 9:22:11
Hi! I take abilify at 15mgs-30mgs a day, depending on my needs. No problems here. BUT Zyprexa was an entirely different story...it was sheer hell on earth in terms of akathisia. I've considered trying Triavil...have you ever taken it?
Posted by zeugma on November 6, 2004, at 7:50:34
In reply to Re: Classical Neuroleptics: Dysphoria in pill form!, posted by Chairman_MAO on November 4, 2004, at 4:29:03
> Atypicals are less likely to cause TD primarily because they aren't nearly as potent DA blockers as the typicals in the doses usually prescribed of each. Also, there is something beyond my understanding called the "dissociation constant" that comes into play, also. Atypicals, IIRC, do not bind as "tightly" to the receptors as the typicals do, or something like that.
>
> I don't have any sources in front of me, but I'd be willing to bet lunch at a nice restaurant that there are at least a few typicals with some meaningful degree of 5ht2a blockade.
>
> --cmcm you are quite correct. i don't have the sources in front of me (actually, I'm too tired to pull them out) but most typicals block the 5ht2a receptor to some degree.
-z
Posted by ed_uk on November 6, 2004, at 16:10:04
In reply to Neuroleptics, posted by anxiety_free on November 6, 2004, at 0:02:50
Hello anxiety_free :-)
I've never taken Triavil. As you will know, it contains amitriptyline and perphenazine. I certainly won't be trying it because a) I tried amitriptyline and it made me ill! and b) perphenazine can cause akathisia (it is similar to Haldol).
The strong anticholinergic effect of amitriptyline may be able to offer some protection from the akathisia. When I took the chlorpromazine I had severe akathisia AND severe anticholinergic side effects all at once! It was horrible. I guess the same thing might happen to me if I took Triavil. It could have a completely different effect on you though- good luck :-)
Ed.
Posted by darkhorse on November 8, 2004, at 7:34:50
In reply to Re: Neuroleptics, posted by ed_uk on November 6, 2004, at 16:10:04
> Hello anxiety_free :-)
>
> I've never taken Triavil. As you will know, it contains amitriptyline and perphenazine. I certainly won't be trying it because a) I tried amitriptyline and it made me ill! and b) perphenazine can cause akathisia (it is similar to Haldol).
> The strong anticholinergic effect of amitriptyline may be able to offer some protection from the akathisia. When I took the chlorpromazine I had severe akathisia AND severe anticholinergic side effects all at once! It was horrible. I guess the same thing might happen to me if I took Triavil. It could have a completely different effect on you though- good luck :-)
> Ed.Hi Ed,
Just want to tell you that I tried Motival which is Nortriptyline+Fluphenazine and it gave more horrible Akathisia and dysphoria; Fluphenazine is a horrible drug for me...
I also tried Flupewnthixol 1mg a day : 1st day was OK it gave saome clean stimulating effect , but on 3rd day I started to have severe leg restlessness which was the beginig of akathisaia so I stopped....
Also I tried Trifluperazine (stellazine)and also it gave me horrible akathisia.
Last I tried Sulpiride and at 50mg it gave me a feeling of indifference ,but at 100mg I felt depressed and so apathetic + some restlessness.In the end I keep away from all AP's since I believe they should be reserved only for psychotic disorder and not for mood and anxiety disorder (Akathisia was the worst side effect that ever happened to me and I'm not willing to have it again )
Adam
Posted by ed_uk on November 8, 2004, at 8:25:45
In reply to Re: Neuroleptics » ed_uk, posted by darkhorse on November 8, 2004, at 7:34:50
Hi Adam!
It seems that neither of us like APs very much. I won't be taking any others in the future unless I absolutely have to. If I really needed one I'd probably go for Seroquel but even Seroquel causes akathisia sometimes.
Ed
Posted by mindevolution on January 16, 2007, at 4:33:25
In reply to Re: Neuroleptics, posted by ed_uk on November 8, 2004, at 8:25:45
in general there are low doses and high doses for aps, like for example with ect they can set the voltage/current at low levels, or turn up the voltage/current. single one off low doses doesn't do much harm, but get to complete dopamine blockade and its pure eps from there, up higher nms and death. a single large dose is capable of frontal lobotomy effects. what the level for triggering eps in an individual differs from person to person.
akathisia is usually from blocking/damaging the cholinergic system such as occurs in alzeihmers, also from organic pesticides.
at low levels they may help some people with some symptoms, at high doses well, you figure it out.
there is no difference between atypical and typical, same receptors same effect, lower doses and voila an atypical drug with less side effects. try chlorpromazine at 0.5mg or haldol at 0.0005mg hey presto we just made a new atypical.
This is the end of the thread.
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