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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by med_empowered on April 24, 2008, at 13:57:07
I remember a post on here from a while ago where someone was saying her doc said the risk was high (makes sense; its a high-potency agent) for an atypical. But then I did a google search and I've seen all of maybe 2 cases, one of which involving someone with long-term prior expsoure to Zyprexa. Also, I read a case study where movements popped up, but then went away (which seems to happen a lot with the atypicals; what gives?)
I'm taking niacinamide and vitamin C in an effort to not develop TD. If I had the $$$, I'd take empowerPLUS with my meds and see if that worked out. I've heard manganese can help, too. My shrink said he'd "work with me" on the TD front, but he hasn't done an AIMS test or anything, so I'm not really sure what "work with me" means.
Sigh. I'm so afraid that my perfect med combo (Klonopin, Ambien, Abilify) will somehow combine to create serious problems over the long-haul. Weird: I've taken lots of meds, and its only now that something is actually working and I'm rebuilding my life that I actually care a whole lot about long-term consequences.
Anyway, if somebody could hit me with #s on TD risks or guess-timates they've heard from anybody in the know, I'd appreciate it.
Posted by dbc on April 24, 2008, at 17:19:14
In reply to Anyone know TD risks for Abilify?, posted by med_empowered on April 24, 2008, at 13:57:07
Given abilify's absolutely weird and unknown methods of action and it being a newer drug theres no way to know. I know with seroquel even in ridiculous doses there hasnt been much movement disorders but who knows if they share even remotely the same mechanics.
Posted by Phillipa on April 24, 2008, at 19:00:05
In reply to Re: Anyone know TD risks for Abilify?, posted by dbc on April 24, 2008, at 17:19:14
Hi med SLS is on abilify and is in remission. Also quite a few others have posted success on various doses from 5mg to 30. Seems some find it stimulating and others no. Haven't heard or read any posts about it causing TD? . Phillipa Hope SLS sees it and responds.
Posted by bleauberry on April 24, 2008, at 19:23:10
In reply to Anyone know TD risks for Abilify?, posted by med_empowered on April 24, 2008, at 13:57:07
> Sigh.I'm so afraid that my perfect med combo (Klonopin, Ambien, Abilify) will somehow combine to create serious problems over the long-haul. Weird: I've taken lots of meds, and its only now that something is actually working...I really smiled when I saw the above phrase "my perfect med combo"; and "something is actually working".
That is so cool. You've been around a long time. I am so glad to hear things are better than they used to be.
Back on topic, I do not know TD risks of Abilify. Right off the top of my head I would think they are very low due to the partial dopamine agonist mechanisms. I think you are doing a great job of researching the correct vitamins and supplements to counteract risks. If I were you, I would just keep doing that but focus more on just enjoying life day to day. For all we know, any one of us could be hit by a car or a heart attack tomorrow. You know what early signs of TD are. Until you see them, and it may be never, just don't even think about it. If you see them, you caught them early with a good prognosis.
Posted by yxibow on April 25, 2008, at 2:40:21
In reply to Anyone know TD risks for Abilify?, posted by med_empowered on April 24, 2008, at 13:57:07
> I remember a post on here from a while ago where someone was saying her doc said the risk was high (makes sense; its a high-potency agent) for an atypical. But then I did a google search and I've seen all of maybe 2 cases, one of which involving someone with long-term prior expsoure to Zyprexa. Also, I read a case study where movements popped up, but then went away (which seems to happen a lot with the atypicals; what gives?)
> I'm taking niacinamide and vitamin C in an effort to not develop TD. If I had the $$$, I'd take empowerPLUS with my meds and see if that worked out. I've heard manganese can help, too. My shrink said he'd "work with me" on the TD front, but he hasn't done an AIMS test or anything, so I'm not really sure what "work with me" means.
> Sigh. I'm so afraid that my perfect med combo (Klonopin, Ambien, Abilify) will somehow combine to create serious problems over the long-haul. Weird: I've taken lots of meds, and its only now that something is actually working and I'm rebuilding my life that I actually care a whole lot about long-term consequences.
> Anyway, if somebody could hit me with #s on TD risks or guess-timates they've heard from anybody in the know, I'd appreciate it.
The aggregate risk of TD is 5% per year with some unknown length up to 25%, in atypicals. However the 5% probably comes more from Risperdal, which has proven cases on record.The answer short is there is no real answer but it is not 25% like (some) typicals.
In fact, Zyprexa and Seroquel are probably down around the 0.1% level
There was a posting I referenced to this a while ago, I dont remember the subject line.
In strength its {Risperdal, Invega) -? {Geodon, Abilify} and {Zyprexa, Seroquel}.
But there are individual variations of course -- I'm really sensitive to them but I have some unusual sensitivity and also can eat other medications for dinner (high metabolism).
I know its a hard choice -- its always in the back of my mind especially since I got a rather rare oral tic (non tardive, psychologically moderated quite highly) disorder. This isn't to scare you -- I had high dose Seroquel for a period of time before I went down.
I suppose looking back on it all it was necessary, but I still have one of the most lonely visual disturbance disorders on the planet and I still take Seroquel, which now helps about 3/4 as much and the disorder has morphed. (it can develop a temporary psychosis but it is definately not a psychotic disorder -- it is somatiform and an unknown exactly variant of OCD.)
Anyhow -- I would say Abilify probably lies a little higher than Zyprexa, but again, some people have taken Zyprexa since it came out 10 years ago.
It is important to monitor for TD though and any doctor dispensing should do so. They should know how to do an AIMS exam and have seen enough patients with varying levels of potential through residency or otherwise. Generally it is given every 6 months but you should be able to request it sooner from your doctor if you want to. It doesn't take very long and is just a couch room setting.Twitches and dyskinesias don't necessarily mean TD but they should be reported to your doctor. The main thing is if you panic and decide to quit the medication because you're worried, do not drop it cold turkey. You'll get WD (withdrawal dyskinesia), which may last for days to several weeks and immense plummeting anxiety. That's why APs are tapered.
Armed with this knowledge, if it is a necessary agent (whatever AP), it's informed consent unfortunately, and you are taking it voluntarily. Basically what the saying goes is the benefit better than the risk? If yes, then proceed with therapy for as long as you need to, until something more lovely (you and me too) comes along or your doctor doesn't feel you need it any more.-- best wishes
Jay
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