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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by Maxime on November 12, 2008, at 17:14:28
Hi
Someone told me that there is an *old* antipsychotic that actually causes weight loss and not weight gain. Of course, do you think I can think of the name of the med.
Does anyone know what it is?
Thanks so much. I am still experiencing hallucinations on the Zeldox/Geodon and may need to try something else.
Maxime
Posted by Ricker on November 12, 2008, at 18:30:53
In reply to Help with anti-psychotic name please, posted by Maxime on November 12, 2008, at 17:14:28
Perphenazine?
Posted by Maxime on November 12, 2008, at 20:10:27
In reply to Re: Help with anti-psychotic name please, posted by Ricker on November 12, 2008, at 18:30:53
Yes, that's the one.
Although I just looked at the side effects profile and I think I would rather not try it!
Hopefully my psychiatrist will increase the Zeldox/Geodon.
Thanks Rick!
Posted by Maxime on November 12, 2008, at 20:13:46
In reply to Re: Help with anti-psychotic name please » Ricker, posted by Maxime on November 12, 2008, at 20:10:27
I mean, check out the side effects! I've never seen such an extensive side effects profile!
SIDE EFFECTS
Not all of the following adverse reactions have been reported with this specific drug; however, pharmacological similarities among various phenothiazine derivatives require that each be considered. With the piperazine group (of which perphenazine is an example), the extrapyramidal symptoms are more common, and others (e.g., sedative effects, jaundice, and blood dyscrasias) are less frequently seen.CNS Effects
Extrapyramidal Reactions
opisthotonus, trismus, torticollis, retrocollis, aching and numbness of the limbs, motor restlessness, oculogyric crisis, hyperreflexia, dystonia, including protrusion, discoloration, aching and rounding of the tongue, tonic spasm of the masticatory muscles, tight feeling in the throat, slurred speech, dysphagia, akathisia, dyskinesia, parkinsonism, and ataxia. Their incidence and severity usually increase with an increase in dosage, but there is considerable individual variation in the tendency to develop such symptoms. Extrapyramidal symptoms can usually be controlled by the concomitant use of effective antiparkinsonian drugs, such as benztropine mesylate, and/or by reduction in dosage. In some instances, however, these extrapyramidal reactions may persist after discontinuation of treatment with perphenazine.Persistent Tardive Dyskinesia
As with all antipsychotic agents, tardive dyskinesia may appear in some patients on long-term therapy or may appear after drug therapy has been discontinued. Although the risk appears to be greater in elderly patients on high-dose therapy, especially females, it may occur in either sex and in children. The symptoms are persistent and in some patients appear to be irreversible. The syndrome is characterized by rhythmical, involuntary movements of the tongue, face, mouth or jaw (e.g., protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements).Sometimes these may be accompanied by involuntary movements of the extremities. There is no known effective treatment for tardive dyskinesia; antiparkinsonism agents usually do not alleviate the symptoms of this syndrome. It is suggested that all antipsychotic agents be discontinued if these symptoms appear. Should it be necessary to reinstitute treatment, or increase the dosage of the agent, or switch to a different antipsychotic agent, the syndrome may be masked. It has been reported that fine, vermicular movements of the tongue may be an early sign of the syndrome, and if the medication is stopped at that time the syndrome may not develop.
Other CNS Effects
include cerebral edema; abnormality of cerebrospinal fluid proteins; convulsive seizures, particularly in patients with EEG abnormalities or a history of such disorders; and headaches.Neuroleptic malignant syndrome has been reported in patients treated with antipsychotic drugs (see WARNINGS).
Drowsiness may occur, particularly during the first or second week, after which it generally disappears. If troublesome, lower the dosage. Hypnotic effects appear to be minimal, especially in patients who are permitted to remain active.
Adverse behavioral effects include paradoxical exacerbation of psychotic symptoms, catatonic-like states, paranoid reactions, lethargy, paradoxical excitement, restlessness, hyperactivity, nocturnal confusion, bizarre dreams, and insomnia.
Hyperreflexia has been reported in the newborn when a phenothiazine was used during pregnancy.
Autonomic Effects
dry mouth or salivation, nausea, vomiting, diarrhea, anorexia, constipation, obstipation, fecal impaction, urinary retention, frequency or incontinence, bladder paralysis, polyuria, nasal congestion, pallor, myosis, mydriasis, blurred vision, glaucoma, perspiration, hypertension, hypotension, and change in pulse rate occasionally may occur. Significant autonomic effects have been infrequent in patients receiving less than 24 mg perphenazine daily.Adynamic ileus occasionally occurs with phenothiazine therapy, and if severe, can result in complications and death. It is of particular concern in psychiatric patients, who may fail to seek treatment of the condition.
Allergic Effects
urticaria, erythema, eczema, exfoliative dermatitis, pruritus, photosensitivity, asthma, fever, anaphylactoid reactions, laryngeal edema, and angioneurotic edema; contact dermatitis in nursing personnel administering the drug; and in extremely rare instances, individual idiosyncrasy or hypersensitivity to phenothiazines has resulted in cerebral edema, circulatory collapse, and death.Endocrine Effects
lactation, galactorrhea, moderate breast enlargement in females and gynecomastia in males on large doses, disturbances in the menstrual cycle, amenorrhea, changes in libido, inhibition of ejaculation, syndrome of inappropriate ADH (antidiuretic hormone) secretion, false positive pregnancy tests, hyperglycemia, hypoglycemia, glycosuria.Cardiovascular Effects
postural hypotension, tachycardia (especially with sudden marked increase in dosage), bradycardia, cardiac arrest, faintness, and dizziness. Occasionally the hypotensive effect may produce a shock-like condition. ECG changes, nonspecific (quinidine-like effect) usually reversible, have been observed in some patients receiving phenothiazine antipsychotics.Sudden death has occasionally been reported in patients who have received phenothiazines. In some cases, the death was apparently due to cardiac arrest; in others, the cause appeared to be asphyxia due to failure of the cough reflex. In some patients, the cause could not be determined nor could it be established that the death was due to the phenothiazine.
Hematological Effects
agranulocytosis, eosinophilia, leukopenia, hemolytic anemia, thrombocytopenic purpura, and pancytopenia. Most cases of agranulocytosis have occurred between the fourth and tenth weeks of therapy. Patients should be watched closely, especially during that period, for the sudden appearance of sore throat or signs of infection. If white blood cell and differential cell counts show significant cellular depression, discontinue the drug and start appropriate therapy. However, a slightly lowered white count is not in itself an indication to discontinue the drug.Other Effects
Special considerations in long-term therapy include pigmentation of the skin, occurring chiefly in the exposed areas; ocular changes consisting of deposition of fine particulate matter in the cornea and lens, progressing in more severe cases to star-shaped lenticular opacities; epithelial keratopathies; and pigmentary retinopathy. Also noted: peripheral edema, reversed epinephrine effect, increase in PBI not attributable to an increase in thyroxine, parotid swelling (rare), hyperpyrexia, systemic lupus erythematosus-like syndrome, increases in appetite and weight, polyphagia, photophobia, and muscle weakness.Liver damage (biliary stasis) may occur. Jaundice may occur, usually between the second and fourth weeks of treatment, and is regarded as a hypersensitivity reaction. Incidence is low. The clinical picture resembles infectious hepatitis but with laboratory features of obstructive jaundice. It is usually reversible; however, chronic jaundice has been reported.
Posted by Ricker on November 12, 2008, at 21:00:26
In reply to Re: Help with anti-psychotic name please, posted by Maxime on November 12, 2008, at 20:13:46
I agree Maxime, side effects looked pretty nasty. Also agree that you should talk with p/doc about an increase. Never know, you might be one small increase away from theraputic range!
Best, Rick
Posted by Phillipa on November 12, 2008, at 21:18:55
In reply to Re: Help with anti-psychotic name please, posted by Ricker on November 12, 2008, at 21:00:26
Doesn't sound like fun to me either. Ricker may be right you never know. Phillipa
Posted by Sigismund on November 13, 2008, at 1:09:36
In reply to Re: Help with anti-psychotic name please, posted by Maxime on November 12, 2008, at 20:13:46
God forbid that you should be unable to communicate and be Rx'd this.
From Wikipedia.....
>Perphenazine also has sedating and anxiolytic properties making the drug particularly useful for the treatment of agitated psychotic patients and, in high doses (up to 100 mg per day), for patients with life-threatening (febrile) catatonia, a state in which the patient is extremely agitated, but is not able to express him-/herself. In this situation perphenazine may be used together with electroconvulsive therapy and correction of electrolytes/fluids in the body.
Ah, civilization.
Posted by yxibow on November 13, 2008, at 1:43:34
In reply to Re: Help with anti-psychotic name please, posted by Sigismund on November 13, 2008, at 1:09:36
> God forbid that you should be unable to communicate and be Rx'd this.
>
> From Wikipedia.....
>
> >Perphenazine also has sedating and anxiolytic properties making the drug particularly useful for the treatment of agitated psychotic patients and, in high doses (up to 100 mg per day), for patients with life-threatening (febrile) catatonia, a state in which the patient is extremely agitated, but is not able to express him-/herself. In this situation perphenazine may be used together with electroconvulsive therapy and correction of electrolytes/fluids in the body.
>
> Ah, civilizationI would say a fair majority of people suffering from the schizophreniform spectrum of disorders are not catatonic.
A number have very negative and introverted feelings about themselves.
Unfortunately there are the very small percent that must be treated with some fairly strong medicine -- I don't know about the one mentioned, it could be outdated, to better stabilize them so the high agitation and possibly criminal (very very small percent) behaviour doesn't happen.
Because the number of violent non-misdemeanor crime criminal acts committed by schizophrenics are in the minutiae. It is a hollywood and misunderstanding view that creates this idea.
-- Jay
Posted by Maxime on November 13, 2008, at 11:43:34
In reply to Help with anti-psychotic name please, posted by Maxime on November 12, 2008, at 17:14:28
A friend gave me the name of the med I was thinking of: Molindone Clearly I was mixed up.
Molindone has less side effects than the other one. I still think I will just ask for an increase in Geodon.
maxie
Posted by Jeroen on November 13, 2008, at 14:54:22
In reply to Help with anti-psychotic name please, posted by Maxime on November 12, 2008, at 17:14:28
perhaps pherpanzine?
Posted by B2chica on November 14, 2008, at 8:13:55
In reply to That was the wrong med, posted by Maxime on November 13, 2008, at 11:43:34
Maxime, if you increase Geodon please monitor yourself and symptoms closely.
i became more psychotically depressed when i increased than with lighter dose...i was at 160 dose.
i didn't catch on that it was the increase of meds and i was SO bad off by then.it might work great for you to increase, i don't want to hinder your efforts, but please keep close eye on yourself. if you notice worsening call your pdoc ASAP and drop back down.
Posted by Maxime on November 14, 2008, at 16:35:44
In reply to Re: That was the wrong med » Maxime, posted by B2chica on November 14, 2008, at 8:13:55
Wow, that's good to know. We increased it to 120 mg today and I hope that's the magic dosage. But if I start to get worse, I will remember your words. I really hope that it doesn't make me worse. I don't think I would be able to handle it. :(
Posted by Zyprexa on November 14, 2008, at 19:25:01
In reply to Help with anti-psychotic name please, posted by Maxime on November 12, 2008, at 17:14:28
Perpehenazine!
Posted by Zyprexa on November 14, 2008, at 19:30:10
In reply to Re: Help with anti-psychotic name please » Ricker, posted by Maxime on November 12, 2008, at 20:10:27
I take perphenazine and have little to no side-effects. Little sedating, not as bad as zyprexa. And the occassional nervous twitch, which I take cogentin for. Its almost not a problem. You should try it if geodon doesn't work.
Posted by maxime on November 15, 2008, at 12:19:11
In reply to Re: Help with anti-psychotic name please » Maxime, posted by Zyprexa on November 14, 2008, at 19:30:10
Well that is good to know. When I researched the possible side effects they seemed rather scary.
But I thought you took only Zyprexa?
Does it help with anxiety?
Posted by Zyprexa on November 16, 2008, at 0:16:01
In reply to Re: Help with anti-psychotic name please » Zyprexa, posted by maxime on November 15, 2008, at 12:19:11
yes it deffenitly helps with anxiety. I don't think I could live without it.
I take:
Zyprexa
Zoloft
Bupropion sr
Perphenazine
Cogentin
Posted by Maxime on November 16, 2008, at 14:13:35
In reply to Re: Help with anti-psychotic name please, posted by Zyprexa on November 16, 2008, at 0:16:01
How much Perphenazine do you take?
Posted by Zyprexa on November 16, 2008, at 16:41:02
In reply to Re: Help with anti-psychotic name please » Zyprexa, posted by Maxime on November 16, 2008, at 14:13:35
12mg x3 /day
Posted by Maxime on November 16, 2008, at 20:05:37
In reply to Re: Help with anti-psychotic name please » Maxime, posted by Zyprexa on November 16, 2008, at 16:41:02
> 12mg x3 /day
Thanks. That's a high dosage.
How much Cogentin do you need to keep TD at bay?
I think that ends my list of questions. ;) Sorry that I have so many!
Posted by Zyprexa on November 17, 2008, at 7:58:44
In reply to Re: Help with anti-psychotic name please, posted by Maxime on November 16, 2008, at 20:05:37
Half a mg cogentin.
12mg is a medium dose.
Posted by Maxime on November 21, 2008, at 15:36:24
In reply to Re: That was the wrong med » Maxime, posted by B2chica on November 14, 2008, at 8:13:55
So at 120 mg of Geodon I have finally found relief from the voices. It's a very good feeling. I wish the Geodon helped my anxiety, but I guess I can have everything.
Posted by ricker on November 21, 2008, at 18:34:12
In reply to Success with Geodon ... finally, posted by Maxime on November 21, 2008, at 15:36:24
Great news Maxi! Maybe your anxiety will subside somewhat with time.
Take care, Rick
Posted by SLS on November 26, 2008, at 7:52:05
In reply to Success with Geodon ... finally, posted by Maxime on November 21, 2008, at 15:36:24
> So at 120 mg of Geodon I have finally found relief from the voices. It's a very good feeling.
YAY!!!
You owe it to yourself to acknowledge your strength of character and single-minded vigilance that yielded an effective treatment.
> I wish the Geodon helped my anxiety...
Small amounts of Seroquel might help with the anxiety. I would wait to see if it will dissipate on its own with continued treatment. If it does not, Klonopin or a SRI like Paxil or Effexor can also be looked at.
- Scott
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