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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Lamdage22 on December 2, 2016, at 11:15:37
How high is it with typical antipsychotics, how high with atypical ones?
Posted by rjlockhart37 on December 2, 2016, at 13:58:53
In reply to tardive dyskinesia incidence of typical APs?, posted by Lamdage22 on December 2, 2016, at 11:15:37
generally typical anti-psychotics have more exrapryamidal side effects, that's why newer versions where created like Clozapine and olanzipine, the newer atypical's but still i knew someone from a out patient program who took Thorazine, and said it made her anxiety and life back to normal, so typical's are not exactly bad, and they do have reliving effects, but they just have more cases reported than the newer ones, it doesnt mean absoluetly you will have bad reactions, they do work and are effective
but here is a overview of extrampyramidal side effects in antipsychotics
https://www.ncbi.nlm.nih.gov/pubmed/1359485
Posted by Christ_empowered on December 2, 2016, at 14:30:30
In reply to Re: tardive dyskinesia incidence of typical APs?, posted by rjlockhart37 on December 2, 2016, at 13:58:53
I seem to recall reading that low to moderate dose Thorazine produces TD at about the rate of normal dose Risperidone. I think the issue is mostly potency (higher potency often equals more TD), from what little I understand of the subject.
Perphenazine is a mid-potency conventional AP that is often tolerable, when carefully dosed. EPS is more common than Zyprexa, but again: dosing is key.
I read somewhere that loxapine is atypical-ish. I don't know if or how that would affect TD rates. Amoxapine is a TCA antidepressant that is partly metabolized into loxapine, so its an AD+AP, in one molecule+one pill. I read a small abstract of a study in which amoxapine was used for Schizophrenia in Mexico, and it did about as well as Risperidone. I think the amoxapine group had better mood scores, but I could be wrong.
Do you take antioxidants? B-vitamins? I DIY Orthomolecular mostly to prevent TD. So far, so good, and I've been on 30mgs/Abilify plus other meds (mostly anti-epileptics) for 5, 6 years now.
Good luck.
Posted by linkadge on December 2, 2016, at 16:18:46
In reply to Re: tardive dyskinesia incidence of typical APs?, posted by Christ_empowered on December 2, 2016, at 14:30:30
The CATIE (spelling) study suggested that the atypicals were no better at controlling either positive or negative symptoms than the typicals.
The typicals did have a higher incidence of TD, but the atypicals had a higher incidence of metabolic issues.
Linkadge
Posted by Zyprexa on December 2, 2016, at 20:59:44
In reply to tardive dyskinesia incidence of typical APs?, posted by Lamdage22 on December 2, 2016, at 11:15:37
Well I took 15mg of abilify for 6 months and got really bad TD, where my hand would shake uncontrolably when I was trying to work and focus on soldering. It seems the worst when I was trying to concentrat on the position of the iron. Anyways that was 9 years ago and I still have it in my hands. I've also been taking perphenazine for 9 years now and only small ticks or jerks, once in a while no where near the severity. It is almost unnoticable. The TD from abilify may have decreased a tiny bit, but never went away. I took a different TAP 20 years ago and had uncontrolably swalowing. They imediatly took me off it. And the swalowing for the most part went away right away. But effects of it lingered for many years. I hardly notice that now. Don't know which TAP it was. But my guess is haldol. Risperdal gave me mucile stiffness. Geodon made me diabetic and blurry vision, both went away after discontinuing. But a few years later I started needing glasses. I used to have 20/10 vision. Zyprexa, no side effects, except weight gain and tiredness.
The great thing about these meds is you can tell what they are going to do fairly quickly, and discontinue if problems and it mostly goes away. Unless you keep taking it then it gets worse.
Posted by Lamdage22 on December 3, 2016, at 2:59:28
In reply to Re: tardive dyskinesia incidence of typical APs?, posted by Zyprexa on December 2, 2016, at 20:59:44
If the risk was 20% to develop tardive dyskinesia long term that is a risk i would be willing to take.
Posted by Lamdage22 on December 3, 2016, at 5:32:19
In reply to Re: tardive dyskinesia incidence of typical APs?, posted by Lamdage22 on December 3, 2016, at 2:59:28
i really dont know what to do
Posted by SLS on December 3, 2016, at 8:04:45
In reply to Re: tardive dyskinesia incidence of typical APs?, posted by Lamdage22 on December 3, 2016, at 2:59:28
> If the risk was 20% to develop tardive dyskinesia long term that is a risk i would be willing to take.
Wow. That says a lot about the severity and chronicity of your illness. It might be helpful to know what are the symptoms that are still most prominent or urgent to be treated.
An ex-girlfriend of mine has schizoaffective disorder, bipolar-type. She began to improve and remained out of the hospital once Navane (thiothizine) was introduced. She was able to discontinue Abilify and Seroquel. It was her good fortune that her doctor wanted to see how adding Saphris (asenapine). This drug reduced depression, gave her more mental and physical energy, and produced cognitive clarity. She has been on Navane for over 5 years. There are no signs of abnormal movements. Of course, tardive dyskinisia doesn't appear right away.
She has lost 30-40 pounds since making these changes.
- Scott
Posted by Lamdage22 on December 3, 2016, at 9:28:05
In reply to Re: tardive dyskinesia incidence of typical APs? » Lamdage22, posted by SLS on December 3, 2016, at 8:04:45
i am thinking high dose clozapine here.
I just feel that my seroquel zyprexa combo is pooping out. Both with sedation and antipsychotic effect. Ontop of that i have harmful OCD thoughts for which i would like to try Memantine.
Posted by Zyprexa on December 3, 2016, at 23:55:10
In reply to Re: tardive dyskinesia incidence of typical APs?, posted by Lamdage22 on December 3, 2016, at 2:59:28
If you are having good luck with zyprexa and seroquel, you might try perphenazine. It will only make you tired,, not hungry. I think the risk of td is less than 20%. Maybe 5%. It becomes more likely over the long haul. If you get it bad right from the beginning you should stop it right away. If not it probably is not going to be much of a problem.
Posted by Zyprexa on December 3, 2016, at 23:58:26
In reply to Re: tardive dyskinesia incidence of typical APs?, posted by Lamdage22 on December 3, 2016, at 9:28:05
I should have mentioned that the higher the dose of AP, the more likely to have td and the faster it can get worse.
Posted by Christ_empowered on December 5, 2016, at 19:41:05
In reply to Re: tardive dyskinesia incidence of typical APs?, posted by Zyprexa on December 3, 2016, at 23:58:26
have you ever considered adding abilify to the zyprexa or the seroquel, and dropping the other, sedating AAP?
Posted by Lamdage22 on December 6, 2016, at 2:57:10
In reply to Re: tardive dyskinesia incidence of typical APs?, posted by Zyprexa on December 3, 2016, at 23:55:10
the 5% accumulate over the years. 5% every year times 20 = 100%. Thats not good
Posted by Christ_empowered on December 6, 2016, at 12:40:46
In reply to Re: tardive dyskinesia incidence of typical APs?, posted by Lamdage22 on December 6, 2016, at 2:57:10
yeah...I read about some Yale study from not too long ago that found that, given enough time, most people on the older drugs develop TD. :-(
I don't know if its the same with the AAP drugs or not. Some things I've read say the newer drugs aren't all that much different in terms of TD risk. Others say there's a big difference.
I think as long as some AAP drugs are still on patent, we'll be hearing that the whole class is safer, better, etc. than the AP drugs. Once Latuda+friends go generic, we'll probably see the experts shrug and say maybe the AAPs aren't so great, after all.
When and if they introduce drugs that handle psychosis, mania, etc. in a different way, we'll hear about how evil all AP/AAP drugs are, at least for a while. That seems to be how psychiatry works.
This is the end of the thread.
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