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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Schlepo on April 3, 2019, at 0:00:11
Alright, now I'm starting to experience some kind of mild spasm thing within a small part of my upper lip, near the corner. It's internal, not a visible twitching. It's coming intermittently but regularly. Almost like a kind of inflating for a few seconds, then terminates. Started when I went to bed. It's not painful, but very annoying. I'm blaming it on olanzapine. Has anyone else experienced this???
Posted by Lamdage22 on April 3, 2019, at 0:24:26
In reply to Annoying lip spasm, olanzapine?, posted by Schlepo on April 3, 2019, at 0:00:11
You may wanna switch to Clozapine before you got permanent problems. I think it is very similar to Zyprexa but it doesnt give you these muscle problems. Talk to your doctor immediately!
Posted by Christ_empowered on April 3, 2019, at 4:06:29
In reply to Re: Annoying lip spasm, olanzapine?, posted by Lamdage22 on April 3, 2019, at 0:24:26
hi. olanzapine -is- still a neuroleptic...which means there's an EPS risk (that's more of an acute reaction...muscle twitches, that kinda thing) and TD (tardive dyskinesia...facial tics, usually...with atypicals, there's a good chance they'll stop, -if- the offending drug is removed) risk.
the old drugs carried an annual TD risk of about 5%. The newer drugs...the best estimate I've heard is, pooled together, about 3.9%. so...the 'atypicals' are somewhat better than taking, say, Prolixin or Haldol...
but not by a huge, massive %. :-(
Seroquel sometimes helps, mainly because its lower potency, and lower potency neuroleptics usually have a lower TD risk than higher potency drugs. Haldol has a higher risk than, say, Thorazine...
and dosage plays a role. 400mgs/Thorazine may not be the greatest thing ever for mood (dysphoria, etc.), but the TD risk may be about the same as, say, 15-20mgs/olanzapine. One reason the 'atypicals' looked so great on paper is that a lot of the early studies (especially risperidone) were done vs excessively high doses of Haldol. I don't know if you've ever experienced the joys of vitamin H, but...
it doesn't take much to beat Haldol, in terms of patient satisfaction and adverse effects.
age (above 40-45, I think), gender (women more than men), mood disorder (moody people=higher risk), and early onset EPS are all risk factors. The 'severely manic depressive' seem especially prone to severe TD. :-(
if low dose olanzapine is doing this, I'd seriously talk to a prescriber about -not- taking a neuroleptic. maybe...buspar (buspirone) ? just a random suggestion.
sorry about this.
Posted by Schlepo on April 3, 2019, at 17:55:21
In reply to Re: Annoying lip spasm, olanzapine?, posted by Christ_empowered on April 3, 2019, at 4:06:29
It seemed to gradually weaken throughout the night, and hasn't happened at all so far today. So it could really been the olanzapine? I've been on at least 2.5mg for three months (on around 5mg the last two weeks) and this is the first time anything like that has happened. I guess I'll have to call if it happens again.
Can I really switch straight from olanzapine to buspar (or clozapine) without any adverse effects?
Posted by Lamdage22 on April 4, 2019, at 5:04:48
In reply to Re: Annoying lip spasm, olanzapine?, posted by Schlepo on April 3, 2019, at 17:55:21
To Clozapine yes, Buspar maybe not. Did you have psychosis? If you didn't have psychosis and you didn't take Zyprexa for a long time you may be able to switch to Buspar swiftly. Clozapine has a very similar mechanism of action, Buspar does not.
If it occurs again I would call the Dr. Because the spasms might spread and then you got face spasm. It doesn't look very good and sometimes it is permanent.
Posted by Christ_empowered on April 4, 2019, at 8:19:55
In reply to Re: Annoying lip spasm, olanzapine?, posted by Lamdage22 on April 4, 2019, at 5:04:48
hi. buspar isn't the best thing as monotherapy (so said one of my many former shrinks), but i can boost antidepressants -sometimes- for some people. welcome to psychopharmacology...its largely a guessing game.
3 months isn't long, but technically, its long enough for TD to develop. if you're getting movements from a low dose atypical after only 3 months...
id -personally- ask about a non-neuroleptic option, sooner rather than later. unless you get psychosis and the neuroleptics help that. if that's the case...id personally go for seroquel, then maybe clozapine. clozapine can be rough going, so...yeah. 3rd line, maybe, from my -personal- perspective.
sorry about this. :-)
Posted by Lamdage22 on April 4, 2019, at 13:23:23
In reply to Re: Annoying lip spasm, olanzapine?, posted by Christ_empowered on April 4, 2019, at 8:19:55
Yes, you shouldn't take Neuroleptics unless you really have to. Except for maybe a low potency NL as needed when you otherwise cant calm down anymore. "Emergency".
If you withdraw, go slow. How slow? You can get all the answers here www.survivingantidepressants.com
Posted by Lamdage22 on April 19, 2019, at 2:17:15
In reply to Re: Annoying lip spasm, olanzapine?, posted by Lamdage22 on April 4, 2019, at 5:04:48
So did the problem subside?
This is the end of the thread.
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