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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by borderliner21 on March 13, 2002, at 17:49:58
I am very med sensitive. I got terrible dystonia and dyskenesia from ssri's which I treated with zyprexa. I take lithium for bipolar and I need to add an anti-depressant for my depression. Is there any effective AD's that don't cause EPS??
Posted by johnX2 on March 13, 2002, at 18:37:42
In reply to dystonia and anti-depressants, posted by borderliner21 on March 13, 2002, at 17:49:58
How about these:1) Lamictal
2) Remeron
3) Serzone-John
> I am very med sensitive. I got terrible dystonia and dyskenesia from ssri's which I treated with zyprexa. I take lithium for bipolar and I need to add an anti-depressant for my depression. Is there any effective AD's that don't cause EPS??
Posted by OldSchool on March 13, 2002, at 19:01:26
In reply to dystonia and anti-depressants, posted by borderliner21 on March 13, 2002, at 17:49:58
> I am very med sensitive. I got terrible dystonia and dyskenesia from ssri's which I treated with zyprexa. I take lithium for bipolar and I need to add an anti-depressant for my depression. Is there any effective AD's that don't cause EPS??
Dopaminergic antidepressants should be better for people prone to EPS. That would include: Wellbutrin, all of the MAOIs. High dose Selegiline might be a good choice. Also, the older Tricyclics can be good for some with EPS/Parkinsons type symptoms as the TCAs are strongly anti-cholinergic and they do some other things good for EPS type conditions.
ECT is also good for people who have trouble tolerating antidepressants for whatever medical reason. ECT also has strong anti-parkinsons properties and would be good for any EPS condition. ECT is even used "off label" for TD and parkinsons.
Since EPS is basically like a mild drug induced parkinsons like condition, the following article might be useful to you.
http://www.mhsource.com/expert/exp1033197b.html
Old School
Posted by TSA West on March 14, 2002, at 0:54:29
In reply to dystonia and anti-depressants, posted by borderliner21 on March 13, 2002, at 17:49:58
Any psychotropic agent that works on 5-HT2a receptor blockade has _anti-EPS_ properties (http://www.preskorn.com/cgi-bin/sp.pl?words=anti-EPS&wt=be&bl=an&IMAGE1.x=0&IMAGE1.y=0&d=/columns/9803.html). Such agents include amitriptyline, nefazodone, and mirtazapine. Dopamine agonists of course work against EPS, but you will find the only ones that are markedly antidepressant in nature are amantadine and pramipexole:
http://biopsychiatry.com/amantadine.htm
http://biopsychiatry.com/pramipex.htm
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