![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 31. Go back in thread:
Posted by judy1 on December 23, 2002, at 10:31:35
In reply to Tardive Diskinesia pictures, posted by Tepiaca on December 21, 2002, at 14:35:58
Sorry, I don't have a site to send you to, although if you do a search on Medscape you'll get the written word. What drugs are you on? I've gotten akathesia from SSRIs and Parkinson-like tremors from APs- both atypical and the older ones- in my hand. The tongue thrusting is usually a result of long term AP usage and I have seen it in psych wards. This is the main reason why I am so against AP usage in someone who is not psychotic, the TD risk far outweighs any benefits, which are usually sedation for which the benzo family works extremely well. If you have any questions? Take care, judy
Posted by Tepiaca on December 23, 2002, at 14:28:50
In reply to Re: Tardive Diskinesia pictures » Tepiaca, posted by judy1 on December 23, 2002, at 10:31:35
Hi judy , so you are telling me that you have suffered from TD? Is this reversible? How many years have you been on Antypsichotics? Why are you
using them for?
Thanks
Posted by syringachalet on December 24, 2002, at 22:07:50
In reply to Re: Tardive Diskinesia pictures-judy-, posted by Tepiaca on December 23, 2002, at 14:28:50
Judy,
Tardive Dyskinesia is a permentent neurological sydrome that its symptoms mimic advanced Parkinsons disease.Although the symptoms can sometimes be reduced by changes in medications, once TD is diagnosised, it almost never totally leaves. Today even having EPS will cause a psych doc to be careful. That is why drugs like SSRIs and other new drugs might take longer to work for the patiewnt but they are so much safer regarding risk of TD.
The majority of those with TD are those whom have been on long term psychotropic medications in the familys of tricyclics( Elavil), benzodyasipanes(Prolixin) , and sedative-hyponotics(Xanax).
It is thought that long term use of these medications cause the brain to permentally need them to 'turn down ' the brain noise/confusion and allow the cognetive part of the brain 'catch up with the emotional' part of the brain.
After months or in most people years of med use, the body builds up a tolerance to the drugs theraputic effects and the neruo systems decides to 'have a mind of its own'.It might just be a eye twitch and a hand tremor or pill rolling to start, later leg jerking, neck hyperextension, and athatoid tongue(snake-like movements). The person having these behaviors may or may not be independentally aware to these actions and most have no control.
I have seen several long term psychic patients who had advanced TD. They had difficulty in walking, speaking, eating/drinking and eventually breathing. Most die from complications of starvation/malnutrition, aspiration pneumonia or accidents.
If you look at Michel J. Fox(actor and Parkinson research activist) or Janet Reno( former high U. S. government offical. Probably the one most visible example of these type of symptoms of Parkinson type behavior is Mohammand Ali.It is because of things like TD, that psych docs now are so cautious prescribing those meds described eariler for long term use.
Sorry that this is so long....
syringachalet
Posted by jimmygold70 on December 25, 2002, at 11:18:53
In reply to Tardive Diskinesia pictures, posted by Tepiaca on December 21, 2002, at 14:35:58
It IS serious, though pretty rare those days. You can walk into some university's medicine library and pick an old movie about schizophernics (from the sixties-seventies). That time - they had it. My late grandpa took a low dose of Haldol fore a copule of years and developed Oral Dyskinesia, which isn't far from TD.
Posted by Guy on December 25, 2002, at 17:54:44
In reply to Re: Tardive Diskinesia pictures-judy-, posted by syringachalet on December 24, 2002, at 22:07:50
Tricyclics and particularly benzodiazepines do not cause TD as far as I know. Please identify your sources.
Posted by syringachalet on December 27, 2002, at 12:30:22
In reply to No TD from benzos, posted by Guy on December 25, 2002, at 17:54:44
As a four year college graduate from a professional nurseing program with 20 years of experience providing direct patient care and then later supervising that same care, I have experienced first hand what these powwerful medications can do.
Most of the clients had been on their psycoactive medications long term greater than 10 years.
Over time when newer,less toxic meds evolved, the psych docs attempted to taper these patients doses down and switch to newer drugs with less negative side effects.
As I am uncertain of your medical credentials,
perhaps you would refer to the U.S. Food and Drug websites for a multitude of website resources for you to read and quote from....I was simply trying to share some of the hands-on working knowledge I have used daily for over 20 years with others whom it might appreciate it...
LB,RN,BSN,ABS
Posted by Alan on December 27, 2002, at 14:47:37
In reply to Re: No TD from benzos, posted by syringachalet on December 27, 2002, at 12:30:22
> As a four year college graduate from a professional nurseing program with 20 years of experience providing direct patient care and then later supervising that same care, I have experienced first hand what these powwerful medications can do.
> Most of the clients had been on their psycoactive medications long term greater than 10 years.
> Over time when newer,less toxic meds evolved, the psych docs attempted to taper these patients doses down and switch to newer drugs with less negative side effects.
> As I am uncertain of your medical credentials,
> perhaps you would refer to the U.S. Food and Drug websites for a multitude of website resources for you to read and quote from....
>
> I was simply trying to share some of the hands-on working knowledge I have used daily for over 20 years with others whom it might appreciate it...
>
> LB,RN,BSN,ABS
=======================================
I know of absolutely no studies or information other than anecdotal information that is provided in the case of bzds.Please provide the source of your information.
There can be sudden withdrawal without a taper from bzd therapy that may cause temporary seizures. Aside from that I know of no research that demonstrates diagnosis of TD (an entirely different matter than seizures).
Alan
Posted by Guy on December 27, 2002, at 18:22:43
In reply to Re: No TD from benzos » syringachalet, posted by Alan on December 27, 2002, at 14:47:37
Benzos definitely do not cause TD...although they have their own problems, they are among the safest drugs available. Dr. Stuart Shipko, who uses benzos extensively to treat anxiety disorders, does say, however, that TD can appear years after discontinuation of anti-psychotics. He says that almost all people with TD have a history of using AP medication. He warns that AP meds should be used only when psychosis is diagnosed.
Posted by Alan on December 27, 2002, at 18:50:30
In reply to Re: No TD from benzos, posted by Guy on December 27, 2002, at 18:22:43
> Benzos definitely do not cause TD...although they have their own problems, they are among the safest drugs available. Dr. Stuart Shipko, who uses benzos extensively to treat anxiety disorders, does say, however, that TD can appear years after discontinuation of anti-psychotics. He says that almost all people with TD have a history of using AP medication. He warns that AP meds should be used only when psychosis is diagnosed.
==================================
Yes, and this is what makes the adminstration of AP's even in small doses to treat anxiety because of benzophobia, so scandalous. It's not the drug (bzds), it's the proper diagnosis, administration, and follow-up that's important with any drug - especially with so much misinformation out there in the ether about them.The folklore takes on mythical proportions.
Alan
Alan
Posted by syringachalet on December 27, 2002, at 20:26:37
In reply to Re: No TD from benzos » Guy, posted by Alan on December 27, 2002, at 18:50:30
It is apparent the all medication questions should be forward to Alan who is all knowing and has nothing better to do with his day than to belittle the efforts of those who care enough to post here... Alan, get a life...
Posted by Alan on December 27, 2002, at 21:06:42
In reply to Re: No TD from benzos, posted by syringachalet on December 27, 2002, at 20:26:37
> It is apparent the all medication questions should be forward to Alan who is all knowing and has nothing better to do with his day than to belittle the efforts of those who care enough to post here... Alan, get a life...
==============================================
Wow. What is the matter? I was addressing Guy, and along with others, requesting research about evidence that bzds cause TD.Bzds have been mentioned as having caused alot of different things. TD is not one of them as far as I've been able to turn up in the plethora of research.
Alan
Posted by J. Wesley on December 28, 2002, at 7:40:01
In reply to Re: No TD from benzos, posted by syringachalet on December 27, 2002, at 12:30:22
> As a four year college graduate from a professional nurseing program with 20 years of experience providing direct patient care and then later supervising that same care, I have experienced first hand what these powwerful medications can do.
> Most of the clients had been on their psycoactive medications long term greater than 10 years.
> Over time when newer,less toxic meds evolved, the psych docs attempted to taper these patients doses down and switch to newer drugs with less negative side effects.
> As I am uncertain of your medical credentials,
> perhaps you would refer to the U.S. Food and Drug websites for a multitude of website resources for you to read and quote from....
>
> I was simply trying to share some of the hands-on working knowledge I have used daily for over 20 years with others whom it might appreciate it...
>
> LB,RN,BSN,ABS
_________________________________Well...doing a simple U.S. Food and Drug website search on MSN turned up 44477 websites. Uggg... I don't have time to check out all these sites. However, I ran across a site a while back that might be of some help. http://www.dystonia- support.org/index.htm
I found this site to be easy to understand and full of information that I wasn't aware of. Certainly no medical professional has discussed any of these dystonic distinctions with me.
I would really appreciate it if someone could point me to research showing a direct correlation between TD and the benzodiazepines.
As far as the newer classes of drugs being safer, such as the ssri's, the atypical AP's, etc., the long term side effects of these drugs have yet to be proven, due to the very fact that they are so new. However, there are anecdotal reports all over the web that these two classes of drugs aren't as safe as initially thought with respect to dystonia type problems.
The use of these newer drugs are still a crapshoot concerning long term use and side effects. One can't honestly state that newer is safer (or less toxic), because long term studies aren't possible with new drugs. That statement is a marketing ploy to gain market share propogated by big pharmicia. I don't understand why so many in the medical profession overlook this (well, yes I do, but I don't want to get into ethics, even though it is now intricately involved in medicine). At least with most of the older drugs we have good research showing what we are dealing with.
J. Wesley
Posted by J. Wesley on December 28, 2002, at 7:47:33
In reply to Re: No TD from benzos » syringachalet, posted by J. Wesley on December 28, 2002, at 7:40:01
> > As a four year college graduate from a professional nurseing program with 20 years of experience providing direct patient care and then later supervising that same care, I have experienced first hand what these powwerful medications can do.
> > Most of the clients had been on their psycoactive medications long term greater than 10 years.
> > Over time when newer,less toxic meds evolved, the psych docs attempted to taper these patients doses down and switch to newer drugs with less negative side effects.
> > As I am uncertain of your medical credentials,
> > perhaps you would refer to the U.S. Food and Drug websites for a multitude of website resources for you to read and quote from....
> >
> > I was simply trying to share some of the hands-on working knowledge I have used daily for over 20 years with others whom it might appreciate it...
> >
> > LB,RN,BSN,ABS
> _________________________________
>
> Well...doing a simple U.S. Food and Drug website search on MSN turned up 44477 websites. Uggg... I don't have time to check out all these sites. However, I ran across a site a while back that might be of some help. http://www.dystonia- support.org/index.htm
>
> I found this site to be easy to understand and full of information that I wasn't aware of. Certainly no medical professional has discussed any of these dystonic distinctions with me.
>
> I would really appreciate it if someone could point me to research showing a direct correlation between TD and the benzodiazepines.
>
> As far as the newer classes of drugs being safer, such as the ssri's, the atypical AP's, etc., the long term side effects of these drugs have yet to be proven, due to the very fact that they are so new. However, there are anecdotal reports all over the web that these two classes of drugs aren't as safe as initially thought with respect to dystonia type problems.
>
> The use of these newer drugs are still a crapshoot concerning long term use and side effects. One can't honestly state that newer is safer (or less toxic), because long term studies aren't possible with new drugs. That statement is a marketing ploy to gain market share propogated by big pharmicia. I don't understand why so many in the medical profession overlook this (well, yes I do, but I don't want to get into ethics, even though it is now intricately involved in medicine). At least with most of the older drugs we have good research showing what we are dealing with.
>
> J. Wesley
>
_________________________Ummm, sorry............
web address,
http://www.dystonia-support.org/index.htmJ. Wesley
Posted by syringachalet on December 28, 2002, at 12:17:42
In reply to Re: No TD from benzos » J. Wesley, posted by J. Wesley on December 28, 2002, at 7:47:33
Thanks for sharing the wealth, J. Wesley.
Now that I have had some time after cleints needs are met, I found this very helpful website that might be of interest to anyone whom has concerns about this issue of TD.
It is provided by the University of Kansas and it is written for the general public/patient info.kumc.edu/parkinson/td.html
Lets all work together on this.. we are all on the same team!!!
syringachalet
Posted by Alan on December 28, 2002, at 16:54:23
In reply to Re: No TD from benzos, posted by syringachalet on December 28, 2002, at 12:17:42
> Thanks for sharing the wealth, J. Wesley.
>
> Now that I have had some time after cleints needs are met, I found this very helpful website that might be of interest to anyone whom has concerns about this issue of TD.
> It is provided by the University of Kansas and it is written for the general public/patient info.
>
> kumc.edu/parkinson/td.html
>
> Lets all work together on this.. we are all on the same team!!!
>
>
> syringachalet
===============================================
This page mentions neuroleptics, AD's, and other medications causing the differing forms of TD. It even recommends the use of bzds to treat some symptoms of TD.Did I miss something about bzd's being responsible for TD? Is there another link showing other info such as studies, etc, linking bzds to the causation of TD?
Alan
Posted by J. Wesley on December 28, 2002, at 16:58:49
In reply to Re: No TD from benzos, posted by syringachalet on December 28, 2002, at 12:17:42
I spent a little time researching the net this afternoon to see if I could find any research showing a link between benzodiazepines and dyskinesias. Here is a link I found. Scroll down to the charts listing meds if you don't want to read all about TD.
If anyone has any idea why xanax is listed, please feel free to educate me.
http://emedicine.com/neuro/topic362.htm#target2J. Wesley
Posted by ZeeZee on December 28, 2002, at 17:18:06
In reply to Re: Xanax linked to Dyskinesias, posted by J. Wesley on December 28, 2002, at 16:58:49
Since caffeine is listed as causing TD along with xanax I'd be very curious to know the incidence or probability of this occuring with either benzo's or caffeine. After working as a psychotherapist for over 20 years in the field of addiction and in-patient psychiatry I can safely say that I never saw, nor heard of TD being caused by an AD or benzo, only AP's (and that was infrequent at best). If I am misinformed I welcome the correction, but I am very doubtful that there is much probablity of developing movement disorders from benzo's or caffeine.
Posted by J. Wesley on December 28, 2002, at 18:04:38
In reply to So is caffeine! » J. Wesley, posted by ZeeZee on December 28, 2002, at 17:18:06
> Since caffeine is listed as causing TD along with xanax I'd be very curious to know the incidence or probability of this occuring with either benzo's or caffeine. After working as a psychotherapist for over 20 years in the field of addiction and in-patient psychiatry I can safely say that I never saw, nor heard of TD being caused by an AD or benzo, only AP's (and that was infrequent at best). If I am misinformed I welcome the correction, but I am very doubtful that there is much probablity of developing movement disorders from benzo's or caffeine.
_________________________________
This is all new to me. But I didn't have to look very hard to find this one article. I have the same questions as you and would like to know specifically why xanax, and no other benzo's are listed. In almost all the other articles I looked at, ativan, klonopin, and valium are listed as sometimes being beneficial in alleviating the symptoms of TD.
I'm not going to lose any sleep over this, but it is curious, as I take a xanax.....
J. Wesley
Posted by ZeeZee on December 28, 2002, at 18:28:01
In reply to Re: So is caffeine! » ZeeZee, posted by J. Wesley on December 28, 2002, at 18:04:38
Xanax is my life saver. Since I began its use before I became such a pharmacaphobe, it is still considered "safe" by my thinking, (unlike the other benzo's that I need to try but am afraid of.)
I'd be very interested in any further information you might find regarding the connection between TD and xanax. Like you, I'm not going to lose any sleep over this and plan on continuing its use as needed.
Thanks
Posted by Alan on December 28, 2002, at 19:55:28
In reply to Re: Xanax linked to Dyskinesias, posted by J. Wesley on December 28, 2002, at 16:58:49
> I spent a little time researching the net this afternoon to see if I could find any research showing a link between benzodiazepines and dyskinesias. Here is a link I found. Scroll down to the charts listing meds if you don't want to read all about TD.
>
> If anyone has any idea why xanax is listed, please feel free to educate me.
> http://emedicine.com/neuro/topic362.htm#target2
>
> J. Wesley
>
========================================I'm sorry but that link only gets me to search page.
Besides, simply listing xanax in a catagory without linking to research isn't worth the cyberspace it's listed on.
I'm open-minded to any credible research out there (which by definition completely eliminates "research" from the usual strident anti-benzo sites).
I even called my doc today....head of a large teaching hospital psychiatric dept. because it concerned me.
He later returned my call and when I mentioned bzds and TD he said that yes, there is a link. That bzds are standardly used to *treat* symptoms of TD...that klon was first approved as an anti-convulsant...that many confuse seizures induced from rapid withdrawal from bzds in drug abuse detox centers (and on his hospital psych ward for that matter) with TD.He said that there were no studies that he had ever heard of let alone seen that linked bzds and TD.
He did remind me that he thought that the present fad of prescribing Neuroleptics - even in low doses - for anxiety disorders was at best risky and relatively ineffective, even less effective than AD's (which the manufacturers own tests claim a 30 - 50 percent efficacy rate which is about as close to placebo as one can get).
Bzds have a huge success rate by comparison. By contrast the risks, however one minimises there frequency of occurance, from neuroleptics are some of the most devastating there are.
Alan
Posted by J. Wesley on December 29, 2002, at 4:10:36
In reply to Xanax and Dyskinesias???, posted by Alan on December 28, 2002, at 19:55:28
> > I spent a little time researching the net this afternoon to see if I could find any research showing a link between benzodiazepines and dyskinesias. Here is a link I found. Scroll down to the charts listing meds if you don't want to read all about TD.
> >
> > If anyone has any idea why xanax is listed, please feel free to educate me.
> > http://emedicine.com/neuro/topic362.htm#target2
> >
> > J. Wesley
> >
> ========================================
>
> I'm sorry but that link only gets me to search page.
>
> Besides, simply listing xanax in a catagory without linking to research isn't worth the cyberspace it's listed on.
>
> I'm open-minded to any credible research out there (which by definition completely eliminates "research" from the usual strident anti-benzo sites).
>
> I even called my doc today....head of a large teaching hospital psychiatric dept. because it concerned me.
>
> He later returned my call and when I mentioned bzds and TD he said that yes, there is a link. That bzds are standardly used to *treat* symptoms of TD...that klon was first approved as an anti-convulsant...that many confuse seizures induced from rapid withdrawal from bzds in drug abuse detox centers (and on his hospital psych ward for that matter) with TD.He said that there were no studies that he had ever heard of let alone seen that linked bzds and TD.
>
> He did remind me that he thought that the present fad of prescribing Neuroleptics - even in low doses - for anxiety disorders was at best risky and relatively ineffective, even less effective than AD's (which the manufacturers own tests claim a 30 - 50 percent efficacy rate which is about as close to placebo as one can get).
>
> Bzds have a huge success rate by comparison. By contrast the risks, however one minimises there frequency of occurance, from neuroleptics are some of the most devastating there are.
>
> Alan_____________________________
Alan, I just threw that out there. I'm not sure what you mean when you say that the link only gets you to a search page? Is there not a long discussion on TD with many citations at the end of the article to support the discussion. It was the first site I came to that showed a link between benzo's(xanax) and movement disorders under the heading of TD. I subsequently found a few others in short order that also "mentioned" a link between xanax and movement disorders. The drug monograph on rxlist.com mentions akathisia and dystonia as possible side effects associated with xanax. Drug monographs can be misleading, not only in what side effects are reported along with their frequencies, but also because side effects are often purposely minimized or discarded by Pharmicia if their research shows something negative. That being the case, to have pharmicia even mention potential movement disorders as a possibility in their own monographs begs for at least a little investigation.
I have yet to find a site that specifically addresses why xanax, and only xanax from the benzo class, is mentioned in association with movement disorders.
None of the sites I found mentioning a link to any aspect of movement disorders associated with xanax seem to be anti or pro anything. I am only relaying some info I have found to those who might be interested about any connection with movement disorders and benzo's, without personal opinions or bias. The sites with the information exist, and I have given the link. Others can evaluate the information as it suits them. I have no agenda, xanax is the only med I use. I suspect that you would agree that it is in my best interest to know as much about any medication I take. It is knowledge that I seek, not just knowledge that is positive and supports rationalizing the use of whatever med I take. The subject of TD and movement disorders came up and I pursued it. Thus far, all that I am finding is that xanax is "mentioned" in association with movement disorders at several sites. I find this curious. The next logical step is to try to find out why xanax is stated to be associated with movement disorders, as opposed to others in the benzo class being used to treat the symptoms of movement disorders.
Whether or not any one site or article meets your criteria for "pure" research, or what is generally accepted as "pure" research, if there is such a thing any longer, is obviously important. But it is not the end all of all discussion and investigation when anecdotal evidence suggests certain information, and said information is found listed more than a few times in different forums. It was once heretical to suggest that the earth was not the center of the universe. Misinformation abounds, in fact is common with benzo's, regardless of the source. No one single person knows all, nor does popular conviction by any group, large or small, necessarily give definitive answers that are absolute Time, discussion, evaluation, and critical thinking are essential to get to the heart of the matter when considering any piece of information as relates to it's validity. To dismiss even a sliver of information because one may find it objectional does a diservice to the discovery process of knowledge, whether it turns out to be correct or not.
The rest of your post is well known and I have no problem with that information. I agree with it. Please don't overreact (calling your doc), I'm not. I may not even pursue this any further, as it is somewhat time consuming and is quite probably of little significance, unless of course, you, me, or anyone else happens to develop a movement disorder while using xanax. In that event it does become significant.
Probability is low, if it even exists, but as you are so fond of stating, statistics are meaningless on an individual basis, and I agree with that also.
J. Wesley
Posted by Dr. Bob on December 29, 2002, at 11:33:29
In reply to Xanax and Dyskinesias???, posted by Alan on December 28, 2002, at 19:55:28
> I'm open-minded to any credible research out there (which by definition completely eliminates "research" from the usual strident anti-benzo sites).
There may be people here who frequent those sites or share some of the same views. Please be sensitive to their feelings, respect those views even if you think they're wrong, and don't post anything that could lead them to feel put down. Strong opinions are fine, but need to be civil. This has come up before, so I'm going to block you from posting for another 2 weeks.
Bob
PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration; otherwise, they may be deleted.
Posted by Dr. Bob on December 29, 2002, at 17:23:44
In reply to Re: No TD from benzos » syringachalet, posted by Alan on December 27, 2002, at 21:06:42
> Wow. What is the matter? I was addressing Guy, and along with others, requesting research about evidence that bzds cause TD.
>
> Bzds have been mentioned as having caused alot of different things. TD is not one of them as far as I've been able to turn up in the plethora of research.I did also mean to thank you for this measured response, sorry about not doing so before. Best wishes,
Bob
Posted by Chairman_MAO on October 25, 2005, at 17:42:37
In reply to Tardive Diskinesia pictures, posted by Tepiaca on December 21, 2002, at 14:35:58
I'm not sure you want to see the bad cases if one day you may have it. I'm totally serious. I've seen some research footage; it breaks my heart.
Posted by Tepiaca on October 25, 2005, at 23:12:25
In reply to Re: Tardive Diskinesia pictures » Tepiaca, posted by Chairman_MAO on October 25, 2005, at 17:42:37
> I'm not sure you want to see the bad cases if one day you may have it. I'm totally serious. I've seen some research footage; it breaks my heart.
>
>wow this is a very old post I made. I was curious about it, because doctor was giving me a lot of APS. I remember watching one person with this problem but in those days I did not know what was that
This is the end of the thread.
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