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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by jay on June 10, 2003, at 15:36:16
Hey folks:
I'd really like to get a better understanding of some of the better qualities of typical antipsychotics. (i.e. chlorpromazine, thiordazine..Trifluoperazine (Stelazine)..etc.)Sorry this is kinda long, but it is an issue I think we have a right to know unbiased observations about. Clearly the atypical's benefits don't seem to be living up to their fetched value, both in action and price.
There is much research now suggesting many of the nasty side-effects of these older drugs where caused by use of extrememly high doses. For example...Thioridazine has prescribing info at general from 150 to 400 mg's daily. Yet in comes in tablet sizes as small as 10 mg's. Stelazine has indications of 15/20 mg's a day, divided, yet comes in as small as 1mg tablets, which can also be used as once a day dosing. Both of these meds have an indication in use of non-schizophrenic uses for excessive anxiety, tension and agitation. (Ala' Zyprexa, Risperdal, etc.)
Most also, especially at the low doses, don't require much concern about diabetes and it's deadly implications, or massive weight gain. One could also get benefits from taking a serotonin antagonist from Serzone, Buspar, and even Periactin.
Dr. Phillip Long, webmaster of www.mentalhealth.com , wrote a great editorial posted here awhile back on many of the distortion of truths about atypical antipsychotics. He makes a couple of facts known that many seem afraid to point out:
-"These serious adverse effects of many of our newer ("atypical") antipsychotic medications were not reported when these medications were initially licenced. The original researchers, however, should have known that there was something seriously wrong with many of these newer ("atypical") antipsychotic medications, because the original studies would often have 83% drop-out rates by 1 year. However, due to an extremely bad statistical convention, the "Last Observation Carried Forward", these unbelievably high drop-out rates were statistically erased and basically hidden from public view." (Read a full research report on the 83% dropout rates of atypical clinical trials at: http://www.update-software.com/abstracts/ab001359.htm
-"Research is showing that there is no clear evidence that atypical antipsychotics are more effective or are better tolerated than conventional antipsychotics - they merely have different side-effects (e.g., Zyprexa, Risperidal, Seroquel, and Clozaril). There is no difference between the newer ("atypical") antipsychotic medications and conventional antipsychotic medications on broad outcomes such as mortality, ability to work, suitability for hospital discharge, or relapse rates." (See research abstract about typical vs. atypical at:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11099280&dopt=Abstract )Having worked in group homes for many years, I've seen the effects of various doses of typical antipsychotics. Despite many being on these drugs for many years, there where a number of clients on smaller doses who where extrememly high functioning, and many in quite healthy shape. Yes there are dangers, always, with TD and such, and there where a number who had been far overmedicated and suffered the TD and associated side effects. A client, who had been on Luvox when it came out, had his daily Largactil (chlorpromazine) dose knocked down to 25mg's at bedtime with his Luvox, and functioned much better then *me*!!! (I was on Zyprexa and Effexor..put on over 50 pounds, became lethargic, would eat *anything* in sight, and called sick into work on a regular basis.)
I'd really love to hear your experiences, good or bad, with typical antipsychotics. Please include the name, dose, and how long on it...as well as how it made you feel, or helped or hurt you.
Thanks for your input....
Jay
Posted by zeugma on June 10, 2003, at 19:43:54
In reply to Looking for experiences with typical antipsychotic, posted by jay on June 10, 2003, at 15:36:16
I took a typical antipsychotic (Trilafon)many years ago. The problem as you mention was dosage: at one point I was on 48 mg a day and all I wanted to do was sleep. It probably had a 'calming' effect but the rational attitude to AP's (conventional or atypical) should always be, Don't take it if you don't absolutely need it. So I was overjoyed to get off it and onto an AD.
Posted by Ritch on June 10, 2003, at 23:13:25
In reply to Looking for experiences with typical antipsychotic, posted by jay on June 10, 2003, at 15:36:16
I've been on Stelazine, Thorazine, Mellaril, Phenergan, Compazine and Haldol. I only got major immediate EPS symptoms with Haldol. Stelazine was a "next-day" EPS thing. Never took more than 50mg of Thorazine at a time and never got any EPS. Mellaril, was the one I was on the longest-no EPS, but got a pigmented retina in one eye and a cataract in the other from long term chronic low dose use (10-30mg hs for about 3 years).
Posted by Kari on June 11, 2003, at 15:11:06
In reply to Looking for experiences with typical antipsychotic, posted by jay on June 10, 2003, at 15:36:16
Hi Jay,
I took perphenazine (1-8 mg) for 3 years, on and off and developed severe depression, dystonia and TD lasting several years. The drug didn't
help much; perhaps this was due to the anticholinergic I had to take with it or to not having taken an AD at the same time.Kari.
Posted by avid abulia on June 13, 2003, at 23:18:54
In reply to Looking for experiences with typical antipsychotic, posted by jay on June 10, 2003, at 15:36:16
well, except for geodon, by and large i had better luck with the typicals--and that sure as hell isn`t saying too much.
haldol--0.5mg qhs, dystonia unresponsive to cogentin or artane...
orap--i can`t remember the dose, but same as haldol otherwise
prolixin--akithisia and depression, no change in tics or compulsions, no relief from cogentin...
inapsine--see above; simultaneous akithisia and dystonia is as close to hell as i can imagine
mellaril--akithisia and paradoxical hypomania
besides that, all i really have to add is that phenothiazines induce tryptophan hydroxylase and i have a friend who had good results from adding a low dose of stelazine qhs to elavil/sinequan combo he wasn`t responding to.
This is the end of the thread.
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