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Dr. Bob is Robert Hsiung, MD,
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Posted by JACJ on November 30, 2004, at 11:29:56
In reply to Re: drug-induced illness, posted by ed_uk on November 30, 2004, at 11:07:48
> Hi Jacj,
>
> Breggins views are very extreme. Not everyone is damaged by APs by any means. Breggin constantly attacks psychiatric drugs but he doesn't provide us with any evidence of the efficacy of the treatments which he suggests as an alternative. He is 'on a mission' to demonstrate the toxicity of all psych drugs.
>
> I very much doubt that you have been damaged by taking Zyprexa etc. It is much less likely to cause TD than older APs like Haldol. I as said before, if you don't have TD now- you never will do!
>
> Dysphoria is a term which refers to mental distress- negative emotions such as feeling depressed, anxious or irritable.
>
> Ed.
>
>
Hi Ed,
I do agree that Breggin views are extreme but he makes great points. I would like to see some validity to his research. Have you seen any research that clearly states AP's cause long term/permanent disorders after the w/d of the drug? Again, thanks for the reassurance. Many symptoms I have now are a direct result of coming off the cocktail of drugs I was on. I can tell the difference. I just hope to get on with my life. It is so hard to let this go. I just feel violated. Why are drugs the first line of treatment instead of therapy, etc? I do believe that people do need drug therapy but I was just a normal person with some anxeity and depression and I got into this mess.Thanks for listening. :)
Posted by ed_uk on November 30, 2004, at 11:34:45
In reply to Re: drug-induced illness » ed_uk, posted by Larry Hoover on November 30, 2004, at 11:27:35
> I didn't mean my presentation of naturalistic data to be used to detract from awareness of the toxic effects of neuroleptics, or other dopaminergic meds.
Hi Larry, I know you didn't. I just wanted to make the point that APs can have serious side effects for some people.
Regards,
Ed.
Posted by ed_uk on November 30, 2004, at 11:41:56
In reply to Re: drug-induced illness » ed_uk, posted by Larry Hoover on November 30, 2004, at 11:27:35
Have you seen these?
Neurol India. 2002 Dec;50(4):473-5. Related Articles, Links
Lithium - induced tardive dystonia.
Chakrabarti S, Chand PK.
Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh - 160012, India. medinst@pgi.chd.nic.in
Tardive dystonia is an uncommon form of chronic dystonia, which usually develops on exposure to neuroleptics. Tardive dystonia (Tdt) following lithium therapy has not been previously reported. The case of 38 year old man with bipolar affective disorder who developed tardive dystonia while on maintenance lithium treatment is described. Presentation of Tdt in this patient was fairly characteristic although there was no suggestion of recent neuroleptic exposure. Tdt known to have poor treatment response, responded very well to clozapine, a novel anti-psychotic, in this case. To conclude, Tdt may develop on exposure to drugs other than neuroleptics. An adequate trial to clozapine can prove to be a useful treatment option.
J Clin Psychiatry. 1996 Jan;57(1):22-8. Related Articles, Links
A cross-sectional study of parkinsonism and tardive dyskinesia in lithium-treated affective disordered patients.Ghadirian AM, Annable L, Belanger MC, Chouinard G.
Allan Memorial Institute, Royal Victoria Hospital, Montreal, Quebec, Canada.
BACKGROUND: The purpose of this study was to investigate the prevalence of extrapyramidal symptoms (EPS) and tardive dyskinesia (TD) in affective disordered patients treated with lithium and to study the association of these symptoms with medication and other factors. METHODS: This cross-sectional study was carried out in all consenting outpatients attending an affective disorders clinic in a psychiatric hospital. The study sample consisted of 130 stable outpatients: 110 with bipolar disorder, 18 with unipolar (major) depression, and 2 with atypical affective disorder. At the time of evaluation, 110 patients were receiving lithium, 37 in combination with antidepressants and 19 with neuroleptics, and 40 had a history of neuroleptic treatment during the previous 6 months. The patients were assessed with the Extrapyramidal Symptom Rating Scale (ESRS) for parkinsonism, akathisia, dystonia, and TD. The prevalence of these symptoms was calculated for all patients and by current lithium and neuroleptic intake. Multiple linear regression analysis was used to investigate the relationship between the ESRS subscale scores and gender, age, diagnosis, and medication type. RESULTS: The prevalence of tremor was 20.8%; hypokinetic parkinsonism, 7.7%; akathisia, 4.6%; dystonia, 3.8%; and TD, 9.2%. Tremor was associated with lithium and neuroleptic intake; hypokinesia was associated with neuroleptic treatment and age; and TD was associated with neuroleptic, lithium, and tricyclic intake and age. Seven of 51 patients taking lithium but without a history of neuroleptic treatment during the previous 6 months presented symptoms of TD. CONCLUSION: The combination of lithium and neuroleptics was associated with a high prevalence of EPS. The presence of TD in lithium-treated patients not treated with neuroleptics for at least 6 months is consistent with the hypothesis that lithium may exacerbate the vulnerability of affective disordered patients to dyskinesias.
Regards,
Ed.
Posted by ed_uk on November 30, 2004, at 11:49:45
In reply to Re: drug-induced illness, posted by JACJ on November 30, 2004, at 11:29:56
Hi Jack?? Not sure if that's your name! :-)
You could try looking up some of the references at the end of Breggins article. You could look them up on PubMed.
Which symptoms do you have at the moment that you think are due to your previous medication?
In the UK at least, you have to wait at least a year to see a psychologist on the National Health Service. In contrast, meds are readily available.
Regards,
Ed.
Posted by JACJ on November 30, 2004, at 12:25:19
In reply to Re: drug-induced illness » JACJ, posted by ed_uk on November 30, 2004, at 11:49:45
Hi Ed,
Why does it take so long to see a therapist? Is there not enough medical personnel there? That is ashame.Let's see. I am expereincing muscle twitches which are very coming off the benzos. My mucles would twitch day and night and now only do it once in a while. I see a flare up in them when I drink caffiene or get stressed. I was so scared when first leanring about symptoms cause I read twitches are the start of TD but one has to be very careful b/c not all twithces are TD related. The nerves to the muscles are hyperexcitable, which leads to tremors, tics, jerks, spasms and twitching, and jumping at the smallest stimulus. I got some twitches in the face but only a couple of times and that was at the beginning of my w/d.
I am also having some obsessive thoughts and anxiety. It is worse than normal and I know that is due to the drug w/d b/c the thoughts are irrational and I never had that before the drugs. I also have fear which is something I can't describe. It is the type of fear one feels watching a horror film or getting a fright. it is fear that can't be controlled and leads to a downward spiral of thoughts. This has decresed alot but is still there sometimes. it is brought on by reading too much. (negative readings) It is also brought on by watching negative shows like those animal abuse shows or documentaries about abuse, neglect etc. I sue to be able to watch them but not now.
My CNS is in such a fragile state and I have to give it time to heal. Healing in drug w/d and healing is not linear and takes time. Healing is quite slow.
Posted by lostforwards on November 30, 2004, at 12:43:52
In reply to Re: drug-induced illness » ed_uk, posted by Larry Hoover on November 30, 2004, at 11:27:35
Stress makes a lot of sense. I was off APs for over a year, and when I was really stress I started to get twitching at the corner of my mouth. I also had some odd behaviours before anyway, like when I was REALLY stressed I would spin stuff. When they put me on the AP again, while stressed I started getting more symptoms of dyskinesia as well as dystonia. I was only on the meds the first time for 2 weeks.
When I went on an even higher dose a month later after being off, I had other symptoms. Like once my left leg collapsed while I was using the bathroom, I developed sterotypies, and I don't think this was Tardive dementia, but I didn't look people in the eye, and I'd sway one way or the other.
Actually...when I missed sleep for a night my body was suck leaning way over one side. Usually missing a night of sleep makes me "manic". I don't know what that leaning stuff was all about.
Nor do I know what compulsively spinning things especially when someone was around me, or not looking people in the face are.
ALL were revealed with the stress of the antipsychotic + environmental stress.
Posted by lostforwards on November 30, 2004, at 12:48:12
In reply to Re: drug-induced illness, posted by ed_uk on November 30, 2004, at 9:50:22
Thanks for for the info. Tardive dysmentia's a new term for me.
Posted by ed_uk on November 30, 2004, at 13:02:57
In reply to Re: drug-induced illness, posted by JACJ on November 30, 2004, at 12:25:19
Hi Jacj,
It sounds like your symptoms are due to benzodiazepine withdrawal. I think it's very unlikely that any of your symptoms are related to the APs that you took. I think you took Ativan, is that right? Did you taper slowly? How long is it since you last took the benzo?
Regards,
Ed.
Posted by lostforwards on November 30, 2004, at 13:17:15
In reply to Re: drug-induced illness » lostforwards, posted by ed_uk on November 30, 2004, at 9:24:57
That's pretty interesting. Tardive dysmentia? Never heard of that before. The breggin paper lists it as just terminology - that it's no different than tardive dementia. What you've described though seems a lot like what I was getting at.
thanks.
Posted by lostforwards on November 30, 2004, at 13:28:07
In reply to Re: drug-induced illness, posted by linkadge on November 30, 2004, at 10:31:32
No, usually exclusively antipsychiatry sites don't offer any treatment options. Some people in antipsychiatry are opposed to all treatments, including psychosocial if you can believe it.
There are other treatment options you just have to look to other sources.
Posted by JACJ on November 30, 2004, at 13:53:28
In reply to Re: drug-induced illness.. to JACJ, posted by ed_uk on November 30, 2004, at 13:02:57
> Hi Jacj,
>
> It sounds like your symptoms are due to benzodiazepine withdrawal. I think it's very unlikely that any of your symptoms are related to the APs that you took. I think you took Ativan, is that right? Did you taper slowly? How long is it since you last took the benzo?
>
> Regards,
> Ed.
Hi Ed,
I did everything wrong when tapering. I tapered 3 mgs of Ativan in a month and then 3 weeks later I tapered 80 mgs of Geodon in 3 weeks. The geodon masked somme of the w/d symptoms. About 2 days later coming off the Geodon my symptoms were full blown. I have been off of Ativan for 8 months now.
Posted by linkadge on November 30, 2004, at 14:31:56
In reply to Re: drug-induced illness... to Link, posted by ed_uk on November 30, 2004, at 11:41:56
I agree with the results but not the conclusion of the studies. Lithium is the most neuroprotective substance we have. I'm not sure what the mechanism of this might be but I can only make a proposition.
Perhaps in people who are predisposed to TD might have a irregulation in dopamine/glutamate that when unmedicated it beeing slowly compensated for
by the brain's own mecanisms. When a glutamate stabalizer is introduced, the brains own mechanisms become supressed and the TD surfaces full force.I've read some studies that show lithium can reduce neuroleptic induced alterations in limbic and substantia niagra (sp.) glutamate activity.
A lot of schitsoprenics drink coffee which might ofset some of the neurolecptic induced movement disorders. Caffiene is protective in a mouse model of PD and TD.
Linkadge
Posted by linkadge on November 30, 2004, at 14:33:59
In reply to Re: drug-induced illness » linkadge, posted by lostforwards on November 30, 2004, at 13:28:07
It is pathetic that we have to make such steps back like this.
The biggest problem, is that people with schitsophrenia can be paranoid and highly susptitious. When a site like this comes on
and starts refering to these drugs in such terms
we take huge steps back in treatment.
Linkadge
Posted by lostforwards on November 30, 2004, at 14:44:20
In reply to Re: drug-induced illness » ed_uk, posted by Larry Hoover on November 30, 2004, at 11:27:35
I already posted a reply describing some of the dyskinesia and dystonia I had as well as a bunch of weird behaviours and mannerisms.
do you have any idea why I would react to stress with bizzare behaviours like those I've mentioned?
Posted by lostforwards on November 30, 2004, at 14:45:38
In reply to Re: drug-induced illness, posted by lostforwards on November 30, 2004, at 14:44:20
Posted by ed_uk on November 30, 2004, at 14:53:32
In reply to For: Larrry Hoover, or anyone with an explanation (nm), posted by lostforwards on November 30, 2004, at 14:45:38
Hi Jacj! :-)
Rapidly tapering from a benzo makes the withdrawal symptoms more intense in the short term (ie. while you are tapering) but doesn't make any difference in the long term. Please don't worry about the way that you tapered.
I understand that you don't want to take any more medication in order to relieve your withdrawal symptoms. Even so, it could be useful to know about some of the options that are available. To give an example, low doses of propranolol (Inderal) can be used to reduce tremor eg. 10mg three times a day. Propranolol is a beta-blocker.
Perhaps psychological treatment could also be helpful. Have you ever seen a psychologist?
Regards,
Ed.
Posted by linkadge on November 30, 2004, at 15:36:51
In reply to Re: For JACJ, posted by ed_uk on November 30, 2004, at 14:53:32
You'll have to give me a rebrief on some of the symptoms you were having ??
Are you referring to the arm rotation and all that ?
I am not sure exactly. I was taking celexa and zyprexa, and had a very distinctive AP shuffle. Head bouncing up and down and body contorting as I walked.
Anyhow I got off of that slowly and introduced the lithium. I drink lots of coffee now which helps my movement.
I think TD symtpoms hit much harder and sooner if you are sitting infront of the computer all day. I need to take breaks to do movement exercises.
All I can recomend it the right meds, lots of antioxidant rich foods (coffee is loaded with antioxidants) regular exercise, redwine/grapejuice. A heart healthy diet is a brain healthy diet. And of course time and love.
Nothing profound here.
If you need to take an AP, make sure you take the lowest possible effective dose, and ask for some divalproex along with it. (has its own antipsychotic properties and may prevent TD)
Linkadge
Posted by lostforwards on November 30, 2004, at 16:43:01
In reply to Re: For JACJ, posted by linkadge on November 30, 2004, at 15:36:51
I assume your post was for me. Thanks. Is coffee really okay to take if you've got possible symptoms of TD? I'd love a nice cup of tea.
There are only a few symptoms that really concern me and don't really seem to fit TD. Initially I was convinced I had tardive dementia symptoms.
Here's a complete list:
- leaning to one side or the other
- spinning things in even mildly stressful situations
- difficulty with eye contact
- tapping my feet, alternating from left to right.
- placing my left arm over my right arm in mildly stressful situations( never did it before ).*these were transient. they appeared as I started the AP, and eventually at the 3mg dose they weren't there ( but they weren't there before I started too ) as I came down they came back for a short period then went away.
Since they appeared as soon as the antipsychotic was given to me while I was under stress...do you think it was TD? The last time I was on APs I was no where near as stressed as I was this time. I can make guesses as to what they are symptoms of, but I'd rather have a "professional" or more-knowledgable-than-me opinion. My doctors have kept very quiet about this stuff even though I did these strange things right in front of them. I know for a fact they are not symptoms of bipolar disorder. Do I have a nerological problem?
What I'll list here are the more TD like problems:
transient while on meds:
- left knee gave way while using the bathroom.
- stereotypies.The other stuff ( present ):
- the arm rotation is now replaced by the feeling that my head feels like staying turned to the right sometimes.
- my left arm doesn't swing
- weakness in my left knee
- my right eyebrow twitches sometimes and is arched in the morning.
- twitches in my neck.
While on 3mg Risperdal- shallow breathing in the morning
- dyskinesia in my fingers
- stiffness in my fingers, arms and legs
- tunnel vision sometimes*
- weight gain
- angry outbursts..emotions felt fully otherwise
- dyskinetic movements on my tongue*drinking chamomile tea XLG made it go away temporarily
In the process of coming off the Risperdal 3mg
- Lisping. ( this occured once before when I was starting the meds )
- arm swing started to disappear
- started to feel very anhedonic and amotivated
- dyskinesia in fingers disappeared
- stiffness started to go away
- dyskinesia in my tongue started to go away
- weight loss, very quickly, my stomach started churning a lot too.After being off the medication for a week or two:
- started having a dry mouth
- both arms weren't swinging
- sterotypies
- stiffness started to come back
- shallow breathing in the morning
- sometimes felt slightly motivated, otherwise dead.
- no more lisping
- no more dyskinesia in fingers or on tongueI know I've mentioned these before.
The symptoms I experienced on withdrwal and on starting the medication this time are really strange. They seem far from normal and I've been having a hell of a time reassuring myself that I was seriously damaged.
Anymore insight would be appreciated.
Posted by lostforwards on November 30, 2004, at 17:03:12
In reply to side-effects/symptoms list., posted by lostforwards on November 30, 2004, at 16:43:01
Posted by linkadge on November 30, 2004, at 17:49:58
In reply to side-effects/symptoms list., posted by lostforwards on November 30, 2004, at 16:43:01
I would assume that some of these symptoms are related to the medication, and that others could be related to stress itself.
I can see no issue with drinking some tea or coffee with the symtpsom you are having. If they are cause by antipsychotic (dopamine blocakde) then coffee could help (and if they subside while on coffee then it is AP related, but if they get worse on coffee, then it might be stress related)
But, I'm totally not discrediting your accounts. I've been on 4 AP's and I know a lot of funky things can happen.
If it doesn't get better, you might try a combination of clozapine, and and anticonvulsant.
Linkadge
Posted by JACJ on November 30, 2004, at 18:57:33
In reply to Re: side-effects/symptoms list., posted by linkadge on November 30, 2004, at 17:49:58
Hi Ed,
I tried counseling six times with different therapists and none really worked. Well, the last one did. I paid her 110 dollars a pop and went four timems a month. I blame the drugs b/c I don't really remember much. I was so suicidal. I self mutilated myself alot. I just can't believe what those drugs did to me and not once did anyone ever say it maybe the drugs causing those side effects. I am thinking of going for DBT training. I just moved to a new state in the United States and don't know the healthcare system very well yet. How long have you been on drugs? I don't know much about anyone here since I am new.Link,
I had and have muscle twitching but that is normal coming off the drugs and it isn't TD. I have more mental symptoms but most of them are due to withdrawal. I am 90 percent better and hope to continue healing. I have to be patient with myself cause the CNS doesn't heal in a linear fashion.
Posted by dancingstar on November 30, 2004, at 19:38:44
In reply to Re: drug-induced illness, posted by linkadge on November 30, 2004, at 10:31:32
Forgive my intrustion, but does this in any way also apply to drugs like Effexor, which wasn't prescribed as an antipsychotic? Is it considered to be in the same class of drugs?
At any rate, thank you for the valuable information. It is most gracious of you.
Posted by JACJ on November 30, 2004, at 20:08:03
In reply to Re: drug-induced illness, posted by dancingstar on November 30, 2004, at 19:38:44
> Forgive my intrustion, but does this in any way also apply to drugs like Effexor, which wasn't prescribed as an antipsychotic? Is it considered to be in the same class of drugs?
>
> At any rate, thank you for the valuable information. It is most gracious of you.
There is some literature out that states effexor maybe linked to TD but nothing is concrete yet. I try to stay up with research on TD. I will try to locate some info for you. I know Effexor does affects the dopamine in your brain. Do you have any symptoms?
Posted by dancingstar on November 30, 2004, at 20:44:57
In reply to Re: drug-induced illness for dancing star, posted by JACJ on November 30, 2004, at 20:08:03
I'm not sure what TD is, but as briefly as possible here's the deal:
At the end of Sept. on a whim I stopped taking Effexor-XR 150mg after taking it for three years. It was originally prescribed for "fatigue" by a family practice doc. that I no longer see. He also prescribed Oxycontin, which I stopped taking on my own for a back injury because I didn't like the way it made me feel. As far as doctors go, I have little respect for the care and treatment that he gave me. My tiredness and pain grew worse and worse; and I couldn't run my own business or teach gym classes for fun as I used to do. I hardly ate but had gained about 25 or so pounds.
Finally someone introduced me to my current internist who began to regulate my thyroid -- who knew? But I still didn't know to quit taking Effexor, and it did not seem to have an effect on my weight. In fact, it was not being able to lose weight that finally made me quit taking Effexor.
The first two days I was fine, but by the third I was in hell in every way one can imagine. I hurt in every part of my body, from my eyelashes to my toes. By the third week off of E, I began to wonder if I would die. I spent hundreds of dollars on every high-end supplement that I read about, but nothing would help, not for long. At this point I am only left with what feels like a hole in my stomach and mildly shattered nerves in my back and neck and a general malaise. I just don't feel terrific, but I can't explain why. It could be that my stomach and back hurt all the time. I hear that the reason my teeth have been a bit ground down could also be because of this, but I didn't know that until now. I can think very, very clearly for the first time in years.
There have been some seriously horrid things that have happened in my life during the course of the last few years that I have not handled as well as I should have both because I haven't had the strength to and because I didn't care as much as I feel that I should have or would have had I not been under the influence of this drug. My fibromyalgia-type pain seems to have vanished. In its place, though, I am stuck with this annoying intestinal problem where I cannot stay out of the bathroom for very long, and my stomach is quite upset most of the time. I guess I should add that I've lost the weight :-).
I was never told about any problems with this drug, and by the look in my highly educated internist's eyes, I get the impression that he has not seen much of what I am going through. I know that he will no longer prescribe Effexor to patients as a new drug to take. In a million ways, despite my current symptoms, I feel tons better off Effexor than I did on it, mostly because of the mental clarity, but the changes were so slow and so subtle that I didn't notice them while I was taking it. I feel like I lost three years of my life, and I can't get them back. I was literally home, unable to get up, to stay awake, and I thought I had some dread disease.
That's about it. Oh, I guess I left off all that brain shiver stuff and the vision changes that I am still going through. Pretty strange things. All for a bit of fatigue? Wow, wish I had known this. Did you know that they prescribe this for things like perimenopause and all kinds of silly things?
That was not at all brief. I got on my soapbox again. I'm sorry.
Bebe
Posted by JACJ on November 30, 2004, at 21:42:14
In reply to Re: drug-induced illness for dancing star » JACJ, posted by dancingstar on November 30, 2004, at 20:44:57
Hi Bebe,
I will write more tomorrow. I am going nighty nite but wanted to let you know if you want to leanr more on Effexor XR go to www.wyeth.com and go to prescribing information and you will find an abundant amount of information on Effexor and withdrawal which will help ease your mind. Well, it may not ease your mind but will give you some answers to your concerns. Knowledge is power and it helped me thru my drug withdrawal b/c I thought I was losing my mind until I did some research. Take care of yourself.JACJ
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