Psycho-Babble Medication Thread 574968

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Re: Haldol experiences? yesac

Posted by ed_uk on November 3, 2005, at 17:04:53

In reply to Haldol experiences? ed_uk, posted by yesac on November 3, 2005, at 14:53:26

Hi Y

>I'm not trying to contradict you at all-- but it seems to me that, in my experience with antipsychotics, they usually work pretty quickly.

They certainly can do for some people, but not for others. Stay at each dose of haloperidol for a few days though - before deciding whether to increase. You could increase the dose in steps of 0.5mg.

>do you think Thorazine is *better* (lower risk, more effective, etc)?

The risk of acute EPS is lower with Thorazine. As an AP, Thorazine and Haldol are similar in efficacy, but Thorazine is more sedating. The risk of TD is similar with both drugs.

Kind regards

Ed

 

Re: Haldol experiences? yesac

Posted by pseudoname on November 3, 2005, at 17:16:16

In reply to Haldol experiences?, posted by yesac on November 3, 2005, at 12:31:52

> Any info would be appreciated

Well, my experience is hardly typical, but...

I started Haldol for depression (after lots of regular ADs had failed). On the third day, I was walking down the hallway and suddenly felt very confused. So I rammed my head into the wall, leaving a small dent. In the wall.

Then I got a running start and rammed it into the other wall. This time it left a sizable hole that we covered with a big picture for several years... That is as close as I have come to psychotic behavior. My pdoc then took me off Haldol. Sorry, I don't remember the dose.

Not trying to scare you off, but I agree with Ed: increase the dose carefully.

 

I wouldn't take add Haldol...

Posted by med_empowered on November 4, 2005, at 0:30:56

In reply to Re: Haldol experiences? yesac, posted by pseudoname on November 3, 2005, at 17:16:16

Haldol by itself is pretty dulling drug--its rough stuff. Haldol and Lithium combined **sometimes** results in permanent brain damage--there's this weird thing that happens with haldol and some other old-school neuroleptics when they're added to lithium; it seems to induce a sort of brain damage (I think similar to encephalitis, but I'm not sure) that can sometimes be permanent. In addition, the neuro-toxicity of APs is boosted by Lithium...there are some studies that show that bipolar people on long-term APs tend to have cognitive impairment that isn't seen in control groups OR in bipolars not on antipsychotics; one theory is that the APs alone do this (very, very possible)...another is that the once common practice of combining lithium with antipsychotics bumps up the brain damag/cognitive impairment, either causing impairment OR worsening the impairment. Plus, Haldol is rough stuff--it tends to dull people, cause akathisia, it causes tardive dyskinesia A LOT...its just not a good drug all around.

I understand your need for cheap drugs. But...Haldol is rough stuff. In addition to the previously mentioned side effects, it tends to cause dopamine hypersensitivity...basically, you could end up **needing** to take Haldol b/c it sensitives dopamine receptors...also, the withdrawal from Haldol (should you choose to withdraw) could lead to a "withdrawal psychosis" (probably caused by dopamine super-sensitivity) and other problems (withdrawal-emergent akathisia, tremors, etc.). And, if you do go back onto antypical antipsychotics...the dopamine sensitization caused by Haldol could change your brain so that higher doses of the atypical are required, which means that you'd get fewer of the good effects of the atypicals and more of the side effects. So...I guess my position would be to TRY to do without antipsychotics (bipolars are particularly prone to tardive dyskinesia and EPS), try another old antipsychotic (my votes would be for Trilafon, Molindone, and Loxapine--in that order), or ditch the lithium and just focus on using the antipsychotic as your primary mood-stabilizer. Trilafon (perphenazine) was recently studied in the CATIE study for schizophrenia; it did almost as well as Zyprexa, for considerably less cash (it is very, very cheap). Its sedating, but not as sedating as Thorazine (its an "intermediate potency" AP, whereas Haldol is "high potency" and Thorazine is "low potency"; EPS and akathisia are more common in high-potency, sedation in low-potency).

If you do opt to try Haldol, you should probably have some Cogentin or similar anti-EPS med on hand. You should probably also have propranolol and/or Benadryl on hand for possible akathisia; benzos help as well (and may help reduce agitation in **some** people...Klonopin is good for schizoaffective/bipolar).

 

Haldol experiences? med_empowered

Posted by yesac on November 4, 2005, at 14:25:57

In reply to I wouldn't take add Haldol..., posted by med_empowered on November 4, 2005, at 0:30:56

> In addition, the neuro-toxicity of APs is boosted by Lithium...there are some studies that show that bipolar people on long-term APs tend to have cognitive impairment that isn't seen in control groups OR in bipolars not on antipsychotics; one theory is that the APs alone do this (very, very possible)...another is that the once common practice of combining lithium with antipsychotics bumps up the brain damag/cognitive impairment, either causing impairment OR worsening the impairment.

Are you talking about atypicals too or just the older APs?

The issue is, I've tried so g*ddamn many drugs, and the lithium/Seroquel combo is the only thing that has worked okay. It's still not perfect, but better than anything else I've ever tried. Neither lithium or Seroquel alone worked too well. I've never been on lithium WITH Depakote, so that's a possibility I suppose, but honesly I didn't like Depakote a whole lot.


 

AP+Lithium

Posted by med_empowered on November 4, 2005, at 22:04:17

In reply to Haldol experiences? med_empowered, posted by yesac on November 4, 2005, at 14:25:57

hi! I dont know enough about lithium+AP combos to give you a really good answer...if you read the Haldol package insert (you can find it online) and PDR-type stuff about Haldol, there should a warning about the Lithium+Haldol combo, and the problems it can cause...in addition, if you google it, you'll find case studies. Apparently, in some cases the combo has proven disastrous (very bad, very permanent brain damage...lithium+AP also seems to boost the risk of NMS) and in others...no one really knows. Since some people end up with such pronounced, permanent brain damage, its possible that long-term use of lithium+AP could lead to more subtle brain damage in a larger number of people. I've only seen case studies on the old antipsychotics, especially Haldol...my guess is that it could happen with the atypicals, but there would be lots of variables (like, what atypical is being used, dosages, other drugs, duration of treatment, etc. etc.)

I can understand your desperation but...to me at least, the risks just seem so great. Plus, Haldol really isn't a great drug. Its popular in institutions because it makes people shut up and cause less trouble, but it isn't exactly an "empowering" drug...its not something thats going to help you reach your full potential or anything. It really is a "dumb drug" in the truest sense of the term.

As for what you can try next...I don't really know what to say. Phenytoin (Dilantin) isn't exactly the anticonvulsant of choice for bipolar, but it has been studied a bit, and it seems that it works well for **some** people--cognitive impairment can be a problem, but with adequate control of dosing, this might not be a problem. Plus, its cheap--its been around since the 30s. Maybe ditching antipsychotics altogether could work...Depakote+Lithium might be a good combo for you, or maybe Tegretol could be part of a mix (it doesn't play well with other drugs, and blood tests are necessary but it does seem a bit more potent mg per mg than Trileptal, and some people swear by it). I don't know how well they'd work for day-to-day, minor agitation and rapid-cycling, but some benzos are pretty good for mood control...Ativan and Klonopin can help a good bit, even at more extreme manic heights of bipolar...they compare pretty well to short-term use of Haldol in those situations, with far fewer side effects ("additcion" isn't really THAT big a problem with benzos).

The only med I could really think of off the top of my head that might be affordable and helpful would be Surmontil. Its kind of a Clozapine-ish tricyclic; it tends to be soothing, and may have some (minor) antipsychotic activity (it doesn't seem to get rid of acute psychosis, but there may be some mild D2 blockade, as well as some action at other dopamine receptors). I would imagine there's a generic, since its been around forever. Combining that with Depakote or Tegretol might be good; that sort of combo could cut the edge off intense depression or intense mania and also provide a bit more stability for more subtle mood shifts.

Anyway, I'm not a big fan of APs in general, especially for mood disorders..I'm *definitely* not enthusiastic about anyone taking Haldol. If you *must* take an antipsychotic (old-school), it seems like Trilafon (perphenazine) would be the way to go...less EPS/Akathisia than Haldol, and a bit more sedation. I think Molindone, Mellaril, and Loxapine are also a bit better than Haldol or Thorazine in terms of side-effects (that's really not saying much, though). If you do opt to take an AP of any sort, I think you'd probably be better off avoiding Lithium just in case (I'd hate to be the person who discovers that the atypicals+lithium=brain damage), but that's really your decision to make.

 

Re: AP+Lithium med_empowered

Posted by ed_uk on November 5, 2005, at 11:55:54

In reply to AP+Lithium, posted by med_empowered on November 4, 2005, at 22:04:17

Hi Med,

I've always felt that perphenazine was fairly similar to haloperidol. What do you think? Mg for mg, haloperidol is more potent than perphenazine. I expect that perphenazine is no less likely to cause EPS than an appropriately smaller dose of haloperidol.

As a *very rough* guide........

10mg perphenazine = 2.5mg haloperidol

Kind regards

Ed

 

Re: AP+Lithium

Posted by Squiggles on November 5, 2005, at 13:01:31

In reply to Re: AP+Lithium med_empowered, posted by ed_uk on November 5, 2005, at 11:55:54

> Hi Med,
>
> I've always felt that perphenazine was fairly similar to haloperidol. What do you think? Mg for mg, haloperidol is more potent than perphenazine. I expect that perphenazine is no less likely to cause EPS than an appropriately smaller dose of haloperidol.
>
> As a *very rough* guide........
>
> 10mg perphenazine = 2.5mg haloperidol
>
> Kind regards
>
> Ed

I just read an interesting article that points
to phenothiazines as likely to induce neurotoxicity when taken with lithium.
I am not sure if pherphenazine is in that class.

Here is the article by Miao:

www.hkjpsych.com/V12n1_lithium_neurotoxicity.pdf

Squiggles

 

Re: AP+Lithium Squiggles

Posted by ed_uk on November 5, 2005, at 13:25:06

In reply to Re: AP+Lithium, posted by Squiggles on November 5, 2005, at 13:01:31

Hi Squiggles

Various dopamine antagonists, not just the phenothiazines, have been associated with neurotoxicity when taken with lithium. Very high doses of potent neuroleptics are particularly dangerous.

Kind regards

Ed

 

Trilafon

Posted by med_empowered on November 5, 2005, at 17:38:19

In reply to Re: AP+Lithium Squiggles, posted by ed_uk on November 5, 2005, at 13:25:06

hey! I just thought Trilafon since its a little better studied than the other old ones...the CATIE study made it seem like a viable option in some cases. But...im not at all for APs, especially for bipolars and especially old ones. I imagine Haldol side effects are largely due to dosing...that said, there are supposedly differences among the old drugs; Mellaril causes less EPS, Loxapine might be atypical-ish, Molindone causes weight loss, so on and so forth. Ideally, though, bipolar should be controlled with mood-stabilizers, add-on benzos, and antidepressants (in my opinion..and in that order).

 

Re: Trilafon med_empowered

Posted by ed_uk on November 5, 2005, at 18:49:35

In reply to Trilafon, posted by med_empowered on November 5, 2005, at 17:38:19

Hi Med!

>I just thought Trilafon since its a little better studied than the other old ones...

As far as I can tell, haloperidol is one of the most thoroughly studied APs of all. It's become the 'gold standard' treatment for schizophrenia, all new drugs are compared with haloperidol.

>the CATIE study made it seem like a viable option in some cases

I agree. Perphenazine is reasonably well tolerated by some patients at low doses. Of course, the risk of TD is high. Haloperidol resembles perphenazine quite closely: potent D2 antagonism, minimal anticholinergic effects, minimal alpha blockade etc.

>I imagine Haldol side effects are largely due to dosing...that said, there are supposedly differences among the old drugs; Mellaril causes less EPS

Thioridazine causes less EPS because it's strongly anticholinergic. Chlorpromazine (Largactil) is second in line. Haloperidol, perphenazine, and similar drugs cause the most EPS ........because their anticholinergic properties are minimal. Due to the long-standing tendency of doctors to routinely (and often inadvertently) 'overdose' patients on haloperidol, it has aquired a particularly sinister reputation for causing serious side effects. In reality, at comparable doses, haloperidol causes a similar incidence of side effects to the other medium/high potency typical neuroleptics.

All typical APs are relatively potent D2 antagonists, the degree of acute EPS is largely determined by how anticholinergic they are. This does not apply to atypical APs. Anticholinergic APs, such as chlorpromazine, are probably just as likely to cause TD as the less anticholinergic APs, despite the lower incidence of acute EPS.

As a side note, I've had some very bad experiences with neuroleptics myself. I have discovered (the hard way) that the clinical effects of neuroleptics are intensely dose dependent.

Kind regards

Ed x

 

Re: AP+Lithium

Posted by linkadge on November 5, 2005, at 19:21:02

In reply to Re: AP+Lithium Squiggles, posted by ed_uk on November 5, 2005, at 13:25:06

I wonder what the mechanism of the neurotoxicity is.

I wonder who is more at fault, lithium or the AP ?

Linkadge

 

Re: AP+Lithium

Posted by med_empowered on November 5, 2005, at 21:18:14

In reply to Re: AP+Lithium, posted by linkadge on November 5, 2005, at 19:21:02

I dont know what the deal is but..its pretty scary. Apparently, lithium alone has a good bit of neurotoxicity and kind of functions as something of an anti-psychotic. I read somewhere that Lithium can reduce the formation of dopamine; it seems like this, coupled with a strong D2 blockade, could be part of the problem...at least, it seems like that could explain why lithium+APs ups the NMS risk considerably (especially for young men, which sucks since they're the high-risk NMS group anyway). At any rate...even if it didnt cause brain damage, the combo seems so bad to me. I mean, wouldn't that flatten somebody out A LOT? It seems like drug-induced dysphoria/depression would be a big problem, along with cognitive impairment and over-sedation.

 

Re: AP+Lithium

Posted by linkadge on November 6, 2005, at 9:41:53

In reply to Re: AP+Lithium, posted by med_empowered on November 5, 2005, at 21:18:14

I have heard of lithium reducing dopamine release, but I have never heard of lithium itself being neurotoxic.

Lithium has been studied as a neuroprotectant. esp through BCL-2 and BDNF upregulation. If it is neurotoxic, that is something I'd be interested in reading about. Let me know if you cross any literature.


Linkadge


 

Haldol experiences? med_empowered

Posted by yesac on November 11, 2005, at 11:47:32

In reply to Re: AP+Lithium, posted by med_empowered on November 5, 2005, at 21:18:14

> At any rate...even if it didnt cause brain damage, the combo seems so bad to me. I mean, wouldn't that flatten somebody out A LOT? It seems like drug-induced dysphoria/depression would be a big problem, along with cognitive impairment and over-sedation.


I have read and heard (directly from research psychiatrists-- I work in the psych department of a medical school and I sometimes attend grand rounds) that lithium has neuroprotective qualities. I'm not saying that it couldn't also be neurotoxic, and I'm not saying that I'd take it if I didn't have to. But it has been around for a hell of a long time and it is very well researched. I guess I probably feel safer with lithium than with most anything newer.

Also, I think you are right that lithium/AP combos could really dull people down. I've even seen it. However, like Ed said, I think it's largely dose-dependent and also person-dependent. I take both, and I have for a while, and my doses are relatively low. I do not feel flat or dulled. I think these types of drugs can be beneficial for people in very low doses, much lower than they've used in many studies.

 

Re: Haldol experiences?

Posted by Squiggles on November 11, 2005, at 12:06:37

In reply to Haldol experiences? med_empowered, posted by yesac on November 11, 2005, at 11:47:32

The searches i made on the net, of which i
only post one conservative one here, do not
look good for haldol/lithium interaction.
However, perhaps a doctor with combo experience
could make it work.

As for the neuroprotective aspects of
lithium - that is in the research mode
right now, and i am not at all sure as
to how quickly this neuroprotective/neurogenerative aspect
lasts, begins, and ends and effects
drug interactions.

I would be cautious given what I have
seen on the net at least.


"DRUG INTERACTIONS

An encephalopathic syndrome (characterized by weakness, lethargy, fever, tremulousness and confusion, extrapyramidal symptoms, leukocytosis, elevated serum enzymes, BUN, and FBS) followed by irreversible brain damage has occurred in a few patients treated with lithium plus HALDOL. A causal relationship between these events and the concomitant administration of lithium and HALDOL has not been established; however, patients receiving such combined therapy should be monitored closely for early evidence of neurological toxicity and treatment discontinued promptly if such signs appear."

see:
http://www.rxlist.com/cgi/generic/haloper_ad.htm

Squiggles


 

Haldol experiences? Squiggles

Posted by yesac on November 11, 2005, at 12:47:11

In reply to Re: Haldol experiences?, posted by Squiggles on November 11, 2005, at 12:06:37

Yes, but did the studies you found give any dosage information?

All I'm saying is that of course caution is warranted with ANY drug, but caution is also warranted when reading studies and other information you find on the internet.

 

Re: Haldol experiences?

Posted by Squiggles on November 11, 2005, at 13:13:17

In reply to Haldol experiences? Squiggles, posted by yesac on November 11, 2005, at 12:47:11

> Yes, but did the studies you found give any dosage information?
>

No, but I think you are right, i was sloppy.
I checked PubMed under

lithium
haldol
interaction


1: Cohen D, Diemont WL. Related Articles, Links
Abstract [Deterioration of schizoaffective disorder due to an interaction between haloperidol and carbamazepine]
Ned Tijdschr Geneeskd. 2002 Oct 12;146(41):1942-4. Dutch.
PMID: 12404911 [PubMed - indexed for MEDLINE]

2: Chou JC, Czobor P, Tuma I, Charles O, Bebe R, Cooper TB, Chang WH, Lane HY, Stone DL. Related Articles, Links
Abstract Pretreatment plasma HVA and haloperidol response in acute mania.
J Affect Disord. 2000 Jul;59(1):55-9.
PMID: 10814771 [PubMed - indexed for MEDLINE]

4: Chou JC, Czobor P, Charles O, Tuma I, Winsberg B, Allen MH, Trujillo M, Volavka J. Related Articles, Links
Abstract Acute mania: haloperidol dose and augmentation with lithium or lorazepam.
J Clin Psychopharmacol. 1999 Dec;19(6):500-5.
PMID: 10587284 [PubMed - indexed for MEDLINE]

6: Normann C, Brandt C, Berger M, Walden J. Related Articles, Links
Abstract Delirium and persistent dyskinesia induced by a lithium-neuroleptic interaction.
Pharmacopsychiatry. 1998 Sep;31(5):201-4.
PMID: 9832353 [PubMed - indexed for MEDLINE]

7: Sadeghipour-Roudsari HR, Farahani M, Shokrgozar AA, Farsam H, Dehpour AR. Related Articles, Links
Abstract Decrease in erythrocyte:plasma lithium ratio by concurrent administration of psychotropic drugs and lithium in mice.
Gen Pharmacol. 1998 Jul;31(1):63-6.
PMID: 9595281 [PubMed - indexed for MEDLINE]

8: Goldman SA. Related Articles, Links
Abstract Lithium and neuroleptics in combination: is there enhancement of neurotoxicity leading to permanent sequelae?
J Clin Pharmacol. 1996 Oct;36(10):951-62.
PMID: 8930783 [PubMed - indexed for MEDLINE]


10: Byerly MJ, Christensen RC, Evans OL. Related Articles, Links
No abstract Delirium associated with a combination of sertraline, haloperidol, and benztropine.
Am J Psychiatry. 1996 Jul;153(7):965-6. No abstract available.
PMID: 8659626 [PubMed - indexed for MEDLINE]

11: Goldman SA. Related Articles, Links
Abstract Lithium and neuroleptics in combination: the spectrum of neurotoxicity [corrected]
Psychopharmacol Bull. 1996;32(3):299-309. Erratum in: Psychopharmacol Bull 1996;32(4):544.
PMID: 8961772 [PubMed - indexed for MEDLINE]

12: Li R, Wing LL, Wyatt RJ, Kirch DG. Related Articles, Links
Abstract Effects of haloperidol, lithium, and valproate on phosphoinositide turnover in rat brain.
Pharmacol Biochem Behav. 1993 Oct;46(2):323-9.
PMID: 8265687 [PubMed - indexed for MEDLINE]


14: Yang YY, Deng HC. Related Articles, Links
Abstract [Influence of haloperidol on plasma Li+ and Li+ index]
J Formos Med Assoc. 1992 Sep;91 Suppl 3:S251-4. Japanese.
PMID: 1362913 [PubMed - indexed for MEDLINE]

16: Carvey PM, Kao LC, Zhang TJ, Amdur RL, Lin DH, Singh R, Klawans HL. Related Articles, Links
Abstract Dopaminergic alterations in cotreatments attenuating haloperidol-induced hypersensitivity.
Pharmacol Biochem Behav. 1990 Feb;35(2):291-300.
PMID: 2320636 [PubMed - indexed for MEDLINE]

19: Miller F, Menninger J. Related Articles, Links
No abstract Correlation of neuroleptic dose and neurotoxicity in patients given lithium and a neuroleptic.
Hosp Community Psychiatry. 1987 Nov;38(11):1219-21. No abstract available.
PMID: 2889659 [PubMed - indexed for MEDLINE]

20: Lowe MR, Batchelor DH. Related Articles, Links
No abstract Neuroleptic malignant syndrome or lithium neurotoxicity?
Br J Psychiatry. 1987 Oct;151:559-60. No abstract available.
PMID: 3447680 [PubMed - indexed for MEDLINE]
Items 1 - 20 of 68

---and more under "related links" and continuation-- just go to PubMed and enter;

---------------------


> All I'm saying is that of course caution is warranted with ANY drug, but caution is also warranted when reading studies and other information you find on the internet.

I got some interesting results confirming that
dose plays an critical role in neuroleptic
malignant syndrome and other "extrapyramidal"?
reactions, according to dose. You are correct--
i was too general; still, I am such a chicken
that I would not mix neuroleptics or even
SSRIs with lithium.

:-)

Squiggles


 

Re: Haldol experiences? - What about Stelazine?

Posted by SLS on November 11, 2005, at 15:11:58

In reply to Haldol experiences? med_empowered, posted by yesac on November 11, 2005, at 11:47:32

What a great discussion!

Nobody mentioned Stelazine (trifluoperazine). It might have substantial antidepressant effects along with a tendency to produce weight loss.

I'm curious as to what others think of this drug.


- Scott

 

Re: Haldol experiences? - What about Stelazine?

Posted by paulbwell on November 11, 2005, at 23:05:55

In reply to Re: Haldol experiences? - What about Stelazine?, posted by SLS on November 11, 2005, at 15:11:58

> What a great discussion!
>
> Nobody mentioned Stelazine (trifluoperazine). It might have substantial antidepressant effects along with a tendency to produce weight loss.
>
> I'm curious as to what others think of this drug.
>
> I was given some 5mg Stelazine tabs. Makes me jiggle and feel like moving-can you say Akathesia?-God help thoes on it long term,mmmmmmm
> - Scott

 

Re: Haldol experiences? - What about Stelazine?

Posted by SLS on November 12, 2005, at 6:46:39

In reply to Re: Haldol experiences? - What about Stelazine?, posted by paulbwell on November 11, 2005, at 23:05:55

> > What a great discussion!
> >
> > Nobody mentioned Stelazine (trifluoperazine). It might have substantial antidepressant effects along with a tendency to produce weight loss.
> >
> > I'm curious as to what others think of this drug.


> I was given some 5mg Stelazine tabs. Makes me jiggle and feel like moving-can you say Akathesia?-God help thoes on it long term,mmmmmmm

Ouch.

So far, Stelazine doesn't look that good.


- Scott

 

Re: Haldol experiences? - What about Stelazine? SLS

Posted by ed_uk on November 12, 2005, at 12:36:47

In reply to Re: Haldol experiences? - What about Stelazine?, posted by SLS on November 11, 2005, at 15:11:58

Hi Scott,

Trifluoperazine (Stelazine) is similar to haloperidol (Haldol) in many ways. It's a potent D2 antagonist with a relatively high (albeit dose-dependent) risk of inducing acute EPS.

2.5mg haloperidol is thought to be comparable to about 5mg trifluoperazine.

Trifluoperazine and haloperidol might rarely provoke weight loss, yet a modest weight gain seems to be the norm.

Kind regards

Ed

 

akasthesia

Posted by yesac on November 15, 2005, at 11:00:43

In reply to I wouldn't take add Haldol..., posted by med_empowered on November 4, 2005, at 0:30:56

Well, I seem to have developed akathesia on only 3mgs of Haldol. I've been taking benadryl to try to reduce the akasthesia. It seems to take the edge off but not wipe it out altogether. I stopped taking the Haldol. I'm going to talk to my shrink about it today and see what he says in terms of what to do.

I may try to stay on it at a lower dose or I may ditch it altogether.

Does anyone know if benzos can help the akathesia? I thought I saw that somewhere.

 

Akathisia yesac

Posted by ed_uk on November 15, 2005, at 15:09:31

In reply to akasthesia, posted by yesac on November 15, 2005, at 11:00:43

Hi Yesac,

I'm glad you were careful with the dose! Akathisia gets much worse as you increase the dose.

>Well, I seem to have developed akathesia on only 3mgs of Haldol.

Akathisia tends to occur when the dose is too high. 3mg isn't that low, haloperidol is very potent. You can adjust the dose is steps of 0.5mg.

Two options.......

1. If haloperidol was helping: reduce the dose until the akathisia disappears.

Do you think you were benefitting from the haloperidol at all?

2. If haloperidol was not helping: try something else instead.

Avoid the temptation to medicate the akathisia eg. with benzos. Akathisia is usually best treated by reducing the dose or switching to an alternative medication.

Kind regards

Ed

 

akasthesia ed_uk

Posted by yesac on November 16, 2005, at 10:31:25

In reply to Akathisia yesac, posted by ed_uk on November 15, 2005, at 15:09:31


> Akathisia tends to occur when the dose is too high. 3mg isn't that low, haloperidol is very potent. You can adjust the dose is steps of 0.5mg.


At 2mgs I seemed to be okay. After I bumped it up to 3mgs-- a few days later the akasthesia kicked in.

> 1. If haloperidol was helping: reduce the dose until the akathisia disappears.
>
> Do you think you were benefitting from the haloperidol at all?
>
> 2. If haloperidol was not helping: try something else instead.


I think it was helping because I reduced my Seroquel dose but still felt okay. Normally if I reduced Seroquel, I'd gradually feel worse and worse. The eventual plan was to quit taking S and only take H, at least for a while, until I get prescription coverage.

Anyway, for the meantime, I've stopped Haldol altogether. I'm still taking S. I think in another day or two I'll try taking just 1mg of Haldol. The akasthesia seems to have pretty much resolved.

 

Re: akasthesia yesac

Posted by ed_uk on November 17, 2005, at 13:29:07

In reply to akasthesia ed_uk, posted by yesac on November 16, 2005, at 10:31:25

Hi Yesac,

>At 2mgs I seemed to be okay.

Did you have any akathisia on 2mg?

>I think in another day or two I'll try taking just 1mg of Haldol.

You could try 0.5mg, 1mg, 1.5mg and 2mg to compare.

Kind regards

Ed


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