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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by kieran2585 on March 16, 2008, at 20:03:17
i started aytipical antipsycotics last summer under the guidance of my psyciatrist, she said that it may be my best treatment from the look of my symptoms (apathy, anhedonia) even though ive never heard voices or anything like that, anyway i cant say ive ever noticed much help from them, so im thinking should i really be on these? and can they do more harm than good, and what are the side effects of the d2 antagonism? can it block the activating effects of prozac, NADH and caffeine too?
Posted by yxibow on March 16, 2008, at 21:12:27
In reply to D2 antagonism, posted by kieran2585 on March 16, 2008, at 20:03:17
> i started aytipical antipsycotics last summer under the guidance of my psyciatrist, she said that it may be my best treatment from the look of my symptoms (apathy, anhedonia) even though ive never heard voices or anything like that
They're used for many other things, I know the stigma well of taking one but they're not just used for thatt.
, anyway i cant say ive ever noticed much help from them, so im thinking should i really be on these? and can they do more harm than good, and what are the side effects of the d2 antagonism? can it block the activating effects of prozac, NADH and caffeine too?
No. In fact low doses of atypicals are used to augment prozac. Caffeine would not be the best if you have any anxiety disorder.
What atypical is it?
Generally Zyprexa and Seroquel are considered the safest and the benefits far outweigh the risks, but there are others as well. Somewhere between 0.1 and 0.5% risk of TD probably. Its unclear. Only Risperdal has had any major reports of unwanted effects.
-- Jay
Posted by Quintal on March 17, 2008, at 16:22:17
In reply to D2 antagonism, posted by kieran2585 on March 16, 2008, at 20:03:17
Dopamine antagonism is the last thing you need IMHO if you're suffering from apathy and anhedonia. Try a dopamine *agonist* (Mirapex, Ropinirole etc.) instead. A dopamine reuptake inhibitor like Wellbutrin or Ritalin may also be helpful. The most serious side effects of atypicals are diabtetes, obesity, heart disease and movement disorders. Not to be taken lightly.
Q
Posted by dbc on March 18, 2008, at 13:26:51
In reply to Re: D2 antagonism » kieran2585, posted by Quintal on March 17, 2008, at 16:22:17
In my experience seroquel absolutely kills any effect of caffeine. Which may or may not be due partly to its histamine effect but i doubt that.
Posted by yxibow on March 19, 2008, at 3:14:33
In reply to Re: D2 antagonism » kieran2585, posted by Quintal on March 17, 2008, at 16:22:17
> Dopamine antagonism is the last thing you need IMHO if you're suffering from apathy and anhedonia. Try a dopamine *agonist* (Mirapex, Ropinirole etc.) instead. A dopamine reuptake inhibitor like Wellbutrin or Ritalin may also be helpful. The most serious side effects of atypicals are diabtetes, obesity, heart disease and movement disorders. Not to be taken lightly.
>
> QThat's not necessarily true, and true dopamine agonists like bromocriptine can cause psychosis.
Its sort of a blanket statement of atypicals -- yes, they can cause diabetes, obesity, and heart disease in those who have high cholesterol in their family and who don't moderate their intake (that goes for any medication that increases weight).
But I believe its sort of an old view on neuroleptics.
It is now widely accepted that the average risk on typicals -- is about 5% per year up to a nebulous lifetime of 25% for TD, and this isn't even clear.
Atypicals, are around 1% probably for the most strongest such as Risperdal which to date has been the only one to produce measurable amounts of tardive symptoms.
Zyprexa and Seroquel are around 0.1% and for a lot of people the benefit outweighs the risk.
I'm not being Pollyanna and saying that there aren't risks in neuroleptics, and that individual genetics can determine reactions to medication, be it neurological or physical, but some people are rather dramatically stabilised on the aforementioned two medications.
As for the poster, who knows why they are experiencing apathy and anhedonia. The root causes have to be explored by -their- doctor.
If those are the only symptoms, well, maybe an antidepressant and/or mood stabilizer is what they need. But sometimes even low dosages of APs also augment this. Lamictal is also a good augmenters.
There are many paths and generalizing a particular class of medication which a number of people need to take I don't think is particularly helpful but you're quite entitled to your belief. I certainly wouldn't advocate -taking- them either, but I personally have a lot of need at the moment too, unfortunately. Sometimes we find ourselves in predicaments where the benefits outweigh the risks. So I may be projecting, but there are others on here who for their own -particular- condition find themselves needing to take them as well as much as we would all like to throw our medicine chest out the window at times I think
-- tidings
Posted by Quintal on March 19, 2008, at 10:40:43
In reply to Re: D2 antagonism » Quintal, posted by yxibow on March 19, 2008, at 3:14:33
I thought something like this would be coming. Honestly, out of the whole pharmacopea I can't think of any class of drugs more likely to cause side effects of apathy and anhedonia than antipsychotics. This particular poster said s/he had felt little or no benefit from taking these drugs, which isn't suprising to me. Viewed objectively, the APs have an unnaceptable long-term risk profile when you're receiving no benefit from them. Obviously low-dose amisulpride would be an exception, but only because it elevates dopamine - having the opposite effect of dopamine antagonists.
>As for the poster, who knows why they are experiencing apathy and anhedonia. The root causes have to be explored by -their- doctor.
Yeah, well I think their doctor should have explored the root causes a bit more carefully -before- prescrbing such dangerous drugs.
Q
Posted by kieran2585 on March 19, 2008, at 12:51:39
In reply to Re: D2 antagonism » kieran2585, posted by yxibow on March 16, 2008, at 21:12:27
> > i started aytipical antipsycotics last summer under the guidance of my psyciatrist, she said that it may be my best treatment from the look of my symptoms (apathy, anhedonia) even though ive never heard voices or anything like that
>
> They're used for many other things, I know the stigma well of taking one but they're not just used for thatt.
>
> , anyway i cant say ive ever noticed much help from them, so im thinking should i really be on these? and can they do more harm than good, and what are the side effects of the d2 antagonism? can it block the activating effects of prozac, NADH and caffeine too?
>
> No. In fact low doses of atypicals are used to augment prozac. Caffeine would not be the best if you have any anxiety disorder.
>
hi thanks for your post, though after doing some research i found that atypicals would block the activating effects of prozac, i found that geodon is a strong 5ht2c antagonist like prozac and at low doses it is just as activating untill the dose is raised to have enough d2 antagonism on bourd to block the activating effects, so i guess it would be the same with mixing prozac with an AP, i was wondering becouse when i retried prozac under abilify i didnt feel anything and thought it just wasnt going to work for me again, as for caffeine, i know that it shouldnt be used if you have an anxiety disorder, but for me it used to help, which sounds confusing i know> What atypical is it?
>
im currently on zyprexa but i was on abilify for quite a while
>
Generally Zyprexa and Seroquel are considered the safest and the benefits far outweigh the risks, but there are others as well. Somewhere between 0.1 and 0.5% risk of TD probably. Its unclear. Only Risperdal has had any major reports of unwanted effects.
>
> -- Jay
Posted by KarenRB53 on March 27, 2008, at 22:14:18
In reply to Re: D2 antagonism » yxibow, posted by kieran2585 on March 19, 2008, at 12:51:39
> > > i started aytipical antipsycotics last summer under the guidance of my psyciatrist, she said that it may be my best treatment from the look of my symptoms (apathy, anhedonia) even though ive never heard voices or anything like that
> >
> > They're used for many other things, I know the stigma well of taking one but they're not just used for thatt.
> >
> > , anyway i cant say ive ever noticed much help from them, so im thinking should i really be on these? and can they do more harm than good, and what are the side effects of the d2 antagonism? can it block the activating effects of prozac, NADH and caffeine too?
> >
> > No. In fact low doses of atypicals are used to augment prozac. Caffeine would not be the best if you have any anxiety disorder.
> >
> hi thanks for your post, though after doing some research i found that atypicals would block the activating effects of prozac, i found that geodon is a strong 5ht2c antagonist like prozac and at low doses it is just as activating untill the dose is raised to have enough d2 antagonism on bourd to block the activating effects, so i guess it would be the same with mixing prozac with an AP, i was wondering becouse when i retried prozac under abilify i didnt feel anything and thought it just wasnt going to work for me again, as for caffeine, i know that it shouldnt be used if you have an anxiety disorder, but for me it used to help, which sounds confusing i know
>
> > What atypical is it?
> >
> im currently on zyprexa but i was on abilify for quite a while
> >
> Generally Zyprexa and Seroquel are considered the safest and the benefits far outweigh the risks, but there are others as well. Somewhere between 0.1 and 0.5% risk of TD probably. Its unclear. Only Risperdal has had any major reports of unwanted effects.
> >
> > -- Jay
>
>Now I'm confused (which isn't hard to do)!! I take Prozac which works great for my depression, however I need to up the dosage but when I do I get hypomanic so I can only take 20mg which doesn't help me as much as I need. I'm trying to find something to use with the Prozac that will allow me to increase dosage of Prozac for the depression but will keep me from becoming hypomanic. Does this make sense?
Karen
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