Remember: Nobody on this site is a doctor,
therapist, or a pharmacist. Know your sources!
Crazy Meds is not responsible for the content of sites we provide links to.
We like them, but what's on those sites is their business, not ours.
You'll see reference to
Extrapyramidal Symptoms, or EPS. They include TD (see below) and
a bunch of other fancy medical terms for various uncontrolled movements. EPS can be weird
hand movements, like you're signing in Esperanto. It can mean you've become the uberklutz,
tripping not only over your own feet but over your own knees. It can mean tremors and
twitches and tics and tap dancing. EPS can be temporary, my weird hand-jive and extra
klutziness (on top of my natural klutziness) went away after a few weeks. Or EPS can last
as long as you take the novel / atypical antipsychotic. The best evidence around, from clinical
studies to the stories of people who take these drugs, is that once you stop taking the
med, or lower the dosage below the point at which it shows up, the problem goes away.
Or you can treat it with an anti-Parkinson's drug.
You have options!
While more likely to happen with the standard antipsychotics, and to last longer with
them, EPS still happens with the atypicals. I should know! But
lowering the dosage took care of my EPS issues. To what extent you're will to
put up with EPS and for how long is between you, your doctor and what symptoms you're
trying to manage with the med in question.
From what I've
read in various online support groups lowering the dosage is often
enough to deal with the issue most of the time, while switching to
another med will do it for many of the other times someone has EPS.
There are some people who can't take any antipsychotic because of
EPS, but they are a small percentage of the population. In
theory it's impossible to get EPS with Clozaril
(clozapine), but there's always someone who proves to be exceptional
to that rule.
So far
Seroquel (quetiapine) and
Zyprexa (olanzapine) have tested to be
the least likely of the popular atypicals (i.e. not Clozaril
(clozapine)) to cause EPS. Anecdotal evidence is suggesting
that Risperdal
(risperidone) is the one most likely to cause EPS. This includes TD.
TD is the absolute worst of the extrapyramidal symptoms. The best evidence is that permanent Tardive Dyskinesia can be avoided if
the offending medication is halted, or even the dosage lowered, once the symptoms (weird
facial tics and twitches, and uncontrollable tongue rolling and bending) first appear. TD
symptoms show up now and then in people who take atypical antipsychotics and really, it's
no big deal. Well, OK, it is sort of a big deal. Lowering the dosage or switching to another antipsychotic is
usually all it takes to
make the symptoms disappear and the threat of TD vanish. TD is nasty and not to be treated
lightly, and your doctor needs to be notified immediately if any symptoms that remotely
resemble TD symptoms present themselves. But as long as you're on top of things you need
not fear TD. However doctors do need to discuss it with
anyone who is going to be taking antipsychotics.
Case in point - my experience with TD. It came on suddenly. One
day Mouse noticed that my tongue seemed to be sticking out of my mouth more
when I spoke certain words and that I had some minor facial tics that I
wasn't aware of. The next day my tongue had a mind of its own, I was
totally aware of facial tics without having to look in a mirror, and I was
blinking like a cartoon owl broadcasting Morse code. Lowering my dosage of Risperdal
(risperidone) from 0.5mg a night to 0.25mg reduced the symptoms, but they
still flared up now and then. Eventually I had to stop taking a very
effective med. The TD was gone for the most part. I still had a
bit of a tic in my forehead, but I'm a really poor metabolizer of meds, so
maybe the Risperdal
(risperidone) was hanging around for a long time, given the 30 hour
half-life of the active metabolite for poor metabolizers. Plus tics are side effects of other meds I take,
and once you get a side effect going like that, it'll just hang around if
the other meds will make it easier to do so. But it really never went
away until I took
Seroquel (quetiapine), which along with
Zyprexa (olanzapine) has been used to
treat the permanent form of TD that is more likely from taking
standard antipsychotics. So, really slow metabolism of Risperdal
(risperidone) or permanent, if intermittent presentation of one minor TD
symptom that didn't bother me all that much that required another
med to deal with? I honestly don't know.
Did it freak me out? Of course it did! For about an hour.
I knew what was going on, I knew how to deal with it. Fortunately I
have the luxury of knowing how meds work and not having to leave my house
for days at a time. So if something like this happens to you, go ahead
and freak out! It's scary! And Christ on a crutch, to go out in
public when that's happening to you on top of everything else you're dealing
with? It's one thing when you're used to dealing with that sort of
thing most of your life, but it's something else entirely when it's a brand
new event in your life. While I personally don't give a shit about
tics and blinking and my tongue going wacky on me when I'm trying to buy
groceries, I'm not the rest of the world.
Still, my experience pretty much
matches that of others I've read. You freak, you talk to your
doctor, you switch meds, the symptoms go away.
An extremely rare but potentially
deadly side effect is Neuroleptic Malignant Syndrome. While TD is more likely to hit old ladies, NMS is more likely to hit young men.
The risk of NMS increases when mixing the standard antipsychotics with
lithium. Does the same hold true for the
novel / atypical antipsychotics? I have no idea.
I can find a case report about it here and there. The case reports I've seen
has it more likely when mixed with other meds, but it has happened
when the drugs are taken by themselves as well. Still,
the very threat of NMS makes me uncomfortable with using an atypical
antipsychotic for monotherapy to treat bipolar disorder in young men
when there are the proven treatments of lithium and
anticonvulsants. While the off-label applications for
these meds are at dosages so low that there's even less of of threat
of NMS, and with untreated schizophrenia you're more likely to die
if you don't treat your illness than you would if the threat of NMS
were a hundred times greater than it is, my philosophy is why take
one more unnecessary risk, along with the other long-term issues of
antipsychotics, when you don't need to?
Early symptoms
include fever, rigidity and increased heartbeat. Unlike TD, NMS requires
a lot of
intervention in addition to cessation of the medication. More than you ever wanted to know
about it at http://www.nmsis.org/general_information.shtml.
Unlike EPS, the chances for NMS, exceedingly rare as they are (I
mean, fewer than 100 cases total for all the atypicals) seem evenly
spread across the board.
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through messages in the Sunday Chronicle to beg you for spare change. So
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If you still have unanswered questions about this or other medications,
including which one is, or combination of meds are the best for you, your best
bet is to ask on Crazy
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worked out for you and want to help out others in their quest for the correct
meds, join the party.
If you want to discuss your issues, I suggest checking out one of
the various
support groups online.
Otherwise, if you're letting me know about how much you like or hate the site,
or need to let me know about medication effects in private, then just drop
a note to jerod23 at gmail dot com Honestly, I usually don't have a
lot of time to answer e-mail these days. The snide autoresponse
message that may or may not hit your mailbox is going to tell you the same
thing.
Another problem is that you may not get a response even if I wanted to send you
one. You see, so many dickweeds with malicious intents and too much time
on their hands have appropriated the crazymeds.org domain name to use for their
spam, viruses and the like. Subsequently some lazy-ass e-mail protection
software authors just go by the domain name, and not the IP address. So
I've been blacklisted because of the actions of others. Or the software
just doesn't like the domain name because of the "crazy" and/or "meds." Or
your question about a particular medication will set off spam flags. So
the e-mail just wouldn't go through regardless. Sorry.
Hey, did you find this page all by itself through Google or some other search engine?
Great! But to really appreciate the entire site, you need to
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Consult one or more doctors and pharmacists before taking, or changing how you take any
neurological and/or psychiatric medication. Your mileage may vary. What happened to us won't necessarily
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cyberchondriac, thinking you have every
disease you see a website about, or that you'll get every side effect from every
medication. Self-prescribing is just as dangerous. All information on this site has been obtained through personal experience,
the experiences of my friends, the experiences of people reported on online support
groups, and from sources that are referenced throughout the site.
Know your sources! As such the information
presented here is not a substitute for real medical advice from your real doctor, just a
compliment to it. No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this
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site by the time you read this. Always read the PI sheet that comes with your medications
and never ever throw them away. If you didn't get a PI sheet, demand one.
Loudly.
Crazy Meds is not responsible for the content of sites we provide links to.
We like them, or they're paid advertisements, or they're something you should
read to make an informed decision about a particular med. Sometimes
they're more than one of those things. But what's on those sites is their business, not ours.
Very little information about visitors to this site is collected or
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"Everything is true, nothing is permitted." - Jerod Poore
