Psycho-Babble Medication Thread 330999

Shown: posts 1 to 17 of 17. This is the beginning of the thread.

 

The TD myth

Posted by AMD on March 31, 2004, at 19:21:02

Every other message discussing AP's on this board gives advice not to take these drugs except in 'extreme' cases of mania, etc., for fear of the dreaded TD. It's quite offensive, actually, to see these words thrown around, often perhaps discouraging a patient from using these classes of drugs where they might be very beneficial.

My request is: put up or shut up. Next time someone warns about 'scary' TD, back it up with some facts: either your having had it, or a study showing it's a significant possibility given the drug in question. And by significant, I mean more than 1 in a 1000. I mean /death/ is a possible side effect of almost every drug, yet you never hear people running around saying, "don't take AD's, you might die!" Statistically speaking, it seems that TD occurs only rarely, and of these cases, only after long-term use (with the occasional exception). Particularly with newer AP's.

If anyone has counter examples, feel free to cite them. I am not biased either way at this point, but it seems to me that there is some fearmongering present on this board.

Thanks,


 

I agree (nm)

Posted by linkadge on March 31, 2004, at 19:54:47

In reply to The TD myth, posted by AMD on March 31, 2004, at 19:21:02

 

Re: The TD myth

Posted by jack9999 on March 31, 2004, at 21:28:58

In reply to The TD myth, posted by AMD on March 31, 2004, at 19:21:02

> Every other message discussing AP's on this board gives advice not to take these drugs except in 'extreme' cases of mania, etc., for fear of the dreaded TD. It's quite offensive, actually, to see these words thrown around, often perhaps discouraging a patient from using these classes of drugs where they might be very beneficial.
>
> My request is: put up or shut up. Next time someone warns about 'scary' TD, back it up with some facts: either your having had it, or a study showing it's a significant possibility given the drug in question. And by significant, I mean more than 1 in a 1000. I mean /death/ is a possible side effect of almost every drug, yet you never hear people running around saying, "don't take AD's, you might die!" Statistically speaking, it seems that TD occurs only rarely, and of these cases, only after long-term use (with the occasional exception). Particularly with newer AP's.
>
> If anyone has counter examples, feel free to cite them. I am not biased either way at this point, but it seems to me that there is some fearmongering present on this board.
>
> Thanks,
>
>
My wife developed TD (confirmed by two doctors) after three weeks of hospitalization and treatment with AP's (Geodon and Risperdal). They have been an absolute nightmare for my wife. She has involuntary hand, arm, and mouth movements almost every 5-10 seconds. She was once a very outgoing and energetic person, but has been forced to stay at home most of the time because of the brain damage she has from AP's.
Some people do need AP's - no doubt about it. But they should not be used in the long term except in extreme cases (chronic psychosis).
I've acumulated dozens upon dozens of articles confirming the dangers of AP's. The drug companies and (sadly) your doctor isn't going to tell you about them so you need to learn about the dangers for yourself.
If you don't absolutely have to have them don't take them!!!!!

 

Re: The TD myth I agree with you (nm) » jack9999

Posted by Tepiaca on March 31, 2004, at 22:31:26

In reply to Re: The TD myth, posted by jack9999 on March 31, 2004, at 21:28:58

 

Re: The TD myth//jack9999

Posted by HappyGirl on March 31, 2004, at 23:50:01

In reply to Re: The TD myth, posted by jack9999 on March 31, 2004, at 21:28:58

Hi jack9999 :
Your wife's case in regard to APs, Geodon and Risperdal sounds to me like 'Extreme case' about which I never heard of. However, I often heard about the older form of anti-pspycho-med., such as 'Haldol' has terrible side-effect, 'TD,' for that reason, new form of anti-psycho.meds. such as Geodon, Zyprexa, Abilify and more to list came to the market, not long ago. I believe that Zyprexa is one of the first APs, around 1996 and all other APs are all quite new, even around last year or so. In my common sense, if there is such 'BAD' reaction among a lot of AP takers, all of AP meds. must have already taken off from the shelf now, ... at least 'NO present/future production' in the pharmatecal market.

In regard to your wife's TD, you didn't state as to what dosage, how often and all other details on which your wife was put. Also, I wonder whether your wife did 'DISCONTINUE' right after her bad reaction, ... noticeable 'side-effects.' Because, any meds., not only APs also other class of med., such as 'Lamical'/skin-rash, SSRIs/suicidal thoughts and the like. Then, it is very important for psycho.-med. takers to 'discontinue' or 'call to the pdoc. IMMEDIATELY once any unusal symptoms developed.

As you quote, many of M.I., including myself are on some form of AP to seek a 'BIG' relief from tremendous pain on which we, at least I've been carrying. Without the Zyprexa, practically my life is almost 'upside down,' not to able to function even simple daily life. I owe tremendously this 'miracle' drug, AP.
H.G.

 

Re: The TD myth » AMD

Posted by rod on April 1, 2004, at 4:17:02

In reply to The TD myth, posted by AMD on March 31, 2004, at 19:21:02

> Every other message discussing AP's on this board gives advice not to take these drugs except in 'extreme' cases of mania, etc., for fear of the dreaded TD. It's quite offensive, actually, to see these words thrown around, often perhaps discouraging a patient from using these classes of drugs where they might be very beneficial.
>
> My request is: put up or shut up. Next time someone warns about 'scary' TD, back it up with some facts: either your having had it, or a study showing it's a significant possibility given the drug in question. And by significant, I mean more than 1 in a 1000. I mean /death/ is a possible side effect of almost every drug, yet you never hear people running around saying, "don't take AD's, you might die!" Statistically speaking, it seems that TD occurs only rarely, and of these cases, only after long-term use (with the occasional exception). Particularly with newer AP's.

Could you be so kind and provide some data to confirm that?


> If anyone has counter examples, feel free to cite them. I am not biased either way at this point, but it seems to me that there is some fearmongering present on this board.
>
> Thanks,
>
>
>

I actually disagree. TD can be life devastating.

"Lower risk for tardive dyskinesia associated with second-generation antipsychotics: a systematic review of 1-year studies."
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14992963

"... The weighted mean annual incidence of tardive dyskinesia for second-generation antipsychotics was 0% in the children, 0.8% (range=0.0%-1.5%) in the adults, 6.8% in the mixed adult and elderly population, and 5.3% (range=0.0%-13.4%) in the patients age 54 years and older, compared to 5.4% (range=4.1%-7.4%) in adults treated with haloperidol...."

I mean 6.8 % is more than 1/1000....

Roland

 

Re: please be civil » AMD

Posted by Dr. Bob on April 1, 2004, at 10:57:48

In reply to The TD myth, posted by AMD on March 31, 2004, at 19:21:02

> It's quite offensive, actually, to see these words thrown around
>
> My request is: put up or shut up.
>
> it seems to me that there is some fearmongering present on this board.

Different points of view are fine, and in fact encouraged. Please don't post anything that could lead others to feel accused or put down.

If you have any questions or comments about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:

http://www.dr-bob.org/babble/faq.html#civil

or redirect a follow-up to Psycho-Babble Administration.

Posting something about your own issues and their possible role in your reaction might be an interesting exercise -- and might help others respond to you supportively.

Thanks,

Bob

 

Re: The TD myth » rod

Posted by AMD on April 1, 2004, at 12:01:25

In reply to Re: The TD myth » AMD, posted by rod on April 1, 2004, at 4:17:02

This is what I'm talking about : 6% applies to mixed/elderly population, not middle aged, otherwise healthy adults.

Nonetheless, even at 6% -- what about the increased risk of alcoholism or suicide for those who do not take medication? Bipolar kills in other, much more dangerous, ways. So perhaps we should say "watch out for the dreaded TD! but also watch out for waking up in the middle of a highway after drinking too much if you don't take the proper medication"

 

Re: The TD myth

Posted by rod on April 1, 2004, at 12:32:58

In reply to Re: The TD myth » rod, posted by AMD on April 1, 2004, at 12:01:25

> This is what I'm talking about : 6% applies to mixed/elderly population, not middle aged, otherwise healthy adults.
>
> Nonetheless, even at 6% -- what about the increased risk of alcoholism or suicide for those who do not take medication? Bipolar kills in other, much more dangerous, ways. So perhaps we should say "watch out for the dreaded TD! but also watch out for waking up in the middle of a highway after drinking too much if you don't take the proper medication"
>
>

Sure, you are right. The people who need it, should take it. But, it shouldnt be prescribed as a first line treatment for uses other than psychosis and schizophrenia in my opinion. If there are alternatives, one should consider them first. Mood stabilisers, anticonvulstants etc. Even I take an AP, Amisulpride for depression, because its one of the few things that somewhat work for me. TD at my low dosage is not really an issue. But I often see patients who get an AP prescribed before they try something else like sedative ADs. In hospital for example. Many people got APs for anxiety etc. Thats wrong in my opinion.

Roland

 

The TD myth » rod

Posted by AMD on April 1, 2004, at 14:20:21

In reply to Re: The TD myth, posted by rod on April 1, 2004, at 12:32:58

I agree was well.

I have been prescribed an AP -- Zyprexa -- but I have not started taking it. I'm seeing my pdoc tomorrow, and I am going to tell her, no AP's for me, not now. Why? Because I don't feel it's necessary at this point. Do I fear TD? Sure. But I fear more the fact that there are no documented studies on the long-term efficacy of the medication. Because I'm not manic, and only obsessive, they are prescribing it in a long-term way. I do not like being a human guinea pig, which I feel a lot of us are.

Anyhow, it's frightening to read such horrible stories about TD on this board -- and makes me question what otherwise might be a good drug (if not now, later). I just want facts, not anecdotes, you know? People like me are easily dissauded my hyperbole (I've obsessive afterall).

Adam

 

Re: The TD myth

Posted by CareBear04 on April 1, 2004, at 16:52:48

In reply to The TD myth ?rod, posted by AMD on April 1, 2004, at 14:20:21

this stuff is scary! i hope for all our sakes that TD is really as rare as it's supposed to be. i think i heard somewhere that the chances of getting it increase the longer you're on them. that worries me a lot. i started taking risperdal a year ago, in the hospital, when i was 20. since then, i've also been on zyprexa, seroquel, abilify, trilafon, and now haldol. i've exhausted my options in the atypical category and i've moved on to the old traditional antipsychotics. it's true that in the hopstial, they try to shove APs down your throat, at least in my case. i'm definitely not schizophrenic or out of control manic, so what are some better alternatives to the APs? i don't know how long my dr plans to keep me on them, but it scares me to think of all those years ahead that could increase my risk for TD.
cb

 

Re: The TD myth » CareBear04

Posted by judy1 on April 2, 2004, at 10:38:06

In reply to Re: The TD myth, posted by CareBear04 on April 1, 2004, at 16:52:48

I'm not going to get into this discussion, but I did want to answer your question about AP use in hospitals. Normally they reserve it for the truly agitated patient- in my case I actually prefer it to physical restraints- and in a psychotic manic episode I've been give 5mg haldol along with 2mg lorazapam with successful results (that is I calmed down). If you are not psychotic then the first line in the ER is IM benzos- usually lorazapam (ativan) and that works out quite well. How did you fare on benzos, I assume your pdoc tried those first before prescribing APs?
take care, judy

 

not going to cause TD over night, are they??

Posted by linkadge on April 3, 2004, at 9:38:59

In reply to Re: The TD myth » CareBear04, posted by judy1 on April 2, 2004, at 10:38:06

Correct me if I'm wrong, but I don't think that AP's are going to cause TD over night (ie short term use is a separate issue from long term use)

If they do cause TD over night, I can't imagine what happend. Temporary blockade of dopamine receptors shouldn't cause any sudden morphological changes.

Linkadge

 

Re: not going to cause TD over night, are they?? » linkadge

Posted by rod on April 3, 2004, at 10:32:51

In reply to not going to cause TD over night, are they??, posted by linkadge on April 3, 2004, at 9:38:59

> Correct me if I'm wrong, but I don't think that AP's are going to cause TD over night (ie short term use is a separate issue from long term use)
>
> If they do cause TD over night, I can't imagine what happend. Temporary blockade of dopamine receptors shouldn't cause any sudden morphological changes.
>
> Linkadge

You are right, as far as I know. I have read that there are multiple mechanisms responsible for TD.
One main factor apart from the supersensitized dopamine receptor theory is neuronal cell death, induced by excitotoxicity and free redicals (induced by neuroleptic drugs! shocking, eh?). I am sure neurodegeneration does not occur aver night.

Roland

 

Re: The TD myth » rod

Posted by Pluto on April 4, 2004, at 4:33:10

In reply to Re: The TD myth, posted by rod on April 1, 2004, at 12:32:58

Many people got APs for anxiety etc. Thats wrong in my opinion.

I am taking an AP now called sulpiride and yes, I take it for anxiety. Should I quit it and resort to clonazepam? What's your opinion? I don't want to risk tardive dyskinesia. But can it occur overnight?
My sulpiride dosage is 100mg daily. Is it enough to cause TD?
This drug has been wonderful for anxiety. It works well or I would say much better than clonazepam. But TD?? I don't want to chew and blink constantly in front of others only because I took something to abstain from the anxious world. I have seen people with TD, and honestly it is the worst of movement disorders.
Percy.

 

Re: The TD myth » Pluto

Posted by rod on April 4, 2004, at 6:22:58

In reply to Re: The TD myth » rod, posted by Pluto on April 4, 2004, at 4:33:10

> Many people got APs for anxiety etc. Thats wrong in my opinion.
>
> I am taking an AP now called sulpiride and yes, I take it for anxiety. Should I quit it and resort to clonazepam? What's your opinion? I don't want to risk tardive dyskinesia. But can it occur overnight?
> My sulpiride dosage is 100mg daily. Is it enough to cause TD?
> This drug has been wonderful for anxiety. It works well or I would say much better than clonazepam. But TD?? I don't want to chew and blink constantly in front of others only because I took something to abstain from the anxious world. I have seen people with TD, and honestly it is the worst of movement disorders.
> Percy.

uhmm, my opinion on this. There is a study at pubmed about this and sulpiride for depression, but I dont know the dosage administered.
Have you tried an SSRI? Do they work for you? If not, I would take sulpiride. But dont blame me if something goes wrong...
From my understanding, I dont think that TD will happen with 100mg sulpiride. One reason of TD are supersensitized Dopamine Receptors, caused by postsynaptic recept blockade. The brain counteracts the blockade by making the receptors more sensitive/increasing receptor density. I dont know for sure, but I think low dose sulpriride/amisulpride will actually cause postsynaptic downregulation, because at such a dose it somewhat acts like increasing postsnaptic dopaminergic stimulation. The stimulation overweights the blockade, an thereby does not cause postsynaptic upregulation. But I might be wrong.

maybe I could help you a bit

Roland

 

Re: The TD myth » rod

Posted by Pluto on April 5, 2004, at 2:29:46

In reply to Re: The TD myth » Pluto, posted by rod on April 4, 2004, at 6:22:58

Dear Roland,

Thank you for your wonderful post. I have tried all those SSRIs and definitely they are not made for me. I spent years on them with a clouded sensorium and a total loss of sensations. I took klonopin to overcome the withdrawals of paxil and since then I never looked back. I got my life back with Rivotril. Contrary to popular belief, Rivotril(klonopin) is not addictive to people who really need it. I am off klonopin for more than a month now and I can't sense any withdrawal symptoms except a slight return of anxiety that originally led me to SSRIs. Sulpiride is effectively covering up that anxiety too. But I am concerned of TD and probably dependence. My past experience is very interesting. I could get off Xanax without any major discomfort, but I really struggled to wean off Zoloft and paxil. So, when my pdoc tells me dependence has never reported with sulpiride, my heartbeat goes up. This was the same assurance I got from doc when I began to use zoloft and paxil later. But both proved to be the most difficult drugs to come off for me. I struggled over a year to escape from that ordeal. So when someone tells me we have prozac, zoloft paxil and effexor I thankfully refuse that offer for the sake of my brain. At least I must have a brain left after all.
Percy.


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