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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by ace on April 27, 2005, at 23:49:45
Me again Kids,
I'm think of swapping Seroquel for Stelazine as Stelazine has robust anxiolytic properties (FDA approved for anxiety associates with neuroses (I believe))
Also, being and antipsychotic, I'm sure it will help the OCD (All I have used have)
They say that most patients need little more than 6mg. 2-4mg for anxiety is the usual (plus anti OCD effect). Psychotic out-patients sometimes need up tp 40mg, and inpatients have been known to be on as much as 80mg.
I will take 2-4mg.
Obviously more EPS is involved, but, at such a low dose I believe EPS is only as likely as 1mg Risperidone.
Any experiences / comments welcome!!!!!!!
Ace
Posted by River1924 on April 28, 2005, at 1:26:09
In reply to ANY STELAZINE EXERIENCES PLEASE!!!!!!!!!!!!!, posted by ace on April 27, 2005, at 23:49:45
I take stelazine on and off. 1 to 4 milligrams at bedtime. (I tend to get sedated by most drugs. It would be better to take twice a day but I can not.) I find it helpful. Not a miracle drug. Sometimes everything that I've put off for months gets down in a few days. Other times I just feel less anxious. When my father died it helped me deal with all the hundreds of people I had to deal with at the funeral, etc. The big side effect: My mind is kinda blank after a week. It feels stuffed with cotton. Zombie-like. By a helpful coincidence, I discovered that the alzheimer's drug reminyl takes away the "blankness." At 37, I obviously don't have alzheimer's. (I tried another drug called exelon but that didn't work for me as well.) I'll only take stelazine for more that a week if I can take reminyl with it. Luckily my doc and insurance company go along with this unusual combo. Good Luck, River.
Posted by Declan on April 28, 2005, at 5:57:35
In reply to ANY STELAZINE EXERIENCES PLEASE!!!!!!!!!!!!!, posted by ace on April 27, 2005, at 23:49:45
Don't be silly. Never taken the newer ones, so I don't know how bad they are. The old ones work for somethings, (like speed overdose), but boy....
Declan
Posted by ed_uk on April 28, 2005, at 14:06:34
In reply to ANY STELAZINE EXERIENCES PLEASE!!!!!!!!!!!!!, posted by ace on April 27, 2005, at 23:49:45
Hi Acie!
Trifluoperazine can be a useful in the short-term treatment of severe anxiety, preferably at a dose of 1-2mg a day. Take care with the dose, if you take too much you will regret it. High doses can be extremely unpleasant. 1mg/day is a suitable starting dose.
Trifluoperazine is not generally suitable for the long-term treatment of anxiety, unless all else has failed and the anxiety is extreme. Even low doses may be substantially more likely to cause tardive dyskinesia than the atypical antipsychotics. To give you an example, after 12 months treatment with haloperidol (Haldol), which is pharmacologically very similar to trifluoperazine, 12.3% of the sample had developed tardive dyskinesia. This was despite the fact that the average dose of haloperdol was very low, only 1.68mg per day, which is approximately equivalent to 3mg/day trifluoperazine.
In the treatment of anxiety, trifluoperazine is probably best taken intermittently, either as single isolated doses or for a few days at a time. Trifluperazine is only suitable for the treatment of moderate to severe anxiety. It is important to find the minimum effective dose. I would not recommend taking it for more than a couple of weeks at a time. In addition, I think it's unlikely that you will find trifluoperazine to be a more effective anxiolytic than risperidone. In fact, you might find it less effective.
Take care,
Ed.
Posted by xbunny on April 28, 2005, at 14:41:08
In reply to ANY STELAZINE EXERIENCES PLEASE!!!!!!!!!!!!!, posted by ace on April 27, 2005, at 23:49:45
> I'm think of swapping Seroquel for Stelazine as Stelazine has robust anxiolytic properties (FDA approved for anxiety associates with neuroses (I believe))
>
> Also, being and antipsychotic, I'm sure it will help the OCD (All I have used have)I used to take stelazine. I found it pretty poor for anxiety not nearly sedating enough. Didnt get EPS from it though and it was only slightly zombieing. Good luck with it Bunny
Posted by Phillipa on April 28, 2005, at 18:51:51
In reply to Re: ANY STELAZINE EXERIENCES PLEASE!!!!!!!!!!!!!, posted by xbunny on April 28, 2005, at 14:41:08
Ace, stick with what was making you feel so good before. Fondly, Phillipa
Posted by River1924 on April 29, 2005, at 0:41:05
In reply to ANY STELAZINE EXERIENCES PLEASE!!!!!!!!!!!!!, posted by ace on April 27, 2005, at 23:49:45
I've read the other posts and they seem to know your situation. I know the urge to find the perfect golden drug but since you state you have ocd that desire may simply be a symptom of the ocd. "If I just do this, it will be all better."
Although I'm a cynic about drug company propaganda, the atypicals are better if you can tolerate them (ie modest weight gain and blood sugar levels.) My doctor lets me use stelazine for periods of time because it is one of the least sedating anti-psychotics and my mental problems don't ever get out of control. (I don't get manic, psychotic, crazy or attempt suicide.) Balance change with the potential negative downsides. Have drug changes made you severely unbalanced in the past?
If you tolerate seroquel, stelazine won't feel as calming. Seroquel seemed like a decent drug but I'm extremely sensitive to sedation. I slept continuously on it. (On the anti-histamine benadryl, I sleep for 20 hours.) Stelazine has been approved for anxiety but all the anti-psychotics will probably help with anxiety...most better than stelazine (including the old "typicals") with fewer eps symptoms.
Just be careful. I sometimes change meds for change's sake (and for hope) but it usually isn't fruitful. Educational but not really necessary or more helpful to my mental/cognitive/emotional state. Good luck and peace, River.
Posted by ace on May 1, 2005, at 1:50:09
In reply to Re: ANY STELAZINE EXERIENCES PLEASE!!!!!!!!!!!!! ?ace, posted by ed_uk on April 28, 2005, at 14:06:34
Thanks mate!!
as you know as well as me Risperidone is the most likely atypical to cause EPS -- but how would you compare that to Stelazine...have you any similar statistics??
Thanks bro!
Andrew (Ace)
> Hi Acie!
>
> Trifluoperazine can be a useful in the short-term treatment of severe anxiety, preferably at a dose of 1-2mg a day. Take care with the dose, if you take too much you will regret it. High doses can be extremely unpleasant. 1mg/day is a suitable starting dose.
>
> Trifluoperazine is not generally suitable for the long-term treatment of anxiety, unless all else has failed and the anxiety is extreme. Even low doses may be substantially more likely to cause tardive dyskinesia than the atypical antipsychotics. To give you an example, after 12 months treatment with haloperidol (Haldol), which is pharmacologically very similar to trifluoperazine, 12.3% of the sample had developed tardive dyskinesia. This was despite the fact that the average dose of haloperdol was very low, only 1.68mg per day, which is approximately equivalent to 3mg/day trifluoperazine.
>
> In the treatment of anxiety, trifluoperazine is probably best taken intermittently, either as single isolated doses or for a few days at a time. Trifluperazine is only suitable for the treatment of moderate to severe anxiety. It is important to find the minimum effective dose. I would not recommend taking it for more than a couple of weeks at a time. In addition, I think it's unlikely that you will find trifluoperazine to be a more effective anxiolytic than risperidone. In fact, you might find it less effective.
>
> Take care,
> Ed.
Posted by ace on May 1, 2005, at 1:51:15
In reply to Re: ANY STELAZINE EXERIENCES PLEASE!!!!!!!!!!!!! » ed_uk, posted by ace on May 1, 2005, at 1:50:09
Posted by ed_uk on May 1, 2005, at 11:49:45
In reply to Re: ANY STELAZINE EXERIENCES PLEASE!!!!!!!!!!!!! » ed_uk, posted by ace on May 1, 2005, at 1:50:09
Hi ace,
>have you any similar statistics??
Lower risk for tardive dyskinesia associated with second-generation antipsychotics: a systematic review of 1-year studies.
Correll CU, Leucht S, Kane JM.
Department of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Schneider Children's Hospital, Glen Oaks, NY 11004, USA. ccorrell@lij.edu
OBJECTIVE: Based on lower rates of acute extrapyramidal side effects associated with second-generation antipsychotics, compared to first-generation antipsychotics, and based on preliminary data, second-generation antipsychotics are expected to cause less tardive dyskinesia than first-generation antipsychotics. This hypothesis was examined in a systematic review of studies involving open or controlled treatment with any second-generation antipsychotic. METHOD: Studies of treatment with second-generation antipsychotics lasting > or =1 year and reporting on new cases of tardive dyskinesia or dyskinesia were systematically reviewed. RESULTS: In 11 studies, 2,769 patients received treatment with risperidone (five studies, N=1,235), olanzapine (two studies, N=610), quetiapine (two studies, N=386), amisulpride (one study, N=331), or ziprasidone (one study, N=207) for a weighted mean and median duration of 263 and 306 days, respectively. Study designs were double blind and randomized (N=3); open-label extensions of double-blind, randomized trials (N=4); and open label (N=4). Of the four trials that had a comparator (all involving adults with schizophrenia spectrum disorders), three used haloperidol (N=408) and one used placebo (N=71). Studied populations included children (N=77), adults (N=1,419), adults and elderly persons (N=794), and exclusively patients age 54 years or older (N=479). 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. CONCLUSIONS: Results from 11 long-term studies support the idea that second-generation antipsychotics have a reduced risk for tardive dyskinesia, compared to first-generation antipsychotics, although the doses of haloperidol used in the comparator studies were relatively high. More carefully designed studies, ideally lasting beyond 1 year and comparing the effects of different second-generation antipsychotics in patients who have never taken first-generation antipsychotics, are needed to estimate the true risk. It would not appear premature for clinicians to consider these findings in making long-term treatment decisions.
Ed.
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