![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Sebastian on November 6, 2005, at 11:01:06
I've read an interesting study which included perphenazine, the CATIE study. They had a lot of good things to say about it. I was wondering if anyone had the experience of taking it and could share there experiences. Does it realy have a low chance of extra piramidaly side-effects.
Posted by Sebastian on November 6, 2005, at 11:08:31
In reply to perphenazine, has anyone taken this?, posted by Sebastian on November 6, 2005, at 11:01:06
, in its good effects.
Posted by med_empowered on November 6, 2005, at 19:07:56
In reply to Is perphenazine anything like zyprexa, posted by Sebastian on November 6, 2005, at 11:08:31
hey! if i remember correctly from the CATIE study, perphenazine tends to cause more EPS than zyprexa (although its not too bad at lower doses). But...its more or less weight neutral, which is nice. It also has fewer effects (good or bad) on mood than zyprexa, which tends to be a mild antidepressant when used alone, and a more potent antidepressant when coupled with an antidepressant. (That said...low-dose perphenazine has been used pretty successfully as an add-on to antidepressants; its just a good idea to discontinue the medication QUICKLY). The TD risk I imagine would be higher than Zyprexa's; the standard rate for old-school neuroleptics is prolly 3%/year, maybe more (a lot of the studies under-estimated the TD rate). Zyprexa is about .5-1% annually. Long-term...after 5 years, 20-30% of people on old-school antipsychotics get TD; after very long administration, the number jumps over 40-50%. Have you thought about Molindone? Like I said, I dont like antipsychotics, especially old ones but...Molindone works differently from the other old ones, and is sometimes considered an atypical AP. It causes EPS, but apparently some researchers think the TD risk is pretty small.
Posted by Phillipa on November 6, 2005, at 21:37:30
In reply to Re: Is perphenazine anything like zyprexa, posted by med_empowered on November 6, 2005, at 19:07:56
Med, answer me this. I know from your posts that you don't like any antipsychotics except maybe abilify. What I don't understand is why the new trend in psch is to give an atypical antipsychotic as a med for anxiety. Why not the benzos where there isn't that risk. Do they think that an atypical will be short term? I think they are delusional on this one. Are the drug companies to blame? Are doctors so greedy they would break the hypocratic oath and hurt their pts for the money or gifts they receive? I just don't get it. Fondly, Phillipa
Posted by med_empowered on November 7, 2005, at 0:36:43
In reply to Re: Is perphenazine anything like zyprexa » med_empowered, posted by Phillipa on November 6, 2005, at 21:37:30
hey phillipa! I don't know where exactly this whole atypicals for everything idea came from. Drug companies I'm sure had a lot to do with it...it seems that shrinks are particularly easy to influence with drug company money, and the FDA panels regulating drugs like antidepressants are often filled with docs with undisclosed financial ties to Big Pharma. That said...if you look back to when Thorazine and other antipsychotics were first introduced, they did similar stuff. I mean, they also prescribed barbs, miltown, and later benzos, but Thorazine and other drugs were initially viewed primarily as **tranquilizers**, hence the term "major tranquilizers". Early ads for Thorazine and Trilafon, etc. often talk about using them in "anxious, agitated" patients, without mentioning schizophrenia or psychosis specifically. They also combined antipsychotics with antidepressants (ex: Triavil), stimulants (Thora-Dex..Thorazine plus dexedrine; it was also common to give patients Ritalin plus Thorazine, to counter the thorazine sedation), and sedatives (I forget what it was called, but there was a barbiturate-antipsychotic combo pill for a while). It really wasn't until the mid-to-late 60s that the "tranquilizers" became considered "antipsychotics"...even after then, it seems like antipsychotics were sprayed around for **EVERYTHING** (most disturbingly, they were used on children for "conduct disorder," often in foster homes and other institutions).
It really wasn't until TD became a **big** deal (primarily b/c of costly litigation, not just research) that shrinks calmed down with the antipsychotics. Benzos were widely prescribed in the 60s-70s, but so were antipsychotics; afterwards, there was a dip in the use of benzos (followed by a rise in the use of antidepressants) and a smaller dip in the use of antipsychotics. Now..the atypicals are everywhere. Part of it I think is money; the drugs are new, expensive, and pushed by money-filled drug companies. Seroquel, for instance, is extremely popular "off-label"; I read that about 50% of seroquel RXs appear to be written off-label, primarily for sleep purposes (Seroquel is sedating b/c of its anti-histamine action; most people could take some benadryl and get similar results). With all the lasting ignorance about benzos (even among shrinks, who really should know better), the rising tide against antidepressants (they really aren't that great), and psychiatry's tendency to dump drugs and pick up new, shiny ones with exuberance, it makes sense that the atypicals are being RX'd like mad.
Frighteningly enough, you see docs recommending atypicals just like they did the old drugs back in the day. Anxiety, depression...even scarier, they're being used for control; kids with "conduct disorder" and ADHD are now being given atypicals. Sure, they "work"..if you want a docile, drugged-out zombie of a kid. One study I read referred to atypicals as "potential broad-spectrum psychiatric agents", basically meaning "they're good for ANYTHING!" And think about: only an overpaid doc who wasn't **experiencing** the same problems as a patient could think that. Give someone, anyone, enough Haldol or Thorazine and of course they'll seem "improved"; they're too docile, dumbed-down and sedated to exhibit any sort of "psychiatric problem". Does this improve their overall quality of life? NO.
I don't know what to say about getting good treatment in psychiatry...it seems that there's a pattern; treatment comes along, its used widely for 10, 15, 20 years. Then people start to complain, there's data that shows problems...luckily, something new comes along which is whole-heartedly embraced, and the cycle begins anew. Look at...lobotomy, electroshock, Thorazine, barbiturates, valium, Prozac...on and on it goes.
Posted by CareBear04 on November 7, 2005, at 10:44:34
In reply to perphenazine, has anyone taken this?, posted by Sebastian on November 6, 2005, at 11:01:06
i took perphenazine (trilafon, right?) for awhile. at 8mg, it knocked me out and made me a complete zombie. it made me less sleepy at lower doses. my dr soon switched me to haldol, though, which i had better luck with. good luck!
Posted by Sebastian on November 7, 2005, at 19:00:21
In reply to Re: perphenazine, has anyone taken this? » Sebastian, posted by CareBear04 on November 7, 2005, at 10:44:34
Have you ever taken zyprexa? Was it anything like perphenazine(trilafon)? How many times a day did you take perphenazine at 8 mg?
Posted by Phillipa on November 7, 2005, at 19:04:05
In reply to Atypicals for anxiety, posted by med_empowered on November 7, 2005, at 0:36:43
Hi Med thanks for answering. I wholeheartedly agree with what you've said. Today I saw a gastroenterologist who didn't even know what trileptal was. So he took out that kind of computer pocket size they carry and looked it up. He said oh it's a seizure drug. I said it's also a mood stabalizer. And then he asked me what luvox was. Don't they teach physicians anything about medications? And do the drug reps visit a GP with info about psychiatric medication? I know the one I saw prescribed lexapro even though I told him it didn't work and only made me more anxious. And when I called and told the nurse my legs were jerking and I was more anxious. Did he let me increase my valium? No side effects from it and it works. And I've never abuesed it. Nope he first has his nurse call back and say take resperidol. And when I said I'm not going there. She called back again and said zyprexa. Again I said no and I never went back and stopped the lexapro too. By the way do you have trouble getting meds you need? Any suggestions how I can get someone to prescribe my valium since I've now moved to Charlotte? What part of the country do you live in. Yes I am very nosey. I'd give you my E-mail address but you seem to want to remain anonymous. But again I make the offer to Babblemail me and I'll send it to you. You are so knowledgeable about meds. I'd really like to talk with you. And I don't stalk people ask anyone on the board. Fondly, Phillipa
Posted by med_empowered on November 7, 2005, at 21:32:00
In reply to Re: Atypicals for anxiety » med_empowered, posted by Phillipa on November 7, 2005, at 19:04:05
hey phillipa! OK, I'll try to get my babblemail to work..if it doesn't, feel free to post your email or whatever, and I'll get in touch with you.
Honestly, I dont know how to get a shrink to RX what works for you instead of trying all kinds of crazy crap. It seems that there's this "benzos bad" "atypicals good/antidepressants good" mentality that's kind of hard to breakthrough...I'm sure I come off as a drug seeker sometimes, but I don't really care. I tend to be really up front with my docs; if they say "try abilify/zyprexa/risperdal/lithium/whatever", I usually say "No, im not interested". I'm open about what's worked for me and what hasn't, and they sometimes seem to respect that (one doc did accuse me of being "manipulative"...if looking out for my own best interest is "manipulative," then fine. Personally, I think coaxing people to take over-priced, potentially dangerous drugs when there are cheaper and better ones available is both "manipulative" and completely counter-productive. But..that's just me).
I'm from the South, so if you want a good shrink (by my standards, at least), here's the formula I've found that works in the South:
1) female
2) a little bit older--not senile, just really experienced
3) Independent private practice, not hospital staff, unless you're feeling **REALLY** bad
4) In the first session, watch body language and language tone; if they come off as kind of arrogant, or unfriendly, or they talk more than they listen...don't go back. You want someone who listens, provides relevant insight, and seems interested in YOUR experiences.
5) It helps if they've published some--these tend to be better both at the bedside manner angle and the actual nuts-and-bolts of medication angle. If you can do some background searching on journal articles, try to do it.Good luck!
Posted by Phillipa on November 7, 2005, at 21:40:18
In reply to Re: Atypicals for anxiety, posted by med_empowered on November 7, 2005, at 21:32:00
Okay now no more excuses. Just click on my name in blue. That will allow you to send ME a Babblemail. And I will inturn send you my E-mail address. But you will have to send me yours in the Babblemail to me if you don't have your Babblemail on. That would eliminate the need to activate it. And I'm in the South too. And believe it or not my pdoc from Greenville was older 60's I'd say. And published numerous articles. Now I need to find one in Charlotte. Fondly, or your friend Phillipa/Jan
Posted by CareBear04 on November 8, 2005, at 10:22:06
In reply to Re: perphenazine, has anyone taken this? » CareBear04, posted by Sebastian on November 7, 2005, at 19:00:21
yep, I've taken zyprexa at 2.5mg. anything more than that would knock me out for the day, and even 2.5mg left me drowsy the next day. i guess the same can be said of perphenazine. i took 8mg once a day at bedtime, and it made me soooo tired. good luck.
Posted by Tepiaca on November 10, 2005, at 21:44:31
In reply to perphenazine, has anyone taken this?, posted by Sebastian on November 6, 2005, at 11:01:06
> I've read an interesting study which included perphenazine, the CATIE study. They had a lot of good things to say about it. I was wondering if anyone had the experience of taking it and could share there experiences. Does it realy have a low chance of extra piramidaly side-effects.
I took it in a med that is a combination of
amitryptiline-diazepam and perfhenazinethis med has good anxyolitic effetcs. However
I had uncontroled muscles movements that Iam sure the pherfenazine was responsible of.In that time, one guy posted a message saying that he got Tardive Diskinesia at only 4mg per day
of perphenazine .I got scared and I stop taking
itI hope this helps you Sebastian
TEP
Posted by Phillipa on November 11, 2005, at 0:02:42
In reply to Re: perphenazine, has anyone taken this? » Sebastian, posted by Tepiaca on November 10, 2005, at 21:44:31
Hi Tepiaca how are you doing? Any better? Love your friend, Phillipa
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.