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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Christ_empowered on September 4, 2022, at 10:56:19
it seems that many long term neuroleptic-treated people end up on high(ish) doses, over time. to me...this is disconcerting, because it invites all sorts of problems -in the aggregate- (emphasis because individuals may get good results; it is the overall not so good results that concern me).
I'm on aripiprazole. my current prescriber tells me this is a better option for the long haul. the internet tells me that -some- studies indicate that people treated with aripiprazole showed some gains in quality of life and satisfaction with the chosen neuroleptic vs older drugs and I think (?) some of the "atypicals," too. so...OK. neuroleptic selection for the long haul...done.
but dosage? I'm at 20. 15 would probably be better for the long haul. My treatment...is more humane and better than I've ever experienced previously, but still worrisome, at times. I have a good counselor, but I think he's more conservative and (oddly enough) has more -faith- in "the meds_ than...
many prescribers. so, what he regards as "paranoia" prompts a med check which results in a bump to 20 that has lasted for 1 or 2 years, now. thing is...
paranoia and being on edge -happen- , and that's the thing....this is heavy artillery.
how are you (generalized you; you out there, etc.) doing, long term, with major tranquilizers? dosage? tics and such? overall quality of life? my other issue...
I kind of wonder about the wisdom of staying on a full dose tranquilizer 24/7, for years and years and years on end. Especially since I'm prone to rather severe depression, it seems...not so ideal. but is it really "ideal" for anyone? just...take what you can, I guess? play the hand you're dealt? I don't know of any alternatives. honestly.
Posted by SLS on September 4, 2022, at 11:16:43
In reply to neuroleptic dosage, long term, posted by Christ_empowered on September 4, 2022, at 10:56:19
If I remember correctly, this was the rule of thumb regarding dosages of aripiprazole (Abilify):
2-10 mg/day = Major Depression; Bipolar Depression
10-20 mg/day = Bipolar Mania
20-30 mg/day = Schizoid DisordersOne study concluded that for depression, 5 mg/day was superior to 10 mg/day.
- Scott
Posted by Christ_empowered on September 4, 2022, at 17:30:08
In reply to Re: neuroleptic dosage, long term, posted by SLS on September 4, 2022, at 11:16:43
that makes sense. thanks. :-)
Posted by Jay2112 on September 14, 2022, at 3:59:57
In reply to neuroleptic dosage, long term, posted by Christ_empowered on September 4, 2022, at 10:56:19
Hi C_e:
I have been on ap's for just over 20 years. I started on ad's about 30 years ago. Now, when I first started the ap's, I thought I would eventually get td, and I do have some very, very mild tremors once in awhile, but not as much as when I was on a very high dose of Prozac. The SRI's do act, sort of, as in a similar method as ap's, suppressing dopamine.
I thought, with the combo of Prozac, Risperdal, and occasional Nozinan (an older ap, similar, but IMHO, way, way less harsher, than the effects of Seroquel) that I would get td, and the Thorazine 'shuffle' at my age. But, as long as I keep a steady, but low dose of my current ad, Effexor, I tolerate the Risperdal and Nozinan very well.
I am also considering using the Nozinan as a prn, and may be adding in a low dose of Abilify. I have some Abilify in my med chest, and am slowly adding it to my regiment. I also am looking at going to a neurologist for a brain health 'check-up', as I am 53, and think it would be a good idea.
My general persona is to be a quite laid-back individual, and a bit shy, and I have finally started to accept and make peace with that. I used to think ad's would make me more 'sharper' and 'resilient', and ap's make me less stressed. But with good counselling, or maybe it's age, I find I am a bit more content and happier with myself. My bipolar disorder was really aggravated by way too high doses of meds overall.
So, that is just 'IMHO', etc.
Best,
Jay
Posted by undopaminergic on September 14, 2022, at 8:29:22
In reply to Re: neuroleptic dosage, long term » Christ_empowered, posted by Jay2112 on September 14, 2022, at 3:59:57
> Hi C_e:
>
> I have been on ap's for just over 20 years. I started on ad's about 30 years ago. Now, when I first started the ap's, I thought I would eventually get td, and I do have some very, very mild tremors once in awhile, but not as much as when I was on a very high dose of Prozac. The SRI's do act, sort of, as in a similar method as ap's, suppressing dopamine.
>
> I thought, with the combo of Prozac, Risperdal, and occasional Nozinan (an older ap, similar, but IMHO, way, way less harsher, than the effects of Seroquel) that I would get td, and the Thorazine 'shuffle' at my age. But, as long as I keep a steady, but low dose of my current ad, Effexor, I tolerate the Risperdal and Nozinan very well.
>
>Parkinsonism, such as tremor, is an acute (and dose-dependent) effect of antipsychotics. Tardive dyskinesia is a problem that develops much later, and consists of dyskinesias, involuntary movements, especially of the facial muscles and tongue.
Second-generation antipsychotics are regarded as less liable to produce TD, but some authors suggest that it is a matter of dose, and that older antipsychotics have been overdosed in comparison to newer ones. More specifically, older off-patent antipsychotics are deliberately overdosed in clinical trials in order to make the new drug look better in comparison.
-undopaminergic
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