Posted by Mitch on July 25, 2001, at 0:12:16
In reply to Now I am a dopamine junkie. » Mitch, posted by Chloe on July 24, 2001, at 19:12:03
Chloe,
I also had a definitely positive response to conventional and atypical AP's (at low-doses) in the past and recently. After listening to your experiences and comparing them with my similar ones I conclude this should be a rule of thumb for ANY pdoc:
IF THE PATIENT IS NOT HAVING PSYCHOTIC SYMPTOMS AND ESPECIALLY IF THEY ARE BIPOLAR, you SHOULDN'T BE PRESCRIBING ANY ANTIPSYCHOTICS!!! We are especially susceptible to their damaging effects upon dopamine function. Hey, it took me MONTHS to get over the dystonia caused by super-low-dose Risperdal over the course of just three weeks!!! And, I don't think I am back at "square one" like I was before I tried the med. I think Mellaril (thioridazine)and Thorazine (chlorpromazine) is no worse(at lower doses used for BP folks) compared to some of the newer stuff that is touted to be so "free from extrapyramidal symptoms". I was so fascinated with the *newer* AP's that "boosted serotonin to prevent EPS" that were developed and of course I wanted to try them (so I suggested them). I wished I would have kept my mouth shut (in hindsight).
It has already been proven that most people that present at the ER with florid manic symptoms can be controlled in most cases just as well with lorazepam or clonazepam or DEXEDRINE as they can by an antipsychotic. Well isn't it interesting that older meds just don't make any money nowadays?
Another thing is SSRI meds. We know that the extra serotonin decreases dopamine function and EVERY SSRI has "extrapyramidal syndrome" as a possible side-effect. I have also had similar problems with Celexa that you have described (and even worse dystonia with Paxil!).
"Start-up EPS" is not something like headache or nausea that goes away with continued treatment-it gets worse or it gets MASKED by the drug that is causing it.
I have no second thoughts recommending dx'ing of the Geodon. In my mind it is akin to damage control. I can tell from your posts that you have had no psychotic symptoms and you have not reported any.
Take care,
Mitch
poster:Mitch
thread:71234
URL: http://www.dr-bob.org/babble/20010720/msgs/71727.html