Posted by MARTY on March 24, 2006, at 16:39:41
Greetings,First, I already thanks you for the time you will take to read my post. It is long because I had 2 objectives in writing it; to get help from the very knowlegeable and kind people of this forum AND also freeze on the Internet something that could be instructive and helpful.
BTW, I'll give 500 points to anyone who find a solution to my problems :P
Before exposing my atypical and very rare problems/symptoms, here's some facts..
that you can skip if you already know about them.+=--- The facts; Acethylcoline 101, effects of antipsychotics, ExtraPyramidal syndrome, parkinson etc.
1: I've been prescribed Procyclidine, which is and anticholinergic drug usually prescribe to treat symptoms of Parkingson.
2: I'm taking Risperdal, an antipsychotic, to help with my anxiety and depression.
3: Antipsychotics usually works by antagonisim (diminishing) Dopamine neurotransmitter in the brain.
4: Antagonisim Dopamine sometime create an imbalance with another neurotransmitter called Acethylcoline; Too much Acethylcoline, not enough Dopamine to counteract. This condition, when symptoms are strong and disabling, is called ExtraPyramidal syndrome.
5: ExtraPyramidal syndrome, or weaker Dopamine/Acetylcoline imbalance, symptoms usually are similars of the symptoms of Parkingson, which also create an imbalance between Dopamine and Acethylcoline.
6: When strong, symptoms are tremors or trembling; difficulty maintaining balance and gait; rigidity or stiffness of the limbs and trunk; and general slowness of movement (also called bradykinesia),dry mouth, blurred vision, constipation, confusion, drowsiness, poor memory (especially visual), and slowness at learning.
7: Acethylcoline Antagonist, like procyclidine, helps by reestablishing balance between Dopamine and Acethylcoline by diminishing Acethylcoline in the body nerves, muscles and the brain.
+=--- My diagnostic and current Cocktail ...
Diag: Generalize Anxiety, Social Phobia which is supposedly modulate (follows) a not yet confirmed Bipolarity type 2 (maybe Type 2.5 (or Type 4) which is hypomania only caused by some antidepressant, 1 episode)
Cocktail:
MAOI (Nardil 60mg) antidepressant
Lamictal 150mg BID (300mg/day)
Neurontin 100mg when needed (help anxiety and sexual side-effect)
Risperdal .5mg at sleep time
and newly added Procyclidine 2.5mg 3/day...+=--- My problems ...
When I take an antipsychotic (Risperdal, Seroquel, etc), I'm suffering very atypical symptoms:Since I've withdrawn from CLONAZEPAM (benzodiazepine anxiolitc)4 months ago, I got strange sensations in my face, sometimes like waves of tingling, dull pain mixed with electric shock in some part like teeth, gums, palate, jaw, nose. I also got pressure in my eyes and bizarre sensation behind my eyes like if the optical nerves are swollen. Also, this is causing weird and strong Anesthsia of the nose, cheecks, near ears and sometime on top of my skull. Those symptoms are 1 day on 5 painfull, sometime are partially disabling and doesn't help my depression.
This is usually starting after diner and get to his paroxism in the evening.
Those symptoms stop when I withdraw (catastrophic results) from Risperdal (antipsychotic, dopamine antagonist) and comeback when I'm back on an antipsychotic (Risperdal OR Seroquel). I've found some CLONAZEPAM, and against what my Pdoc will, took some to see the effect on my facial symptoms; remember that all this started with a withdrawal of Clonazepam. The clonazepam did atenuate the force of the symptoms.
The procyclidine that I started 4 days ago, for the second time, totally solve the problem. This indictate that I suffer from an imbalance between Acetylcoline and dopamine caused by my antipsychotic Riperdal. But at a cost...
BTW; I only take .5 mg of Risperdal ! (this is a very small dose compare to the majority of people who are taking 3-4 mg)
And when I take procyclidine (very small dose also) I'm feeling bad; difficulty speaking, little anxiety, different sens of reality, walking and moving differently, very weird.
I have a hard time with it. Enough to have the dilem between face problem vs Procyclidine.So here's where you could help me..
* Have you ever heard of a similar story ? Face symptoms ? different part of the body ?
* How can such a small dose of antipsychotic can cause all those problems ?
* Is there something, other then Acethylcoline Antagonist, I could try ? (Challenge: I'm on a MAOI, Nardil 60mg which even interact with meds you don't even take ;) )
* Could procyclidine lower too much my Acethylcoline level causing an inverse inbalance making the procyclidine very unpleasant to take ?
* Could those symptoms caused by an underlying physical condition like dental problems ? a small benign tumor (not dangerous) in the sinus (I have one) ?
* What could be the link between Clonazepam withdrawal face symptoms appearance and cause by Risperdal that I was, with Seroquel, taking a couple of months before the withdrawal ?
* Since it is drug induced, what are the probability that the whole think is something 'physical' like Facial Anaesthesia or Atypical Face Pain syndrome ?
Thank you for you time ... know that it is very much appreciate.Best Regards,
Marty
poster:MARTY
thread:624235
URL: http://www.dr-bob.org/babble/20060322/msgs/624235.html