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Re: what drugs would kill off my remaining emotion

Posted by Squiggles on January 17, 2008, at 8:07:06

In reply to Re: what drugs would kill off my remaining emotion » CareBear04, posted by Jedi on January 17, 2008, at 2:25:29

You might want to check on the safety of
taking lithium along with antipyschotics.
Dr. Charles Nemeroff And Dr. Shatzberg,
in his "Recognition and Treatment of
Psychiatric Disorders: A Psychopharmacology
Handbook for Primary Care
", p. 105, Table
62. Common drug interactions with lithium--
lists a number of drugs with low to high
safety risk. For antipsychotics, the table
describes the following:

"May increase toxicity even with normal
lithium levels. Rare encephalpathic
syndrome (weakness, lethargy, fever,
increased Extrapyramidal Syndrome,
confusion) with irreversible brain damage
may be same as neuroleptic malignant syndrome;
may be more common with high-potency
antipsychotics (e.g. haloperidol).

The atypical antipsychotics --
clozapine, olanzapine, quetiapine,
respiredone) (p. 136) are much safer than
the typical antipsychotics, causing minimal
EPS, little TD, and have great advantages
for the negative as well as positive symptoms
of schizophrenia, for which they are
commonly used. They also cause minimum
cognitive impairment.
Clozapine does pose a great risk of agranulocytosis,
especially in people of Jewish descent.

Regarding the interaction of lithium with
atypical antipsychotics, i looked at the new
"Lithium in Neuropsychiatry: the Comprehensive
Guide
" (eds., Bauer, Grof, Muller-Oerlinghausen)
recently published, and on p. 65 under Table 7.2
(A Company-initiated parallel group designed
randomized cotrolled trials designed for drug
approval using lithium as a internal standard
to validate assay sensitivity, published in
peer-reviewed international journals, listed by year of publication) --
authors Bowden et al, Tohen, Sachs,
Yatham et al). resutls are listed.

This is what Licht, the author of this
chapter says, on p. 65:

COMBINATION THERAPY TRIALS:

"Several drug companies have tested
their atypical antipsychotic in combination
with lithium or valproate (Table 7.2). In
these studies, lithium or valproate combined
with respiridone, haloperidol, quetiapine,
or olanzapine, were modestly more beneficial
in controlling manic symptoms than the
monotherapy alone....."

So, it would seem that the antipsychotics
combined with lithium are not safe, and the
atypical antipsychotics are safe but introduced
as combination therapy by marketing initiatives.
This is the impression I get.

Squiggles



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poster:Squiggles thread:807143
URL: http://www.dr-bob.org/babble/20080114/msgs/807190.html