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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by DanielJ on October 20, 2003, at 13:24:20
After reading several posts today, I have to ask this question. I have noticed some patients are taking anti-psychotic meds for insomnia, anxiety etc even though they do not have psychosis. Are there risks taking these drugs for lesser problems? Could they in fact cause psychotic behavior in a patient who doesn't have them prior to taking them? They are powerful drugs with an intended use, isn't it a risk to use them where other medications with less side effects would suffice? ps Just asking.
Posted by Penny on October 20, 2003, at 14:16:31
In reply to Anti Psychotics for Insomnia and ?, posted by DanielJ on October 20, 2003, at 13:24:20
> After reading several posts today, I have to ask this question. I have noticed some patients are taking anti-psychotic meds for insomnia, anxiety etc even though they do not have psychosis. Are there risks taking these drugs for lesser problems? Could they in fact cause psychotic behavior in a patient who doesn't have them prior to taking them? They are powerful drugs with an intended use, isn't it a risk to use them where other medications with less side effects would suffice? ps Just asking.
Actually, many sleep meds have more side effects than the atypicals. I have been on both Seroquel and Geodon with *no* side effects (other than the intended SE of drowiness), and actually have also reaped the benefit of Geodon calming me when I was feeling suicidal. I have also been on Ambien and Sonata with no problem. But a good friend of mine took Ambien and experienced hallucinations.As with all psych meds (and with other meds), the 'FDA approved use' doesn't mean that's all the med is good for. I've taken propranolol (a beta-blocker) for migraines. Lamictal was only recently approved for use as a mood stabilizer, but has been used in that way for a while, even though it was initially intended as just an anticonvulsant.
P
Posted by DanielJ on October 20, 2003, at 15:23:50
In reply to Re: Anti Psychotics for Insomnia and ?, posted by Penny on October 20, 2003, at 14:16:31
This is fascinating. A family member of mine is taking 20 mg Zyprexa and 75 mg Zoloft for Schiz/etc. I know the Zyprexa can put a person to sleep, he never complains of nightmares. To much Zoloft makes him Giddy and similar to Intoxication. A cut back of 25% and he is on a even keel again. This medication stuff is pure wizardry and in some cases it can truly perform miracles. One tricky thing though often there is a period of adjustment before the drug takes significant effect. This can be confusing and difficult to deal with. Thanks Penny!
Posted by galkeepinon on October 20, 2003, at 20:25:55
In reply to Anti Psychotics for Insomnia and ?, posted by DanielJ on October 20, 2003, at 13:24:20
I think there are risks, but more so just side effects of taking these AP's for anxiety/sleep instead of psychosis.
I know doctors prescribe AP's for symptoms other than what they are prescribed for (psychotic/psychosis behavior/schizophrenia).
It's prety universal, IMO.
I see it as, 'I take Seroquel and it actually helps me *not* be angry, and/or ruminate on little things that tick me off', rather than 'causing psychotic behavior in a patient who doesn't have them prior to taking them'.
I like that Seroquel does that for me.
I hit rush hour this morning. I just said everyone else is feeling the same thing, I'll deal with it. I hadn't been on the freeway for weeks, and the people who travel it for work everyday~Wooooooweeeeeeee. More power to them.
Today I was advised though, to take 50mg of the Seroquel for sleep, instead of the 100/200mg I was taking for sleep.
Hope this helped some...
Take care> After reading several posts today, I have to ask this question. I have noticed some patients are taking anti-psychotic meds for insomnia, anxiety etc even though they do not have psychosis. Are there risks taking these drugs for lesser problems? Could they in fact cause psychotic behavior in a patient who doesn't have them prior to taking them? They are powerful drugs with an intended use, isn't it a risk to use them where other medications with less side effects would suffice? ps Just asking.
Posted by DanielJ on October 21, 2003, at 7:28:30
In reply to Re: Anti Psychotics for Insomnia and ? » DanielJ, posted by galkeepinon on October 20, 2003, at 20:25:55
Hi Gal,
What I meant by symptoms of psychosis was hallucinations and delusions etc. and of course this could be a bad thing. We are all just trying to hang in there and make it through another day. A few years ago I had tremors and insomnia. An MD prescribed Tranxene and Halcyon which probably would have been OK for someone else but it made me angry and explosive. After 2 months he figured out hypoglycemia (low blood sugar) was the problem and discontinued the drugs. Years later I found out Diet Coke was causing the tremors etc. (nutra sweet). I gave up diet soft drinks for 2 weeks and my low blood sugar symptoms disappeared. I still drink regular coke today 7 years after symptoms disappeared but I do not drink anything with nutra sweet or eat diet cookies etc.
I guess if a person experienced strange and bizarre effects from any medication, they should get right back to their Dr. and let them know what is happening so changes could be made. See Ya Dan J.
Posted by nickm on October 21, 2003, at 9:12:13
In reply to Re: Anti Psychotics for Insomnia and ?, posted by DanielJ on October 21, 2003, at 7:28:30
I guess I cannot trust psychopharmacologists so easily. My wife was put on Zyprexa, Prozac, Provigil, Lamictal, and Klonopin. In March she developed EPS symptoms, tremors of lips and hands, and a shuffling gait. Her doctor wouldn't admit that Zyprexa and/or Prozac or both could give such symptoms. Wouldn't even discuss it!!!
My wife changed doctors. The minute she went off Prozac, the EPS symptoms improved. The minute she went off Zyprexa, all the symptoms disappeared.
The new doctor put her on Abilify, the akathisia, dysthonia, and EPS came back, and she developed panic attacks as well as lost all appetite, and couldn't sleep. Her Klonopin doses were augmented to 4-5 mg per day even if she's over sixty. She began to need more and more Klonopin.
A third doctor wanted to give her ECTs, and did it by saying to her, "You will die if you don't have them." She had five and almost died. A month after the ECTs she still has long term memory loss, inability to sleep, and confusion.
During and after the ECTS she was kept on Serzone, Trazodone, Ambien, and Abilify. She dropped the Abilify on October 12, and yet a new doctor gave her Benadryl to help her sleep and alleviate the EPS-Parkinson symptoms. The akathisia is subsiding and hopefully she will be able to gradually go off Klonopin.
This last doctor also confirmed what I had already read about Zyprexa and Serzone. Zyprexa, with its weight gaining properties (My wife gained thirty plus pounds) can eventually help you develop diabetes or hyperglicemia. First of the four doctors she's seen who's been willing to admit to this. He also told us he wouldn't prescribe Serzone because of its black dot on the Physcian's Referal's Manual, on the Drug's Box, and its banning in Europe and Canada for potential liver damage.
All these medications are a knife with two edges. And none of them helps - in our experience - for more than a few months.
Good luck,
Nickm
Posted by Penny on October 21, 2003, at 9:20:42
In reply to Re: Anti Psychotics for Insomnia and ?, posted by nickm on October 21, 2003, at 9:12:13
I'm sorry to hear about your wife's experience. It just serves to emphasize how important it is that you see a competent doctor - someone who knows about these things AND is willing to share that information with you!
I am fortunate to have a doc who is aware - we were just talking on Friday about Zyprexa and the risk of diabetes, after I was reading about it here on babble. He is the same doc who prescribed Geodon for me - and he gave me an EKG before putting me on it, as is recommended. The doc I had prior to him was the one who prescribed Seroquel, and also had me on 80 mgs of Paxil, which was terrible for me. I was having major side effects. His comment to me then was that I needed ECT. My response was that I needed a new doctor.
I found my new doc through sheer luck - he's a neuropsychiatrist, not just a psychiatrist, and he's always very upfront with me about side effects, and he monitors me closely. If I start having trouble with something, he doesn't let it continue. It's unfortunate that more people can't have doctors like the one I have.
P
Posted by judy1 on October 21, 2003, at 9:45:40
In reply to Re: Anti Psychotics for Insomnia and ?, posted by nickm on October 21, 2003, at 9:12:13
I have a similar med history to your wife (even down to the recommendations for ECT which I refused). I also developed EPS from APs and get concerned when I see it prescribed for anything but psychotic states. I imagine it's all perspective- if people don't develop the type of symptoms I (and your wife) did, they find APs a helpful class of drugs. It took several pdocs to find one who didn't put me on a 'cocktail' of 6 or more meds. I'm glad you were able to find a doc that isn't a med pusher, and actually spends the time to discuss side-effects of different meds. Best of luck to your wife- judy
Posted by Camille Dumont on October 21, 2003, at 14:06:41
In reply to Re: Anti Psychotics for Insomnia and ? » DanielJ, posted by galkeepinon on October 20, 2003, at 20:25:55
Well ... for me the drwosiness was to great compared with the insomnia ... however I think that the important variable here is dosage.
I was on 50 mg Seroquel and it knocked me out cold at night whereas when it is prescribed for psychotic episodes control its at much higher doses like 300 and beyond.
Posted by sean7 on October 24, 2003, at 2:40:10
In reply to Anti Psychotics for Insomnia and ?, posted by DanielJ on October 20, 2003, at 13:24:20
The reason doctors give people antipsychotics and antidepressants for insomnia is because all the other drugs for insomnia such as halcion or ambien are habit forming.It seems to me doctors would rather test other drugs on you than you become addicted to the normal ones.
Posted by Dinah on October 24, 2003, at 19:50:38
In reply to Re: Anti Psychotics for Insomnia and ?, posted by sean7 on October 24, 2003, at 2:40:10
Geez, I hope that isn't why. Becoming physiologically dependent on klonopin seems like a far better risk than the risk of permanent movement disorders or diabetes from antipsychotics.
Mind you, I think antipsychotics are excellent for anxiety, and in cases where nothing else is effective I can certainly see that they're worth a certain degree of risk.
But I would hope that it would be based on more than a fear of dependence on the part of my pdoc.
Posted by silmarilone on October 25, 2003, at 23:22:01
In reply to Re: Anti Psychotics for Insomnia and ? » sean7, posted by Dinah on October 24, 2003, at 19:50:38
That IS why. That, and MARKETING.
> Geez, I hope that isn't why. Becoming physiologically dependent on klonopin seems like a far better risk than the risk of permanent movement disorders or diabetes from antipsychotics.
>
> Mind you, I think antipsychotics are excellent for anxiety, and in cases where nothing else is effective I can certainly see that they're worth a certain degree of risk.
>
> But I would hope that it would be based on more than a fear of dependence on the part of my pdoc.
Posted by galkeepinon on October 26, 2003, at 0:12:38
In reply to Re: Anti Psychotics for Insomnia and ?, posted by silmarilone on October 25, 2003, at 23:22:01
Posted by silmarilone on October 26, 2003, at 0:15:06
In reply to Re: Anti Psychotics for Insomnia and ?, posted by silmarilone on October 25, 2003, at 23:22:01
why, thank you! likewise. feel free to email me, [email protected]
Posted by galkeepinon on October 26, 2003, at 0:16:49
In reply to Re: Anti Psychotics for Insomnia and ? » silmarilone, posted by silmarilone on October 26, 2003, at 0:15:06
:-) I will :-)
Posted by tiredman on October 26, 2003, at 18:24:13
In reply to Re: Anti Psychotics for Insomnia and ?, posted by sean7 on October 24, 2003, at 2:40:10
I am in the middle of a “severe reactive depression” (as my pdoc puts it). For a few weeks 1.5 mgs Lozazapam worked fine. Then 2.0 mgs were needed. Then I would wake up after 4 hours. My pdoc put me on Trazadone as well but I still woke up because of the anxiety. I tried Seroquel but it made me more jumpy. I just tried a small dose of perphenazine and it seems to work on the anxiety. I am scared about the nasty side effects of this 30 year old anti-psychotic but I am risking the small dose because it is the only thing that has given me relief. I still feel like crap, but I’m not jumping out of my skin.
Posted by Nickm on October 29, 2003, at 11:23:05
In reply to Re: Anti Psychotics for Insomnia and ? » nickm, posted by Penny on October 21, 2003, at 9:20:42
Thanks to Judy1 and Penny. Yes, I had read the warnings in Prozac Backlash by Glennmullen, but he mostly talked about SSRIs causing parkisoninsm, akathisia, etc. He didn't talk much about APs in his book. When I first confronted the psychiatrist treating my wife, in March 2003, she was resentful and asked me - politely - to leave her office (I had been polite, and presented her with a letter from a neurologist telling her to consider reducing SSRIs, antipsychotics, and lamictal, provigil, klonopin - she was on a cocktail of six). The psychiatrist then told my wife "Your husband is interfering with my treatment." Instead of evaluating what was happening as side effects, and taking that into consideration. She then referred my wife to the quack that performed the ECTs, and he too refused to diagnose parkisonism caused by medications, and instead added OCD symptoms "very somatic" to account for my wife's obvious symptoms of involuntary movements and rigidity.
Thanks to both of you,
Nickm
This is the end of the thread.
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