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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by lostforwards on November 2, 2004, at 14:52:56
I don't know if this is parkinsonian anymore..
I'm going to make a few assumptions, correct me if I'm wrong. First, I think a drop in dopamine levels is a trigger for sleep.
If you take a dose of antipsychotic at night to artificially drop dopamine levels every night while taking another antipsychotic in the morning ( gradually increased ) which is the reason itself that you can't sleep, will you just dig yourself into a pit? Would this have any effect ( changes in receptor densities ) that would lead to the symptoms I'll mention later.
Will you eventually settle your brain into a sleep-wake cycle where dopamine just goes between really low ( sleep ) and low ( awake )? What long term effect would this have after quitting the medication?
Why do I feel so screwed up after this? Typical parkinsonian would include tremor, and rigidity. My arms just don't swing and I've got clouded states of mind, very numbed emotions, even amoral thoughts sometimes. These are not symptoms of my illness and never were.
****AFTER taking a dose of lithium one of my arms sort of swings ( and lithium lowers dopamine ) but my mind goes completely blank***
It's like I've got very low dopamine levels and they just keep moving from place to place.
Posted by jboud24 on November 2, 2004, at 18:10:25
In reply to Somebody think this through for me..., posted by lostforwards on November 2, 2004, at 14:52:56
Gosh this is complex. I think whoever put you on 2 antipsychotics probably made a mistake in doing so. I mean their intentions were probably good, its just that unless your dopamine levels are extremely elevated, ala psychosis/schizophrenia, anti-psychotics, particularly that anti-psychotic you were taking that was a typical (the other one, not the risperdal) probably lowered the dopamine levels to too low a level. I mean, even very low dose Risperdal antagonizes DA2/3 receptors to a high degree, so adding a phenothiazine that targets only the D2/D3 receptors probably lowered the DA levels too much.
You're going to have to respond back and tell me the current dose of the Risperdal (I still remember the old dose of 1,2,and 3mg) and the name (chemical if possible) of the phenothiazine you took and at what dosages and for how long you took the phenothiazine. Also, what country do you live in?
I think you should look into a drug that will assisst you in overcoming the AP-induced side-effects that could modulate or restore some of the DA function back to a better level. I don't remember what your diagnosis is exactly, but Abilify at low doses may help alleviate the side-effects you are experiencing by exerting a stabilizing function on your DA system. I also strongly believe that a drug call Mirapex (pramipexole) would alleviate all if not most of the AP-induced side-effects. In case you dont know what Mirapex is, it is a dopamine agonist used to treat Parkinson's and Restless Leg Syndrome, as well as off-label uses for depression and anxiety. I really think that Mirapex could help you.
Lostforwards, I know what you are going through is rough, and my prayers are with you. If you need anything else, don't hesitate to ask!
Best Wishes
Justin
Posted by linkadge on November 2, 2004, at 19:34:10
In reply to Somebody think this through for me..., posted by lostforwards on November 2, 2004, at 14:52:56
Sounds a little bit more complex that just high/low dopamine. I think you are right that a general lowering of dopamine facilitates some aspects of sleep (ie decreased altertness)
Sometimes withdrawl from an antipsychotic can exasperate movement problems.
Lithium is not as simple as dopamine lowering.
It does lower dopamine in certain regions of the brain. But I don't think it lowers dopamine in the movement areas of the brain. Ie vitamin C lowers dopamine in the hippocampus, but increases dopamine/noradrenaline in the frontal cortex.
Lithium is extremely neuroprotective and neurotropic. I would stick with it if it works, cause you may see an improvement in your movement symptoms.
Jog as much as you can. Jogging can not only improve mood, but it will really facilitate your adjustment to your current meds as well as your movement.
Linkadge
Posted by lostforwards on November 3, 2004, at 7:01:22
In reply to Re: Somebody think this through for me..., posted by jboud24 on November 2, 2004, at 18:10:25
I was on Nozinan 10mg at night for 4 weeks, but I didn't take it every night, so it was probably more like 2 or 3 weeks. I'm off the Risperdal now. I tried going back on 0.5mg a while agao just to see what would happen but within one dose I ended up having difficulty breathing ( a symptom I had at 3mg in the hospital ). I did feel a little better - closer to normal, as if it had alleviated some of the drug induced negative symptoms. I'm bipolar. I live in Canada.
One weird thing that happened while I was ON the medication, at 3mg of Risperdal, is I hallucinated. Also, while i was on the Risperdal, regardless of the dose, I felt normal, as I usually do. It's only after discontinuing that I got all of these negative withdrawal symptoms - including the missing arm swing. My arms were swinging on 3mg Risperdal.
Posted by ed_uk on November 3, 2004, at 7:30:49
In reply to Re: Somebody think this through for me... » jboud24, posted by lostforwards on November 3, 2004, at 7:01:22
Hi :-)
I think your problems may indeed be related to the Risperdal but are probably nothing to do with the Nozinan (levomepromazine/methotrimeprazine). Such low doses of Nozinan have little effect at dopamine receptors.
The difficulty breathing could have been due to a dystonic reaction. Antipsychotics can rarely cause airway obstruction due to pharyngeal/laryngeal spasm.
Ed
This is the end of the thread.
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