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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 Sebastian on October 8, 2005, at 15:52:20
Supposed to be the second best AP, just behind zyprexa. Without the weight gain.
Just wondering what this drug does and what are the side-effects. Want to hear the good and bad.
Posted by Sebastian on October 8, 2005, at 15:55:13
In reply to Anyone take Perphinazine?, posted by Sebastian on October 8, 2005, at 15:52:20
Posted by ed_uk on October 8, 2005, at 16:13:13
In reply to Anyone take Perphinazine?, posted by Sebastian on October 8, 2005, at 15:52:20
Perphenazine is one of the 'classical' neuroleptics, it's similar in many ways to haloperidol (Haldol).
~ed
Posted by Phillipa on October 8, 2005, at 18:23:12
In reply to Re: Anyone take Perphinazine? » Sebastian, posted by ed_uk on October 8, 2005, at 16:13:13
That doesn't sound good! Fondly, Phillipa
Posted by med_empowered on October 8, 2005, at 19:03:34
In reply to Re: Anyone take Perphinazine?, posted by Phillipa on October 8, 2005, at 18:23:12
hey! Like Ed said, perphenazine (Trilafon; also found in Triavil, the perphenazine+elavil combo, and in Etrafon, a perphenazine+elavil combo w/ slightly different perphenazine:elavil ratio) is a "classical" neuroleptic, so it is kind of thorazine/haldol-ish. Until recently the official line has been that *all* of the old neuroleptics were pretty much the same in terms of efficacy and side-effects, which just isn't true. One reason the atypicals looked so good on paper early on is that reserachers tended to use haldol at high-ish doses (20mgs or so)...haldol is very potent, and tends to produce **marked** extra-pyramidal symptoms (EPS). Perphenazine **can** do the same--there are lots of variables consider with it, like dosing, individual characteristics, and such--but it isn't **as** big a problem as haloperidol. Just like Zyprexa, perphenazine in its day was used in combo with antidepressants to deal with psychotic depression, depression in schizophrenia, treatment-resistant depression, etc. So...its kind of a mixed-bag. From what I read, some of the metabolites of perphenazine are rather atypical-ish in terms of their actions, and this may be why perphenazine compared so well to the new drugs. Like you said, weight gain and metabolic syndrome isn't a big problem with perphenazine, and the stuff is really, really cheap, especially compared to the new drugs like Abilify or Zyprexa. I also read an article about "making an atypical" by combining perphenazine with other medications (I think it was Remeron and/or Buspar in this study, but I'm not sure)...apparently, the results were pretty good and cost effective, and the overall side effects were still pretty good with the polypharmacy approach as compared to monotherapy with zyprexa. Its worth noting that although haldol is **rough** stuff, it also compared pretty well with zyprexa; one study compared 5mgs zyprexa with co-prescribed cogentin to take care of EPS w/ zyprexa monotherapy (the zyprexa dose was set by the doc at his/her discretion). Even with the additional ill-effects of the anticholinergic drug (mental dulling, etc.), the haldol group was virtually indistinguishable from the zyprexa group except on concentration, and I believe that difference barely rose to statistical significance, so it wasn't a big difference. If you're going to go for an old school antipsychotic, I'd recommend trying to get a co-prescribed benzo; not only with this help deal with any akathisia that may emerge, it can also help tremendously with anxiety, tension, agitation, AND it helps keep the dose of the antipsychotic at a minimum. Since Remeron may help with akathisia and/or the negative symptoms of schizophrenia, that may be a worthwhile add-on, too; Buspar is an odd drug that seems to help some people when combined with an antipsychotic (helps with akathisia, might help small group of people with tardive dyskinesia, etc.)...that may be worth looking into. Also, Provigil helps the negative symptoms of schizophrenia (so do other stimulants, but dosing is tricky and there's always a risk of inducing psychosis). Good luck!
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