Posted by JahL on February 12, 2001, at 19:16:36
In reply to Sulpiride, Tardive Dyskinesia and Me, posted by jimmygold70 on February 12, 2001, at 18:29:17
> I’ve suffered from anxiety disorders from many years so far. My diagnoses vary: Social Phobia (Consensus), Borderline Personality Disorder without temper outbursts (Psychologist), Avoidant Personality Disorder (Psychiatrist I), Schizoid Personality Disorder (Psychologist, Psychiatrist II), Obsessive-Compulsive Personality Disorder (Psychiatrist III).
> I have tried all sorts of medications: SSRIs (practically each and every), MAOI (phenelzine), RIMA (moclobemide), NARI (reboxetine), SNRI (venlafaxine), Novel (nefazodone,mianserin), Benzodiazepines (clonazepam,alprazolam,alprazolam XR).> Then, I suddenly come to know that sulpiride, which is available here in Israel, might be of help. My psychologist also insists that he sees it as helpful in similar situations, but, unfortunately, he cannot prescribe anything…
> My psychiatrist (No. III, the last one) insists that I should not take sulpiride, since it will cause me tardive dyskinesia. He has good reasons to believe that – my grandfather of my mother’s side took haloperidol in low doses for Bipolar for many years, and ended up with TD. My father took thioridazine in a low dose for a very short time for acute hypomanic episode, and had severe extrapyramidal symptoms. My psychiatrist insists that, regardless of my genetics, sulpiride is supposed to be effective but harmful in the long term, so he refused to prescribe it.
> Eventually, after many efforts, I managed to put my hand on sulpiride, and it does seem to work better than anything else before. I take 50mgx2 (probably the lowest dose possible). I have taken it for a couple of days with no side effects so far.
> Now, my plan is to use it for a month and see if it works. However, if I discover that it does (and so it looks so far) – I have a problem. No, it’s very easy to say “don’t take it – why take the risk ?”. But it might be the only available treatment that does work for me. In that case, I might look for two other senior psychiatrists, that would act as a “committee”, and see what they see (BTW I got the idea from the ECT approval here in Israel - you need 3 MDs to sign in order to get it…).
> 1. What do you think ?Personally speaking, the benefits from Sulpiride were apparent almost immediately and did not increase with time.
> 2. Have you seen any similar cases ?Sulpiride is the only drug to help with my social phobia. I take 150mg every morning.
> 3. Is there really any serious concern for TD with sulpiride in low doses ?
The psychiatrist who prescribed it said there was no cause 4 concern due to its specifity for (I think) D3 receptors. Other pdocs I have seen since have concurred with this opinion. However I've seen at least one article that says in practise Sulpiride is just as likely to cause TD as conventional APs.
Personally I'm a little concerned; it's not a drug I intend being on forever.
> 4. Are there any early signs for TD development (i.e. tremor) on sulpiride?
Apparently you should watch out for fine tongue vermiculations. I think this is so for APs generally.
> 5. And the most important Question (!) – In case sulpiride does work for me, can you think of another drug with similar pharmacology (olanzapine ??? anything ?!) that might help me with lower incidence of EP symptoms ?
Amisulpride?
Jah.
poster:JahL
thread:53827
URL: http://www.dr-bob.org/babble/20010212/msgs/53831.html