Posted by Sunnely on April 23, 2001, at 21:42:06
In reply to Re: Demerol Interaction, posted by Beverly Adams on April 23, 2001, at 1:13:42
Hi Bev,
Firstly, kudos to you for all your sacrifices and unselfishness in providing the needed care for your mom despite having major problems of your own.
Yes, there is such a thing as "respiratory dyskinesia" (RD). It consists of abnormal, involuntary movements of the respiratory muscles and clinically shows as an irregular respiratory rate, tachypnea (rapid breathing), and grunting. I believe you mentioned in your earlier post that your mom grunts or makes some funny noises while breathing. Aging (and presence of brain disease) appears to be a major risk factor for RD.
In one study, the prevalence (the number of cases at any given time) of RD is about 3.9% in patients with prior antipsychotic treatment. The prevalence rate is higher (17.5%) if accompanied by other symptoms of tardive dyskinesia (TD).
The diagnosis of RD is oftenly missed. When one talks of TD, most doctors, even psychiatrists, would immediately think of the classic TD (i.e., oral-buccal-lingual masticatory movement disorder or the mouth-and-tongue movement disorder). To make matters worse, RD can exist without the classic symptoms of TD. IMHO, in your mom's case, the long-term use of Prolixin is probably the culprit in the development of RD.
Good idea to have a respiratory specialist take a look at your mom. She may need a special test such as spirogram (a machine that records the rate, intensity, and pattern of respirations) and laboratory tests such as blood gases, among other things.
BTW, why was your mom on Prolixin for such a long time? Was she diagnosed with a major psychotic disorder such as schizophrenia? Just in case she needs antipsychotic treatment again, definitely avoid the older antipsychotics. The newer generation (atypical antipsychotics) such as olanzapine (Zyprexa) and quetiapine (Seroquel) are probably be the first choices. If she can tolerate clozapine (Clozaril), probably the best drug. However, use of this drug requires weekly blood count because of the risk of agranulocytosis (marked drop in white blood cell count) and aging is one of the risk factors for clozapine-induced agranulocytosis. Incidentally, there have been anecdotal reports of Clozaril being effective in tardive dystonia. Definitely avoid risperidone (Risperdal), although an atypical antipsychotic, Meige syndrome has also been reported with its use.
I included the following reference regarding RD (I'm sure there are more in the literature) for your info. Good Luck.
Hayashi T, Nishikawa T, Koga I, Uchida Y, Yamawaki S: Prevalence of and risk factors for respiratory dyskinesia. Clinical Neuropharmacology 1996;19:390-398.
P.S. I'm sure you know that Sunday, May 13 is Mothers' Day. Only the best for your mom.
++++++++++++++++++++++++++++++++++++++++++> Hey Thar Sunnely,
>
> Yes, I have read about TD. I did not know there was a respiratory one. I'll ask her GP about it and possibly getting her to see a RS. She needs help with her breathing and I want it close to home instead of 45 boring miles away.
poster:Sunnely
thread:60539
URL: http://www.dr-bob.org/babble/20010417/msgs/60923.html