Posted by medlib on July 27, 2001, at 14:41:02
In reply to NMDA agonists to prevent TD?, posted by chloe on July 26, 2001, at 19:43:47
Hi Chloe--
Memantine is an NMDA *antagonist*. AndrewB talked about it on July 16th (Message # 70284) in relation to stimulant "poop-out." Also, Geodon and other atypical antipsychotic meds are dopamine antagonists, not agonists (so you're not really a dopamine "junkie").
BTW, you had asked me earlier about TD and EPS (sorry, I haven't been online in a few days). EPS is a whole umbrella of movement abnormalities, including akathisia, dystonia, torticollis, dyskinesia, RLS, rigidity, chorea, etc., which can affect parts or all of the body and which can occur at various times during treatment. "Tardive" just means "late onset," and refers to dyskinesia or dystonia which occurs only after 6 months or more of treatment. It is taken more seriously than other EPS symptoms because it can be irreversible, and because it becomes more likely to occur, and more severe, as the cumulative total of meds increases over time. You might be interested in this info on risk factors for EPS:
http://www.priory.com/psych/frames/risk.htm
You'll note in the last paragraph that the tongue symptoms you developed on Mellaril put you at high risk for EPS on other APs.
Some practitioners prescribe anticholinergic drugs along with APs to try to counteract or prevent EPS. Others use Symmetrel (amantadine). You can find info about that by going to Medscape Search Drugs and checking out the Pharmacology and Chemistry section for Symmetrel. I've heard of a few prescribing bromocriptine (an ergot-derived dopamine agonist) for EPS as well.
It's my impression that seratonin and dopamine receptors exist in a kind of balance, such that a big increase in one type can lead to an opposite effect on the other. (I've just ordered a S. Stahl book that will, I hope, improve my grasp of such specifics.) I do know that Celexa is a highly selective (and potent) SSRI; perhaps, a different AD that's not an SSRI, such as Serzone or Remeron or even a TCA would work better with Geodon for you.
For me, I've sent my pdoc some stuff on Mirapex (a dopamine agonist) and hope that he'll okay a trial on that. The endless hunt goes on....
Well wishes---medlib
poster:medlib
thread:71950
URL: http://www.dr-bob.org/babble/20010725/msgs/72095.html