Posted by SLS on February 26, 2003, at 21:09:41
In reply to Re: Anyone on typical antipsychotics?, posted by stjames on February 26, 2003, at 14:27:05
Hi James.
> My experience is they all cause TD or EPS
Forgive my sieve of a hippocampus, but which atypical neuroleptics have produced EPS in you?
> at far too high a rate to be a resonable treatment for all but the most ill psychotic persons.
Do you feel it is reasonable to use Zyprexa to treat the most refractory of treatment-resistant non-psychotic affective disorders - especially when it works so well?
It might take another 10 years to more fully evaluate the potential for Zyprexa to produce serious irreversible side-effects. From what I can see so far, it doesn't seem to have a great potential to do so.
When I was first offered to use Zyprexa for my treatment-resistant bipolar depression, I was scared and refused. The term "tardive dyskynesia" was as frightening to me as the word "cancer". Even a 0.00000000001 percent risk was too great for me to consider. My feelings have since changed. Unfortunately, our current pharmacopoeia leaves wide gaps in offering drugs that treat all cases of axis-I disorders adequately, let alone safely. I seem to have fallen into such a gap. As you know, James, my doctors have been trying to obtain a long-term antidepressant response for me since 1982. With the exception of a 9-month period in 1987, they have failed while using an armamentarium of both traditional and exotic treatments. For me, I deem the risk of TD using Clozaril, Zyprexa or Seroquel close enough to zero to opt for using these drugs - at least until they can be replaced with something else that works. And they DO work. I guess each of us who fall into treatment gap must balance for himself the pros and cons of any particular treatment.
I recently began taking Abilify. Using the data produced by the few pharmacological investigations available, there are some theoretical predictions of a virtual zero risk of motor EPS and TD. The studies indicate that Abilify does not accumulate in the striatum, the region of the brain thought to be involved in producing these side-effects through receptor supersensitization. I am not so convinced, although I have no evidence to speculate otherwise. I just don't like the fact that Abilify has such a high binding affinity to postsynaptic D2 receptors. However, with what little exposure I have had to information - both public and sequestered - and the thoughts and judgments of the many clinicians I have had personal contact with, I remain convinced that these drugs are valid choices for some people who suffer from non-psychotic mental illnesses.
That's just me, of course. I guess I have become sufficiently sick-and-tired of being sick-and-tired to be more receptive to risk in exchange for a potential cosmic benefit.
What about hiccups?
- Scott
(I didn't have the energy to proofread this).
poster:SLS
thread:204030
URL: http://www.dr-bob.org/babble/20030224/msgs/204155.html