Posted by King Vultan on December 12, 2004, at 20:41:52
In reply to Movement Disorders from Risperal .25mg/d options?, posted by fachad on December 12, 2004, at 14:29:31
> My wife was prescribed Risperdal 0.25mg/day for anxiety.
>
> To me that seemed like a bad idea - a benzo would have been much safer, but I think her pdoc is a benzophobe.
>
> Anyway, she is now showing signs of TD, twitches of hands and arms, especially when falling asleep.
>
> What are the options at this point? If she stops the Risperdal, she will have horrific anxiety and aggression.
>
> Does she switch to another atypical AD or is her doc going to have to face her fears and RX for a benzo?
>
> P.S. Beta blockers do not work, that was the first thing her pdoc tried.
I highly doubt this is TD--I've noticed the twitching you describe while falling asleep on Nardil, as well as on a combination of desipramine and low dose Zoloft. I do not know what the exact mechanism is, but it is apparently related to either serotonin or dopamine. Assuming your wife is not taking another drug which is causing blood plasma levels of the Risperdal to increase, or that she is not a poor 2D6 metabolizer, this very low dosage of 0.25 mg/day blockades the dopamine D2 receptors associated with TD and other EPSEs to a very minimal extent. The only real pharmacologic effect normally seen at this dosage is a blockade of serotonin 2A receptors, which will tend to reduce anxiety and help sleep, while also releasing a small amount of dopamine throughout the cortex. This can have a variety of different effects, but the mechanism is rather opposite from, and not generally associated with EPSEs such as TD.Todd
poster:King Vultan
thread:428333
URL: http://www.dr-bob.org/babble/20041211/msgs/428562.html