Posted by chess on December 13, 2006, at 16:31:48
In reply to Re: Risperdal for GAD?, posted by med_empowered on December 13, 2006, at 11:08:34
how do you explain this then:
The antidepressant Wellbutrin causes anxiety and even panic sometimes because it increases the activity of dopamine by being a dopamine reuptake inhibitor. Therefore a med that reduces dopamine activity (atypicals) can work as an anti-anxiety agent.btw, my doc offered seroqeul also, saying he would prefer to start with that one or zyprexa but zyprexa can cause weight gain. i should have made my post "Seroquel for GAD?"
your shrink is full of s**t. some people get better on neuroleptics--they blunt everything, so if being apathetic works for you, then you'll love neuroleptics. No atypical neuroleptics are approved for GAD or social phobia or any sort of anxiety. I believe Stelazine, an old one, is approved for non-psychotic anxiety but...very few docs use it anymore, because its so risky.
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> Some studies have actually shown an *increase* in anxiety of antipsychotics, which makes sense...when you use neuroleptics, you block dopamine, which creates a state of Parkinsonism (you may not get physical signs, but Parkinson's is also a psychiatric condition, marked by apathy and fatigue, etc., so I'd wager all doses of neuroleptics make one somewhat Parkinsonian..and lots of people with Parkinson's have intense anxiety). Personally speaking, neuroleptics made my anxiety 10 times worse. It was pure, unmitigated hell, and that's not including the akathisia, which is another fun side effect shrinks tend to not tell their patients about. Ask your doc about that, and the risks of TD and neuroelptic malignancy syndrome (that one's potentially fatal, by the way).
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> RXing a neuroleptic for GAD is totally irresponsible and puts the patient at risk. There are benzos and antidepressants and buspar to use; one could even brand out and go for hydroxyzine, propranolol, anticonvulsants, "alternative" therapies, opiates....but neuroleptics? Ridiculous. Especially Risperdal--as the atypials go, Risperdal is the *least* atypical (its closer to, say, Haldol than it is to clozapine) and possibly the most likely to cause god-awful side effects, including tardive dyskinesia. The FDA hasn't even approved it for long-term use in bipolar (only management of acute mania), much less GAD or other relatively minor problems.
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> Do what you want, but I think a neuroleptic for GAD is a very, very bad call, and I think your shrink should be ashamed of suggesting it without presenting all the risks and pointing out the (inconvenient) fact that there isn't all that much quality data to support using Risperdal for this indication.
poster:chess
thread:713232
URL: http://www.dr-bob.org/babble/20061212/msgs/713314.html