Posted by yxibow on January 13, 2007, at 1:50:01
In reply to ABILIFY + EPS, posted by alanjacobs on January 12, 2007, at 20:39:45
> Hello,
>
> I started Abilify 2.5mgs about a month ago. After two weeks of taking the meds I started getting the EPS side effect, like tardive dyskenesia (spelling?.) It really made me nervous so I took myself off the Abilify and poke with my Psychiatrist after the weekend. He had me come in, we talked, agreed to stay just on the Prozac( which I started at the same time as Abilify) He also prescribed me Cogentin, which after two days of taking it completely rid me of the EPS syndrom.
>
> Here is the problem. I felt better on the Abilify then I have in 5-6 years. Any of the drugs in the same family as Abilify could cause the same side effects which I seem to be suseptable too.
>
> This week I met with my Pdoc again we decided to try the ABilify again but with an ongoing dose of the cogentine.
>
> What do you think? Seem like a reasonable plan, what do you think?
First of all, lets get our terms correct -- I think he should have given you informed consent about the medication. Abilify is a neuroleptic that can cause EPS which is another term for side effects on neuroleptics. EPS and TD are generally on a sliding scale, and TD, meaning Tardive, is something almost always developed late in treatment.
What you felt was akathisia, a form of EPS. Akathisia is intense restlessness which may feel to someone like anxiety but it is not, it is a movement disorder caused by neuroleptics.
The general scale of strength (and EPS) of atypicals -- we now have a new one, Invega, which is basically a patent extender of Risperdal, would probably roughly be {Risperdal,Invega}->{Geodon,Abilify}->Zyprexa->Seroquel->{Clozaril, except for pseudoparkinsonism}.
Strong EPS can be a sign of possible future TD but in general atypicals on average with limited studies are about 2% annually, with a wide variation. Also if one is aware first of a movement issue, it is generally EPS and not TD, as a rule, but doctors nevertheless should give AIMS exams every 6 months.
And yes, Cogentin will help with EPS, it is one of the strongest of the anticholinergics, with Artane and Akineton being a bit less. Too much of them of course can cause an atropine syndrome which is not a pleasant thing and involves chills or heat and can lead to psychosis itself. So keep to your dosage.
Now getting the medical stuff out of the way, what is the diagnosis that warrants an atypical and an SSRI, but can get by with an SSRI alone for a period of time while your doctor made a decision to restart ? That is the key here. I'm assuming it is for some sort of bipolar or psychotic depression or schizophreniform disorder to warrant a mid-strength atypical neuroleptic. Otherwise I don't see the plan of continuing a medication that has given you akathisia when there are other classes of medications out there that are effective. But obviously your doctor thinks there is something warranted so I think we would need to hear something more about how you feel and what is going on to give any opinion on your treatment plan.-- Jay
poster:yxibow
thread:721839
URL: http://www.dr-bob.org/babble/20070107/msgs/721895.html