Posted by mindevolution on February 2, 2007, at 7:18:02
In reply to Re: Atypicals for anxiety? » mindevolution, posted by yxibow on February 2, 2007, at 2:44:51
>It is a description at best of the highest doses of old line neuroleptics.
that's debatable, with many people suggesting that the new antipsychotics are not atypical at all.
indeed why are they called atypical APs? if you block more than 80% of the dopamine in the brain you get eps including dyskinesias, this is impossible to escape therefore there is no such thing as an atypical antipsychotic that opertates by blocking dopamine. a truly atypical drug would achieve its antipsychotic effect by using a non dopamine pathway. it is a marketing ploy to charge 50 times as much for a "new drug" with "less eps" lol!!!!
all the "atypical" drugs block dopamine, can all trigger eps just by upping the dose until dopamine receptor occupancy approaches 80% or greater, none of them can avoid it. Non of the "atypicals" are atypical, they all typically "work" by blocking dopamine. http://www.nature.com/npp/journal/v25/n5/full/1395704a.html
let's see, lets rebrand haloperidol at between 0.1mg and 5mg as the next low eps atypical. our marketing pitch can be "at between 0.1mg and 1mg haloperidol acts as a dopamine agonist, but at higher doses it tends to act more like a typical antipsychotic"if you want to look at your "atypical" of choice ziprasidone, they say the risk of eps is low
"although the risk with risperidone increases in daily doses above 6 mg" this is where dopamine receptor occupancy starts approaching the eps mark. so look for studies > 6mg... in fact I wonder what happens to patients given 20mg????> Geodon has gone through a 4000 patient study and was reapproved by the FDA. It does not posess nearly the QTc elongation that was previously thought. Mellaril still remains on the market with a greater risk and a black box warning. That's 4000 patient-years of study that went for the former (Zeldox) into Geodon.
well these studies say otherwise: http://www.bmj.com/cgi/content/full/325/7375/1253?etoc
http://www.medscape.com/viewarticle/457366_8also who paid for the trial? if the research doesn't support the company they simply do not release the study as they own the data. academics that don't fall into line get axed.
something else for you to read on this point
http://www.slate.com/id/2133061/
> The risk of suicide in untreated schizophreniform disorders is magnitudes greater than treated with any neuroleptic. The problem, granted, is patient compliance due to EPS effects which are the bane of neuroleptics and continue to be addressed. Depot injections are one method of patient compliance for the populations that are in danger of harming themselves or others.show me the studies that prove that antipsychotically naive patients with schizophrenia have higher rates of suicide than patients treated with antipsychotics. this i know you will not be able to produce. most studies that I have read suggest that suicide is induced by the antipsychotics particularly the ones producing greater blocking and damage to the cholinergic system which is the damage induced by most nerve gas eg vx or sarin, pesticides and organophosphates.
> The positive side of Geodon is that it doesn't have the weight gain effects of Risperdal, Zyprexa, or Seroquel. The negative side is that it may have more EPS than the latter two.
now you are deciding what brand to buy, they all do roughly the same thing.
> "> APs are typically used on the elderly, the retarded, the criminals, and the mentally ill."
> This is an incredibly insensitive statement for someone (myself) who has a need to take Seroquel. I fall under none of those categories short of "mentally ill" which in your tone is an old fashioned way of describing it and I take offense at that statement.
I said they are used on, implying that often these groups of people do not get a choice in the consumption of these drugs and the statement is true. criminals get no choice while in prison, "carers" of the elderly and the intellectually retarded also will typically force their patients to take APs, and involuntary patients in hospitals also get no choice in the matter. I am not being discriminatory or uncivil towards another group of people, just pointing out truths that operate in our society.
I stand by my comment that APs are an extremely dangerous and toxic medication, the most toxic psychiatric medication available, and I am sorry that you have to take it, but at least you have a choice in the matter, when the groups I described do not.
>
> Furthermore it is an inflammatory charge that the "mentally ill" are a subhuman population. The "mentally ill" are people who, like a lot of us on the board are born with a biochemical imbalance that will change over a lifetime. We are human, we range in our disorders.I never implied that mentally ill are a subhuman population, in fact I actively campaign for the rights of the mentally ill. see these threads : http://www.dr-bob.org/babble/poli/20061123/msgs/728000.html
http://www.dr-bob.org/babble/poli/20061123/msgs/726938.htmlAlso your comment gives away your position that you actually do think you have been incorrectly grouped with "subhuman" groups in society. you were offended because you regard the mentally ill as superior to the other categories i mentioned. that is you do consider the mentally retarded, criminals and the elderly as subhuman. i on the other hand do not, i see these groups as victimised and persecuted unfairly by our society, and being force fed APs is one way in which they are persecuted.
btw, the biochemical imbalance theory has no scientific backing.
> The only sound statement in the above overgeneralization was "informed consent."well that's your point of view and I am debating it with you.
>All medical practice by law is or should be informed consent and if your doctor is handing out prescriptions without informing of major side effects or if you do not elect to decline counseling at the pharmacy and you are not counseled on your medication you have been done a disservice.
well I agree with you on this point but the mental health legislation does not include the concept of informed consent when considering involuntary detention and treatment. patients are typically treated with APs on arrival even before a diagnosis has been made, biasing the assessment towards a diagnosis of illness. Informed consent is a luxury millions do without when it comes to psychiatric drugs in first world countries.
> Please respect the community without issuing gross generalizations.
after you read my reply and read the threads I mentioned I think you'll realise that I respect this community far more than you give me credit for.
It is important that both sides of the picture are presented in order that a person can truly make an informed choice, I just tend to promote a view that does not support the drug companies, particularly when they produce drugs as toxic as the antipsychotics that can be misused so readily to take advantage. although i should point out that I already said that ADs can also be life saving. you seem to present a view that informed consent is your perspective only, i think of it is a much broader concept than that.
me
poster:mindevolution
thread:728141
URL: http://www.dr-bob.org/babble/20070201/msgs/728972.html