Posted by yxibow on February 20, 2007, at 20:12:30
In reply to tardive dyskinesia problem, posted by Jeroen on February 20, 2007, at 19:32:41
> hi, got TD 2 years now
>
> i am a year on seroquel, i wanna quit it because of my eye muscle cramp
>
> i wanna get rid of my TD first before i take any neuroleptic again
I've offered a number of suggestions that would make this process a possibility. I am floored that your doctor either has 1) never done an AIMS test or 2) never told you what an AIMS test was.
One treatment for TD is a different atypical antipsychotic though, up and including Clozaril. I understand your concerns about another antipsychotic. I do not know your diagnosis, is it psychotic depression or a schizophreniform disorder ? If its none of the above an antipsychotic isn't necessarily a needed choice.
But if it is, you have to accept psychotic breaks when you discontinue medication and while I don't want to sound pedantic or mean, you may not understand or trust people on here because of paranoia. This I cannot make a judgment because again, I don't know your diagnosis and I don't want to hurt your feelings.
So, off the neuroleptic, well you AND YOUR DOCTOR, I can't emphasize this enough, I don't hear anything about your doctor, will make informed decisions.
The best decisions to date are:1) Clozaril.
Shown some general improvements in various trials. MUST be discontinued if you get the 2% possibility of low white blood cell count.
2) Tetrabenazine (Nitoman / Xenazine)
Proven effective in small trials at Baylor College, TX. You will get pseudoparkinsonism (shaky hands), which can be adjudicated with procyclidine or the like. It is a dopamine depleter. Reserpine may have a similar effect but is fraught with worse problems.
3) For your blepharospasms:
6 month injections of alternating Botox A and B
4) BuSpar at levels exceeding 1000mg
ONLY with your doctor. Possible effects, major dizzyness.
5) Vitamin E, at levels approaching 1600 IU
ONLY with your doctor. Possible somewhat rare side effects for someone your age, internal bleeding or brain hemorrhage.
All of the above has to be done with an AIMS baseline and an AIMS measurement 6-12 weeks or sooner into the trial of each one that your doctor thinks is effective and worth pursing. There are other ideas out there, including clonidine, and other substances.I wish you well, but I really want to hear about how you and your doctor are collaborating and that he understands about AIMS exams. Anybody giving antipsychotics should.
The last thing to mention is -- you've been on various antipsychotics on a fairly continous basis.
30% or more of the time TD will discontinue on its own without any intervention.
Again, because of this reason, your doctor should measure your AIMS now, and since you want to discontinue an antipsychotic, should measure it some weeks down the line after the washout of Seroquel.
I wish you well, but I can't offer anything more if your progress is not being monitored by AIMS exams.
Your doctor should also look into Drs. and Messrs. Wirshing and Wirshing here in the US, who are leading researchers and experts on movement disorders caused by neuroleptics.-- tidings
Jay
poster:yxibow
thread:734600
URL: http://www.dr-bob.org/babble/20070219/msgs/734608.html