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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by JohnX2 on January 27, 2002, at 15:19:41
Well I have my Klonopin tapered down to
1.5 mg from 6 mg since the start of the month,
but I am/was experiencing Mania and I got into
deep do-do at work and am now on medicle leave.
Whoops.My pdoc upped my Zyprexa to 10 mg from 5 mg to
help with my Mania. I have been experiencing this
twitching and clenching in my left hand, which is
what I wanted to ask Cam about since he seemed to
know about Zyprexa and TD. But alas Cam has disapperead
from Pbabble (is he still banned?).
Does anyone know if this is Zyprexa
related, or some sort of Klonopin tapering seizure
withdrawl? Its making nervous.Meanwhile, my job hangs by a thread (long ugly
stort, bound to do something stupid while manic)...-John
Posted by spike4848 on January 27, 2002, at 17:13:17
In reply to Klonopin 6 mg - 1.5 mg!, Manic debacle :(, posted by JohnX2 on January 27, 2002, at 15:19:41
> My pdoc upped my Zyprexa to 10 mg from 5 mg to
> help with my Mania. I have been experiencing this
> twitching and clenching in my left hand, which is
> what I wanted to ask Cam about since he seemed to
> know about Zyprexa and TD.Hey John,
Sorry to hear your going through such a tough situation. The twitching and clenching definately could be a form of tardive dyskinesia. We usually talk about the facial movements the most, but it can occur all over the body. Dopamine in the brain not only effects mood, but regulates muscle movement. Drugs like zyprexa which block dopamine can cause dysregulation of the muscles ... leading to twitching and jerking movements. It could be either the increase dose of zyprexa causing new td or the reduction to klonapin has unmasked old td. You should talk to your doctor .... tardive dyskinesa is reversible by lowering the dose ..... permenant td usually occurs after many years of taking neuroleptics. Hope this helped. Hang in there and keep us updated.
Spike
Posted by Ritch on January 27, 2002, at 17:34:29
In reply to Klonopin 6 mg - 1.5 mg!, Manic debacle :(, posted by JohnX2 on January 27, 2002, at 15:19:41
>
> Well I have my Klonopin tapered down to
> 1.5 mg from 6 mg since the start of the month,
> but I am/was experiencing Mania and I got into
> deep do-do at work and am now on medicle leave.
> Whoops.
>
> My pdoc upped my Zyprexa to 10 mg from 5 mg to
> help with my Mania. I have been experiencing this
> twitching and clenching in my left hand, which is
> what I wanted to ask Cam about since he seemed to
> know about Zyprexa and TD. But alas Cam has disapperead
> from Pbabble (is he still banned?).
> Does anyone know if this is Zyprexa
> related, or some sort of Klonopin tapering seizure
> withdrawl? Its making nervous.
>
> Meanwhile, my job hangs by a thread (long ugly
> stort, bound to do something stupid while manic)...
>
> -JohnJohn, When I reduced my standard daily dose of Klonopin from .5mg twice daily to just .5mg at bedtime I noticed muscle twitching and spasms in my *chest* wall around my ribs. It was like a "fluttering" muscle contraction. It would start up a few hours before my bedtime dose and would subside rapidly after I took it. If I ever go off of Klon. it will have to be very very slowly. It took a week or two to stop twitching after I lowered the dose in half.
hope this is of some help.
Mitch
Posted by TSA West on January 28, 2002, at 2:08:41
In reply to Klonopin 6 mg - 1.5 mg!, Manic debacle :(, posted by JohnX2 on January 27, 2002, at 15:19:41
Greetings friend,
In the only clinical trial that I know about which documented rates of EPS with Zyprexa, several patients had "mild" EPS, including "rigidity and/or cogwheeling of the elbow, wrist, or shoulder joints." Scores on the Barnes-Akathisia 8 and Abnormal Involuntary Movement Scales were negligible in that trial though. But keep in mind that this was a trial in which patients were given 30 to 40 mg of Zyprexa per day: Sheitman B, Lindgren J, Early J, Sved M. High-dose olanzapine for treatment-refractory schizophrenia. Am J Psychiatry 1997
I could e-mail you the full study.
I don't believe the Zyprexa will help as much for mania as say, Carbamazepine would, IMHO.
Freedom from emotional pain is what I desire for you,
TSA West-----------------
Posted by JohnX2 on January 28, 2002, at 23:28:48
In reply to Zyprexa: anti-manic component and EPS » JohnX2, posted by TSA West on January 28, 2002, at 2:08:41
I mentioned the fist clenching to my pdoc and
he did not think it was zyprexa. He did do some
arm movement tests which seem to be going after
that cogwheeling stuff mentioned. The
spasms seem to start after clenching an object
like the steering wheel of my car and are exacerbated
by caffeine. I'm thinking it'll go away when i
finish the Klonopin tapering, but I still get a little
panicky because I developed chronic myofacial pains
after taking other meds for a number of months.
Zyprexa seems to be one of the safest anti-psychotics
however, so I'm not too concerned, and neither was
my pdoc.Thanks everyone for your feedback.
John
> Greetings friend,
>
> In the only clinical trial that I know about which documented rates of EPS with Zyprexa, several patients had "mild" EPS, including "rigidity and/or cogwheeling of the elbow, wrist, or shoulder joints." Scores on the Barnes-Akathisia 8 and Abnormal Involuntary Movement Scales were negligible in that trial though. But keep in mind that this was a trial in which patients were given 30 to 40 mg of Zyprexa per day: Sheitman B, Lindgren J, Early J, Sved M. High-dose olanzapine for treatment-refractory schizophrenia. Am J Psychiatry 1997
>
> I could e-mail you the full study.
>
> I don't believe the Zyprexa will help as much for mania as say, Carbamazepine would, IMHO.
>
> Freedom from emotional pain is what I desire for you,
>
> TSA West-----------------
Posted by spike4848 on January 29, 2002, at 22:34:10
In reply to Re: Zyprexa: anti-manic component and EPS, posted by JohnX2 on January 28, 2002, at 23:28:48
Hey John,
> I mentioned the fist clenching to my pdoc and he did not think it was zyprexa.
So did he tell you what the cause was if it wasn't zyprexa?
>He did do some arm movement tests which seem to be going after that cogwheeling stuff mentioned.
I guess he was looking for "cogwheel rigidity". You see it in patients with parkinson's (lack of dopamine) and people on neuroleptics like zyprexa (blockade of dopamine).
>so I'm not too concerned, and neither was
my pdoc.I am glad you pdoc feels your are well. If this continues though over several weeks, I would not ignore it ....
Spike
Posted by JohnX2 on January 30, 2002, at 18:28:15
In reply to Re: Zyprexa: anti-manic component and EPS » JohnX2, posted by spike4848 on January 29, 2002, at 22:34:10
It seems to have gotton better as I have
slowed down my klonopin tapering and increased
my Zyprexa dosing (I had to increase it to fight
some pretty bad Mania of late).I think part of it may just be incidental hand cramps as I have been doing
a lot of funny excersizes with a golf club that
require me to improve my hands grip strength.
The cramping and spasms seem to usually occur
after I have been holding the steering wheel of
my car for a while. Caffeine exacerbates things.
I think the mania I have been experiencing and
the klonopin tapering may be related.If it doesn't stop when i get off klonopin, I will
quit zyprexa (it's making fat anyways, and topamax
is duking it out but loosing).My pdoc didn't know the cause, but thought it
was strange given the number of anti-convulsants
I take.Thanks for your feedback.
-Johh
> Hey John,
>
> > I mentioned the fist clenching to my pdoc and he did not think it was zyprexa.
>
> So did he tell you what the cause was if it wasn't zyprexa?
>
> >He did do some arm movement tests which seem to be going after that cogwheeling stuff mentioned.
>
> I guess he was looking for "cogwheel rigidity". You see it in patients with parkinson's (lack of dopamine) and people on neuroleptics like zyprexa (blockade of dopamine).
>
> >so I'm not too concerned, and neither was
> my pdoc.
>
> I am glad you pdoc feels your are well. If this continues though over several weeks, I would not ignore it ....
>
> Spike
Posted by spike4848 on January 30, 2002, at 23:04:53
In reply to Re: Zyprexa: anti-manic component and EPS » spike4848, posted by JohnX2 on January 30, 2002, at 18:28:15
John,
I'm glad your better. Take care.
Spike
This is the end of the thread.
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