![[dr. bob]](/dr-bob-sm.gif)
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 ace on March 3, 2006, at 21:30:40
I like Stelazine....at 1mg seems to smooth things out...I have titrated Seroquel right down to 25mg (no insomnia or any ill effects) and think I will change to 1-4mg Stelazine....
I think it is a safe drug in many ways
comments/experiences....
BTW, it has long been known that the old school of psychiatrists prefer older antipsychotics with MAOI's.....
Ace
Posted by ed_uk on March 4, 2006, at 14:14:23
In reply to Nardil + Stelazine, posted by ace on March 3, 2006, at 21:30:40
Hi ACE!
Take care with your Stelazine dose! Stelazine is a potent neuroleptic, small changes in dosage can have profound effects.
Trifluoperazine (Stelazine) 1mg is similar in effect to haloperidol (Serenace, Haldol) 0.5mg. Haloperidol has been much more thoroughly studied however.
If you do decide to increase your Stelazine dose, PLEASE increase in very small steps eg. from 1mg to 2mg, 2mg to 3mg etc. An abrupt increase in dose could quite easily give you a nasty shock. I'm not kidding! It's important to have an anticholinergic drug on hand in case of severe dystonia or akathisia.
Hyperprolactinaemia is often a problem with Stelazine. Sexual side effects may occur.
Even at low doses, tardive dyskinesia is a concern with Stelazine. I would not recommend taking it for more than 3 months unless it is ABSOLUTELY necessary. You might want to consider amisulpride as an alternative.
Kind regards
Ed
PS. Stelazine 1mg can be useful PRN med, are you sure you need to take it every day?
Posted by med_empowered on March 4, 2006, at 17:48:12
In reply to Nardil + Stelazine, posted by ace on March 3, 2006, at 21:30:40
hi! I'm glad you've found something that works. That said, maybe you could give a new(ish) neuroleptic a whirl? Seems like it'd reduce the TD risk. If you opt to do stelazine daily, for a long time, maybe you could try an antioxidant supplement? There's a theory that TD is caused in part by "oxidative stress," which is why vitamin E therapy is sometimes used with mixed success...taking a c/e or mixed antioxidant supplement might reduce problems.
Posted by ed_uk on March 4, 2006, at 18:17:34
In reply to Re: Nardil + Stelazine, posted by med_empowered on March 4, 2006, at 17:48:12
Hi Med
>vitamin E
Are there any other antioxidants which might be useful?
Regards
Ed
Posted by med_empowered on March 4, 2006, at 20:59:41
In reply to Re: Nardil + Stelazine » med_empowered, posted by ed_uk on March 4, 2006, at 18:17:34
I seem to remember something about some B-vitamins or related compounds (may lecithin?) being helpful...there's apparently some sort of amino acid drink that can reduce acute EPS and also help a bit with TD...I guess supplementation could be helpful.
The **best** course would be prevention by using a low-ish risk agent.
Posted by ed_uk on March 5, 2006, at 14:15:33
In reply to anti-oxidants for (possible) TD prevention, posted by med_empowered on March 4, 2006, at 20:59:41
Hi Meddie
I think I've heard of lecithin being used too.
Ed
Posted by djmmm on March 6, 2006, at 9:53:46
In reply to Re: anti-oxidants for (possible) TD prevention » med_empowered, posted by ed_uk on March 5, 2006, at 14:15:33
> Hi Meddie
>
> I think I've heard of lecithin being used too.
>
> Eda good powerful antioxidant, like vit. E, or perhaps a potent brain specific antioxidant like melatonin would help. I think most research supports Vitamin E... there has been some success with manganese, and as I stated earlier, melatonin.
Vitamin E:
Elkashef AM, Wyatt RJ. Tardive dyskinesia: possible involvement of free radicals and treatment with vitamin E. Schizophr Bull. 1999;25:731–740.
Adler LA, Edson R, Lavori P, et al. Long-term treatment effects of vitamin E for tardive dyskinesia. Biol Psychiatry. 1998;43:868–872.
Lohr JB, Lavori P. Whither vitamin E and tardive dyskinesia? Biol Psychiatry. 1998;43:861–862.
Also there has been some research on :BCAAs (Branch chain amino acids:
Richardson MA, Bevans ML, Weber JB, et al. Branched chain amino acids decrease tardive dyskinesia symptoms. Psychopharmacology (Berl). 1999;143:358–364.
Richardson MA, Small AM, Read LL, et al. Branched chain amino acid treatment of tardive dyskinesia in children and adolescents. J Clin Psychiatry. 2004;65:92-96.
Richardson MA, Bevans ML, Read LL, et al. Efficacy of the branched-chain amino acids in the treatment of tardive dyskinesia in men. Am J Psychiatry. 2003;160:1117-24.
DMAE:Casey DE, Denney D. Dimethylaminoethanol in tardive dyskinesia [letter]. N Engl J Med. 1974;291:797.
Re' O. 2-Dimethylaminoethanol (deanol): a brief review of its clinical efficacy and postulated mechanism of action. Curr Ther Res Clin Exp. 1974;16:1238–1242.
Alphs L, Davis JM. Noncatecholaminergic treatments of tardive dyskinesia. J Clin Psychopharmacol. 1982;2:380–385.
Melatonin:Shamir E, Barak Y, Shalman I, et al. Melatonin treatment for tardive dyskinesia: a double-blind, placebo-controlled, crossover study. Arch Gen Psychiatry. 2001;58:1049–1052.
Nelson LA, McGuire JM, Hausafus SN. Melatonin for the treatment of tardive dyskinesia. Ann Pharmacother. 2002;37:1128-31.
Niacin:Kunin RA. Manganese and niacin in the treatment of drug-induced tardive dyskinesias. J Orthomol Psychiatry 5:4-27, 1976. In: Werbach MR. Nutritional Influences on Illness [book on CD-ROM]. 2nd ed. Tarzana, CA. 1996.
Vitamin B6:Lerner V, Miodownik C, Kaptsan A, et al. Vitamin B6 in the treatment of tardive dyskinesia: a double-blind, placebo-controlled, crossover study. Am J Psychiatry. 2001;158:1511–1514.
Posted by ed_uk on March 6, 2006, at 13:44:45
In reply to Re: anti-oxidants for (possible) TD prevention, posted by djmmm on March 6, 2006, at 9:53:46
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.