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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by jay2112 on February 7, 2022, at 22:23:24
I have been on risperidone for 3 months, and in the past month, I have literally had "meltdowns", in the middle of the night. I can FEEL it...like something is misfiring or not working right. To top it off, I have a neighbour who constantly asks for and takes my meds!! I am a nice guy, and I have a terror of saying "no".
:( Jay
Posted by Christ_empowered on February 8, 2022, at 14:35:52
In reply to Can Antipsych's cause huge panic attacks?, posted by jay2112 on February 7, 2022, at 22:23:24
hi. funny you should ask (LOL)...
I somehow stumbled on a somewhat lengthy article a while back. I wish I'd bookmarked it...
the shrinks were describing a number of cases in which treatment with neuroleptics for schizophrenia-spectrum disorders seemed to result in severe anxiety and/or panic attacks.
If I recall correctly, most of the people/patients in the article had initially been prescribed older medications. Maybe that was or is standard practice in some nations? Haloperidol seemed to pop up frequently, which raises obvious questions such as...why do shrinks do this to us? etc.
Again, if I recall correctly, the drug-induced intense anxiety and/or panic attacks resolved with a gradual switch to a newer tranquilizer (seroquel was frequent, although I seem to recall a couple of the patients being put on Abilify or amisulpride?), plus a short term prescription for xanax xr or some other flavor mother's little helper.
haloperidol and many other tranquilizers seem to induce anxiety, panic, dysphoria, etc. in part because of their high affinity for D2 receptors, along with long lasting blockade, plus the relative lack of action at other receptors (serotonin, NE, etc...the so called "receptor rich" atypicals, such as quetiapine and olanzapine).
risperidone is still considered "atypical," but it isn't that much better than good ole vitamin H in many respects. dysphoria, cognitive dulling, "neuroleptic-induced deficit syndrome," etc...
plus the long term TD risk, EPS, etc...not so great. maybe a switch? is that an option?
quetiapine is sedating, and it also seems to cause less dysphoria and EPS than equivalent doses of Thorazine, so...not the best drug ever, but a step above the older options for many people.
Abilify is high potency, but the action at other receptors, plus the D2 partial agonism, make the neuroleptic induced deficit syndrome less of an issue than many other treatments.
olanzapine...I dunno. hated it myself, but it does seem to have some advantages over many of the other drugs, for many people.
some doctors swear by very low dose loxapine. just a thought...
Posted by beckett2 on February 8, 2022, at 15:35:40
In reply to Re: Can Antipsych's cause huge panic attacks?, posted by Christ_empowered on February 8, 2022, at 14:35:52
Oddly, I do alright with an occasional haldol dose to nip hypomania or intense anxiety
Posted by beckett2 on February 8, 2022, at 15:39:02
In reply to Can Antipsych's cause huge panic attacks?, posted by jay2112 on February 7, 2022, at 22:23:24
> I have been on risperidone for 3 months, and in the past month, I have literally had "meltdowns", in the middle of the night. I can FEEL it...like something is misfiring or not working right. To top it off, I have a neighbour who constantly asks for and takes my meds!! I am a nice guy, and I have a terror of saying "no".
>
> :( JaySure. Well, I can see why they might bc they cause a real sense of disassociation in me. This feels really 'wrong' or off, and when I have panic attacks, they are usually triggered by a feeling of alienation. Just my personal observations, though. AP's are not my friend.
And wow, the cheek of your neighbor asking for drugs!
Posted by jay2112 on February 8, 2022, at 15:44:58
In reply to Re: Can Antipsych's cause huge panic attacks?, posted by Christ_empowered on February 8, 2022, at 14:35:52
> hi. funny you should ask (LOL)...
>
> I somehow stumbled on a somewhat lengthy article a while back. I wish I'd bookmarked it...
>
> the shrinks were describing a number of cases in which treatment with neuroleptics for schizophrenia-spectrum disorders seemed to result in severe anxiety and/or panic attacks.
>
> If I recall correctly, most of the people/patients in the article had initially been prescribed older medications. Maybe that was or is standard practice in some nations? Haloperidol seemed to pop up frequently, which raises obvious questions such as...why do shrinks do this to us? etc.
>
> Again, if I recall correctly, the drug-induced intense anxiety and/or panic attacks resolved with a gradual switch to a newer tranquilizer (seroquel was frequent, although I seem to recall a couple of the patients being put on Abilify or amisulpride?), plus a short term prescription for xanax xr or some other flavor mother's little helper.
>
> haloperidol and many other tranquilizers seem to induce anxiety, panic, dysphoria, etc. in part because of their high affinity for D2 receptors, along with long lasting blockade, plus the relative lack of action at other receptors (serotonin, NE, etc...the so called "receptor rich" atypicals, such as quetiapine and olanzapine).
>
> risperidone is still considered "atypical," but it isn't that much better than good ole vitamin H in many respects. dysphoria, cognitive dulling, "neuroleptic-induced deficit syndrome," etc...
>
> plus the long term TD risk, EPS, etc...not so great. maybe a switch? is that an option?
>
> quetiapine is sedating, and it also seems to cause less dysphoria and EPS than equivalent doses of Thorazine, so...not the best drug ever, but a step above the older options for many people.
>
> Abilify is high potency, but the action at other receptors, plus the D2 partial agonism, make the neuroleptic induced deficit syndrome less of an issue than many other treatments.
>
> olanzapine...I dunno. hated it myself, but it does seem to have some advantages over many of the other drugs, for many people.
>
> some doctors swear by very low dose loxapine. just a thought...
Hi C_E...thanks kindly for the response. Yeah, I had to stop the risperdal, for now, to get my brain back! lol. I seriously felt like a Parkinson's patient...like my engine wasn't firing on all cylinders. I was taking the risperdal for my bipolar switches, but it really, really messed me up unlike many times in the past taking it. Must be me getting older...ughhh..I am scared to crap of getting dementia, and this doesn't help.
So, I now rely on Tegretol and Lyrica to keep my mood balanced. I don't feel quite so secure, but I also don't feel like a Parkinson's patient.I think I also may have a hormone problem, needing testosterone supplementation. I am SO triggered easily, I crawl the walls daily. Maybe I should add Buspar again, as it seems to be like a 'mini-me' antipsych. Hi dose Lyrica sometimes helps me 'reset'...calms my maniac side down (literally...I become a maniac!) But, I tried Largactil, and ughh...worse than the risperdal. Seroqeul sent me to the hospital a few times! I had a panic attack x100 on that stuff. I seem to have a paradoxical reaction to antipsychotics. They don't calm me down...they set me up! I don't like messing with my dopamine, seriously, as even SSRI's do so, make me feel like I just had brain surgery.
Thanks kindly,
Jay
Posted by jay2112 on February 9, 2022, at 5:42:35
In reply to Re: Can Antipsych's cause huge panic attacks?, posted by beckett2 on February 8, 2022, at 15:39:02
> > I have been on risperidone for 3 months, and in the past month, I have literally had "meltdowns", in the middle of the night. I can FEEL it...like something is misfiring or not working right. To top it off, I have a neighbour who constantly asks for and takes my meds!! I am a nice guy, and I have a terror of saying "no".
> >
> > :( Jay
>
> Sure. Well, I can see why they might bc they cause a real sense of disassociation in me. This feels really 'wrong' or off, and when I have panic attacks, they are usually triggered by a feeling of alienation. Just my personal observations, though. AP's are not my friend.
>
> And wow, the cheek of your neighbor asking for drugs!I get the same, actually...disassociation, a feeling of 'not being connected'..you described it perfectly! My panic lays in that feeling. Tegretol SEEMS to really be the thing for me...it's like a benzo, without all of the side effects. AP's have just brought me so much grief, not in taking them as needed, but when I take them consistently. I seem to be a strong GABBA responding person, and Tegretol works strongly on GABBA, and gives a little bit of a serotonin boost as well. It doesn't seem as 'heavy' as Depakote/Epival/Divalproex.
And yes, I am setting some heavy boundaries for said 'friend'. :)
Jay
Posted by Christ_empowered on February 9, 2022, at 5:47:00
In reply to Re: Can Antipsych's cause huge panic attacks? » Christ_empowered, posted by jay2112 on February 8, 2022, at 15:44:58
it seems that individual reactions to -all- psych drugs tend to be...far, far more unpredictable and complicated than the official data and/or "clinical wisdom" leaves many to believe/think.
if I recall correctly, the real "point" of neuroleptics is to achieve varying degrees of "de-activation." Early on, Thorazine was hailed as a quick and easy pill substitute for a lobotomy. Oddly enough...
although dosage varied -wildly- , it seems that lower doses were more common in the UK, much of what is now the EU...
but in the US, there was a trend towards higher doses, often with extra pills for adverse effects and such...
especially among US psychiatrists. Not a "conspiracy theory" or anything, just...kind of interesting, from a sort of sociohistorical perspective.
so,yeah...de-activation. apathy, indifference, reduction in reaction to external stimuli, reduction in movement and overall activity...
-sigh- I guess that's the goal of treatment? -eek-
to be fair, de-activation can be just what the doctor ordered (so to speak) when things get extra rough and intense. I remember this one vintage Thorazine ads, classic 50s all around...
well dressed housewife in 50s grab, on a stool, obviously in the throes of some sort of episode, sense of high tension all over the ad. Thorazine for extreme emotional states. I think they had the Spansule, by then?
ads in those days were directed to the shrinks (and other doctors, f course), not so much the direct to consumer "information" beaming into everybody's homes, these days. and so...
that, coupled with what appears to be some rather lenient FDA guidelines for psych drugs (Quaalude plus amphetamine? sure!), resulted in some awesome ads, from the late 40s to the 70s or so. at a certain point, the dsm-speak and such took over, so the ads weren't as blunt and awesome...the style wasn't as sophisticated or appealing, either, too clinical ("because we are real doctors, treating real illnesses," etc.), and...
yeah. yeah. moving on...
could an as needed/PRN neuroleptic do the trick, maybe? some people report good results from taking a low(er) daily dose, and then adding in more as needed (example: 15mgs/abilify daily...freak out? add 5-15 till distress resolves...), that sort of thing.
is amoxapine available where you live? a former shrink brought it up. I declined, because I've been on Abilify forever, and the idea of adding in a drug that is both a tca "antidepressant" (what does that -mean- ?) and also metabolizes to some unknown quantity of loxapine...
-not appealing- . but, another former shrink said she got good results with amoxapine in cases that were heavy on the low mood, agitation, anxiety end of things, coupled with milder psychotic symptoms. for whatever reason(s), amoxapine is considered a viable option in psychotic depression and also in cases of low, low, low mood that require a faster acting option. not a good idea if TCA drugs are a no go and/or if you are currently suicidal, on multiple other meds, etc.
perphenazine did OK in that big, big study of neuroleptics in long term treatment of Schizophrenia-spectrum people, back in the early 2000s. I think the dosage has to be calibrated more carefully, and even then the EPS, akathisia, and TD risks would probably (?) be higher than, say, olanzapine or quetiapine. and yet...yet another former shrink (clinic underpays, can't keep anybody) said it was a viable, lower cost option, when dosed appropriately, proper selection of people to be treated, etc. just a thought...
I hope things work out well for you.
Posted by jay2112 on February 9, 2022, at 20:44:24
In reply to Re: Can Antipsych's cause huge panic attacks?, posted by Christ_empowered on February 9, 2022, at 5:47:00
Hey, thanks for your very thoughtful points. I think I am gonna do risperdal prn...as needed. Abilify is a bit different, for sure, because of it's D2 agonism/activation. I have Bp2, and it seems a bit of a combo of lithium and larger doses of Tegretol (carbamazepine), with Lyrica (pregablin) seems to help better keep my mood a bit more even, minus the lobotomy of risperdal every day. I may have some hormone issues too, so doesn't help.
Antidepressants and bipolar...an ever debatable subject..uggh. I have lowered my Effexor to 75mg's, but I take 20mg of Vyvanse, a stim, which, once in a while, launches me into dysphoric mania.
But, here's the thing...I think our brains adapt and become used of certain meds...esp the mood stabilizers. My pdoc, today, added in Baclofen for me, which is a non-addictive muscle relaxant...but acts on that great chemical I seem to do well with...GABA. Yes, seems like a lot of meds, but I have been on most or all of these at one point or another. Some days I reduce dosages...not supposed to, but it works better for me.I recall reading that Bipolars should use AP's only when traditional mood stabalizers don't work. So, I will use AP's prn. I am glad Abilify works for you. I did well, partially, on it. But I couldn't tolerate more than 2.5mg's. Higher doses made me manic, and the weight gain was un-freakin-believable! Plus, it threw my blood sugar for a wild ride! I am type 2 diabetic.
I am really interested in what is new out there for BP2. My pdoc has said there may be public esketamine clinics coming that are payed for by my government disability. He also talked about Spravato, being available for me to. So.....I'd still like more stability in my mood before I go out and attempt to work again. One step forward...two steps back..it often feels like!
Jay :)
Posted by Lamdage22 on February 13, 2022, at 4:33:13
In reply to Can Antipsych's cause huge panic attacks?, posted by jay2112 on February 7, 2022, at 22:23:24
It doesn't always help anxiety I figure. It depends on the med though. Zyprexa is certainly comforting if the anxiety is mixed with (pre)psychotic symptoms.
Posted by Christ_empowered on February 13, 2022, at 8:17:23
In reply to Re: Can Antipsych's cause huge panic attacks?, posted by Lamdage22 on February 13, 2022, at 4:33:13
I think individual response is part of the issue, too. some people do well with older tranquilizers at reasonable doses. I read a person's account of being hospitalized in the 60s...because of intense stress and traumatic life experiences, low dose Thorazine here and there was something of a relief. I imagine the rather bleak setting contributed to that, too...sort of a cycle, it seems.at the biological level, it seems that drugs that carry a lower akathisia and EPS liability early on would probably (?) be less of a problem with anxiety, panic, neuroleptic induced deficits and neuroleptic induced dysphoria...
but again: each individual is unique, not only at the biological level, but also in terms of psychosocial factors that drive overall response to any psych drug (and...life itself, lol).
I vaguely recall skimming over some of the 50s material on Tofranil. Rather noxious drug, Tofranil, but...
I seem to recall the authors going into factors -- age, gender, social class, education, length of hospitalization, etc. -- that seemed to either contribute to "successful treatment" or...made other treatments more appropriate.
even now, I think -some- clinicians have gathered their own body of "clinical wisdom" for different drugs. a former prescriber told me about the patients she tries on amoxapine -- mostly middle aged or older, severe mood and anxiety problems, light on the psychosis -- and that may or may not be supported by the official data, but...
yeah. yeah. a lot goes into all of this, lol.
maybe rexulti? it seems to have the lower overall EPS rates one finds in studies of aripriprazole, plus it seems to cause less akathisia. I think its also far less likely to elevate prolactin, but I could be mistaken.
just...random question...do you find any supplements helpful? I do a DIY Orthomolecular protocol (my anxiety and general levels of unease and distress are vastly improved, btw), but I was skimming over some "alternative" medicine material and...
it really does seem that most available antioxidants -- even vitamin C, at sufficient doses -- can mitigate a lot of adverse effects from neuroleptics. Oddly enough, I did skim over an animal study that found that coenzyme Q10 did very, very little to prevent TD in animals or reduce the movements once they had developed. strange...
hope this helps. :-)
Posted by Lamdage22 on February 13, 2022, at 10:31:49
In reply to Re: Can Antipsych's cause huge panic attacks?, posted by Christ_empowered on February 13, 2022, at 8:17:23
I think that a good level of manganese helps with movement disorders.
Posted by undopaminergic on February 13, 2022, at 11:12:38
In reply to Re: Can Antipsych's cause huge panic attacks?, posted by Lamdage22 on February 13, 2022, at 10:31:49
> I think that a good level of manganese helps with movement disorders.
Maybe, but at high doses it *causes* them, more specifically a condition called manganism that resembles Parkinson's disease but does not respond to anti-parkinsonian drugs. So it is not to be toyed with.
-undopaminergic
Posted by Christ_empowered on February 13, 2022, at 17:10:07
In reply to Re: Can Antipsych's cause huge panic attacks?, posted by undopaminergic on February 13, 2022, at 11:12:38
yeah...never tried manganese. i didn't know about the potential toxicity, just...never made it into my DIY protocol. I'm all about mega-dose vitamins and antioxidants, lol. so far, so good... :-)
Posted by Lamdage22 on February 14, 2022, at 0:37:05
In reply to Re: Can Antipsych's cause huge panic attacks?, posted by Christ_empowered on February 13, 2022, at 17:10:07
Blood test I guess. Not free usually.
Posted by Jay2112 on February 16, 2022, at 21:38:11
In reply to Re: Can Antipsych's cause huge panic attacks?, posted by Christ_empowered on February 13, 2022, at 8:17:23
>
> I think individual response is part of the issue, too. some people do well with older tranquilizers at reasonable doses. I read a person's account of being hospitalized in the 60s...because of intense stress and traumatic life experiences, low dose Thorazine here and there was something of a relief. I imagine the rather bleak setting contributed to that, too...sort of a cycle, it seems.
>
> at the biological level, it seems that drugs that carry a lower akathisia and EPS liability early on would probably (?) be less of a problem with anxiety, panic, neuroleptic induced deficits and neuroleptic induced dysphoria...
>
> but again: each individual is unique, not only at the biological level, but also in terms of psychosocial factors that drive overall response to any psych drug (and...life itself, lol).
>
> I vaguely recall skimming over some of the 50s material on Tofranil. Rather noxious drug, Tofranil, but...
>
> I seem to recall the authors going into factors -- age, gender, social class, education, length of hospitalization, etc. -- that seemed to either contribute to "successful treatment" or...made other treatments more appropriate.
>
> even now, I think -some- clinicians have gathered their own body of "clinical wisdom" for different drugs. a former prescriber told me about the patients she tries on amoxapine -- mostly middle aged or older, severe mood and anxiety problems, light on the psychosis -- and that may or may not be supported by the official data, but...
>
> yeah. yeah. a lot goes into all of this, lol.
>
> maybe rexulti? it seems to have the lower overall EPS rates one finds in studies of aripriprazole, plus it seems to cause less akathisia. I think its also far less likely to elevate prolactin, but I could be mistaken.
>
> just...random question...do you find any supplements helpful? I do a DIY Orthomolecular protocol (my anxiety and general levels of unease and distress are vastly improved, btw), but I was skimming over some "alternative" medicine material and...
>
> it really does seem that most available antioxidants -- even vitamin C, at sufficient doses -- can mitigate a lot of adverse effects from neuroleptics. Oddly enough, I did skim over an animal study that found that coenzyme Q10 did very, very little to prevent TD in animals or reduce the movements once they had developed. strange...
>
>
> hope this helps. :-)Hi...sorry for taking a bit to get back. I still really want to leave the AP's for emergency use...for now. But, I have been constantly on the lookout for supplements that seem to work. Herb's seem to be the best, for me. I am using Macca for my post-Vyvanse fatigue, and am looking for a herbal solution for general pain. (I get bad migraines and sore body in general. I am trying to lose weight, but it's tough at 52.) Butterbur seems like a nice herbal alternative to NSAID's for pain. I like herbal medicine and strongly believe in it...at least the researched stuff. I am part Indigenous, and that is how our peoples survived since...as far back we can't even know.
As far as meds....rexulti caused me even more anxiety than abilify. I may give a small dose of abilify a shot again if I run into problems....but knock on wood, I am doing fine.
Cheers!
Jay
Posted by undopaminergic on February 18, 2022, at 9:12:48
In reply to Re: Can Antipsych's cause huge panic attacks? » Christ_empowered, posted by Jay2112 on February 16, 2022, at 21:38:11
>
> I am using Macca for my post-Vyvanse fatigue,Do you mean Maca root? I tried that. The taste was so disgusting I almost puked.
-undopaminergic
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