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Re: Antipsychotic with lowest incidence of TD? cybercafe

Posted by Ritch on August 22, 2002, at 23:56:45

In reply to Antipsychotic with lowest incidence of TD?, posted by cybercafe on August 22, 2002, at 13:02:36

> Okay i've been searching the web, but I can't seem to find which antipsychotic (besides clozapine) has the lowest incidence of TD? and EPS?
> anyone know?

Hi Cyber,

It depends on the history of the medicine for a great part, because TD is a historical phenomenon (over a relatively large span of time). Of the "conventional" phenothiazine antipyschotics, Mellaril (thioridazine), probably has the least potential for TD *based on* its lower level of EPS symptoms compared to chlorpromazine and trifluoperazine (and others). Haldol (haloperidol) is newer, but is notorious for TD, however a very effective acute treatment for psychosis. Of the newer "atypicals" (besides clozapine) you have only relative EPS occurence to guide you as a possible indicator for possible future TD (not enough time has passed to make a good judgement). I have had personal experience with Thorazine, Stelazine, Compazine, Phenergan, Haldol, Mellaril, Risperdal, and Seroquel. Of those, Stelazine, Haldol, and Risperdal (in rank) were the worst for me regarding EPS symptoms. They all just happen to be higher *potency* antipychotics (response/mg-dosage). The lower the potency, it seems, the less adverse effects-EPS-wise (despite a relatively higher dosage of the lower potency agent). This is highly personalized, so take it with a grain of salt.





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