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Re: Anticholinergics and typical antipsychotics

Posted by Christ_empowered on April 24, 2022, at 20:58:32

In reply to Re: Anticholinergics and typical antipsychotics, posted by Jay2112 on April 24, 2022, at 18:31:08

hi. I read a summary of a study on mad in america...the researchers were given patients' medication cocktail information. based on available information, the anticholinergic intake was assigned a number value...I think I thru 4, maybe I'm incorrect...

and then the patients were given cognitive tests and such. OK. so, at low -overall- intake levels, anticholingerics...not a huge problem. once the individuals hit the moderate to high levels...cognitive impairment and other adverse effects became pronounced, compared to differently medicated peers.

the neuroleptics (all, old and new) seem to be associated with brain damage. in animal studies, zyprexa caused less brain damage than haldol over the course of...I think 12-18 months, maybe? that study used some sort of monkey, so its probable that humans will also see brain damage.

some drugs are worse than others. haldol has a toxic metabolite that may explain some of the brain damage and also the high rates of td, akathisia, overall eps. dosage seems to be an issue. brain imaging studies seem to indicate that loxapine, for instance, is sort of atypical-ish at low, low doses. problem? for the longest time, no one was using low, low doses, especially in those with a schizophrenia-spectrum label.

for a long time, high dose, high potency neuroleptics were...standard. 20mgs/haldol (roughly 1,000mgs thorazine, which ideally should be dosed at or under 600mgs/daily) was the dose...1st episode, chronic, didn't matter...and doses went upwards from there. -some- of those patients ended up developing tardive dementia, an observable loss of IQ, overall intellectual capacity, etc. related to neuroleptic treatment.

-sigh- this isn't to say that all neuroleptics should be avoided by everyone, all the time, every day, forever and ever. its looks like the individual drug matters, not simply 'conventional' or 'atypical' classification, and dosage plays a key role (this is generally true of TD, too). and...

the issue of individual susceptibility may be an issue. some data would indicate that long term use of additional drugs (example: lithium) can make cognitive impairment, TD risk worse...probably indicative of more brain damage than just the neuroleptic or just the lithium. vulnerabilities. -some- psychiatrists suggested that Bipolar I patients and Schizophrenia-spectrum patients with strong mood symptoms were/are more vulnerable to TD from the conventional tranquilizers, and the TD tended to be more severe, more likely to be crippling. again, that would -probably- suggest that entire classes of people/patients who are especially vulnerable to severe neuroleptic-induced brain damage should probably be treated differently. for a time, clonazepam was used in some people with bipolar and schizophrenia-spectrum labels, either to avoid neuroleptics or to minimize the dosage.

and now...

I'm frightened, personally. I'm fairly certain the primary reason I don't have TD, etc. is high dose vitamins and antioxidants (DIY orthomolecular), but not only are few patient told to take any antioxidant as prevention...

now, it seems the anti-supplement crowd is making it harder to even suggest basic things, such as higher dosage vitamin E at the 1st signs of TD. oh well.




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