Health - dangers of anti psycotics ?

Discussion in 'Antipsychotics' started by adzket, May 26, 2006.

  1. adzket

    adzket R.I.P. Gold Member

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    in this thread https://drugs-forum.com/threads/18001
    about switching benzo's i offerd an alternative for anxiaty but was told it was manly an anti-psycotic. could any one tell me more about these and any possible side efects there maybe asosiated with long term use as I have been taking tripurflourzine (stellasine) for about 3yrs now for anxiaty with out beeing aware of it being an anti-psycotic. swim have had no noticeble side effects as yet. at 6mg a day. i dont want to get my doctor to waste his time exsplaing things to me as our national helth service is over run as it is any helpfull advice would be good. thanks.
     
  2. Nagognog2

    Nagognog2 Iridium Member

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    The main long-term danger with phenothizine-based drugs, which is what you are describing, is Tardive Dyskinesia. Briefly, this is a hole they make in your brain-stem that causes uncontrollable twitching, shuffling of the feet while walking, drooling, and lots of other fun things. For more info on TD, try a google search.

    TD is a permenant affliction.
     
  3. adzket

    adzket R.I.P. Gold Member

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    well that sounds like the end of any weekend so nothing to worry about there
    just sounds like i will end up like ozzy ozborne lol. no seriously i will have a look. thanks.
     
  4. Micklemouse

    Micklemouse Platinum Member & Advisor

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    Sorry, Nag, but TD is neither caused by Antipsychotics making a hole in your brain stem, nor is it necessarily a permanent conditon.

    It is not actually proven how or why tardive dyskinesia occurs, but there are several theories...


    Typical antipsychotics work by blockading the brains dopamine receptors, including the D2 receptors that are responsible for controlling fine muscle movement, and are generally indicated in the control of tics and other unfortunate physical stuff. By altering the bodies ability to take in dopamine at the D2 receptors you leave yourself open to all sorts of lovely side effects and potential longer term effects, such as tardive dyskinesia.

    Tardive dyskinesia is characterised by

    - involuntary movement of tongue and jaw, primarily tongue flicking, 'cud-chewing', gurning, grimacing, smacking & puckering of the lips, and sometimes excessive blinking.

    - involuntary strumming motions with the hands, and other uncontrollable flexing and movements of the fingers and wrists, and occasionally other extremities, the abdomen & diaphragm.

    Other more specific aspects include:

    - tardive akathisia; a feeling of internal restlessness, the urge be in constant motion, constant tapping. Usually ocurs as a dose is reduced after long-term treatment, and treatable with beta-blockers, some benzo's, codeine, anticholinergenics.

    - tardive dystonia; characterised by fixed posturing in the face, neck, extremities & trunk.

    - tardive Tourettes.

    - tardive tremor.

    - tardive myoclonus; brief jerks of muscles in theface, neck, trunk & extremities.

    - tardive blepharospasm; repetitive, forceful, sustained contraction of orbicularis oculi, the part of the eye responsible for closing the eyelids, and the passage and drainage of tears.

    Tardive Dyskinesia is diagnosed from an assessment of these symptoms after treatment with antipsychotics for at least 3 months (1 month if over the age of 60). It can also be caused by amphetamines, l-dopa, several antidepressants (including Prozac & Zoloft), antihistamines ... A comprehensive list can be found here -

    http://www.emedicine.com/neuro/topic362.htm#target2

    Although often permanent, tardive dyskinesia has been known to subside with discontinuation of meds if caught early enough. The movements described are involuntary & generally occur when at rest. Often the sufferer is unaware that they are actually doing it. Like many involuntary movements they can often be controlled when the sufferer becomes aware of them. Tardive dyskinesia is often masked by Parkinson's disease (with which it shares many similarities) or the antipsychotic regime itself.

    Short term side effects are often similar to tardive dyskinesia, but more acute and less predictable, generally (but not always) appearing early in treatment, and often (but not always) subsiding as the body & brain adjust to the changes brought about by the dopamine blockade. Commonly known as Extra-pyramidal Side Effects, they can be broken down into

    - Acute Dystonia; often intensely painful contractions of the neck, face, back. Think of the guy from Scream, and you've got an idea of the way a face looks during an acute dystonic reaction. Also sometimes accompanied by arching of the back. In the early stages of a reaction swelling of the tongue is often seen, as well as stiffening of the wrists, arms & shoulder blades, and either dry mouth or over salivation. If this happens, its the time to get yourself some antimuscarinics asap (e.g. procyclidine (Kemadrine) or benxhexol (Artane). Anticholinergenics are also used.

    - Akathisia; restlessness, inability to settle in one place, constant movement & walking.

    - Occulogyric Crisis; possibly the most painful and distressing of the side-effects, and thankfully one of the rarer ones. Occulogyric Crisis is a virtually uncontrollable upward movement of the eyeballs towards the back of the head.

    Other complications can include

    - Neuroleptic Malignant Syndrome; again rare, but is however potentially fatal. Symptoms include hypractivity, muscle rigidity & delirium. High fever develops rapidly, along with hypertension, tachycardia (raised heartrate), elevated white blood cell count, & if not accurately & quickly diagnosed, possible death. Again, this is a rare condition, more associated with high levels of typical antipsychotics used for a long time, but all antipsychotics carry this risk.

    - constipation, dry mouth & blurred vision.

    - lowered libido & impotence.

    - gynaecomastia, or man boobs in plain English. Occasionally milk is expressed (galactorrhoea).

    - cardiovascular problems, including hypotension often leading to increased risk of falls; tachycardia & arrhythmia. Regular monitoring of blood pressure is recommended, as are ecg's.

    - over-sedation & respiratory depression, especially in combination with other sedative drugs, e.g. benzo's, alcohol.

    - Parkinsonian symptoms, including tremor, shuffling or stiff gait; relieved again by antimuscarinics.

    - weight gain.

    - blood disorders.

    - agitation.

    - photosensitivity (especially with chlorpromazine; dealable with by a liberal dose of sunblock!)

    All scary stuff, and enough to put you off yer meds. However, as I've said, these side effects do not affect everyone, and often as not pass with time or an adjustment in dosage. Do not discontinue antipsychotics abruptly unless under medical supervision.

    At the levels used for anxiety, these side effects should be rare, and tardive dyskinesia even rarer, being associated more with high doses over long periods.

    http://www.emedicine.com/neuro/topic362.htm
     
    Last edited by a moderator: Sep 10, 2017
    1. 3/5,
      Gives me hope for future
      Jun 1, 2016
    2. 5/5,
      Useful advice and an eye-opener for someone recently started on Chlorpromazine. Thanks.
      Nov 5, 2015
    3. 5/5,
      superb contribution on tardive dyskinesia
      Jul 19, 2013
    4. 5/5,
      Information about antipsychotics in this post a valuable addition to DF.
      Jun 17, 2009
    5. 5/5,
      very informative
      Oct 4, 2006
    6. 5/5,
      yeah, you've done it again.
      May 30, 2006
    7. 3/5,
      very helpfull information
      May 29, 2006
  5. adzket

    adzket R.I.P. Gold Member

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    thanks that info very helpfull I may be asking there doc to change meds I has had photosensitivity problems from this befor it ruind his holiday due to sevear reaction to the sun whikes on these meds. and thing they may have had some of those simptoms but put it down to general drug use.
     
  6. Micklemouse

    Micklemouse Platinum Member & Advisor

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    You're very welcome, Adzket! And yes, I'd definitely recommend getting your meds reviewed in the not too distant future - 3 years is a long time to be taking a medication without some sort of review somewhere along the line. I'd also think about maybe asking for something other than drugs to help you deal with the anxiety - counselling perhaps? Don't know what the causes (if any) of your anxiety are so don't know if counselling would be appropriate. I do know however that long term use of any anxiolytic without review or being made aware of the potential pitfalls is not appropriate.

    One more word of advice - always ask for and read the patient information leaflet that comes with your medication. Your pharmacist will gladly give you one, and will probably be happy to go through it with you. Although your gp should be giving you this information without being asked, there is also a certain responsibility on the side of the patient to educate themselves & know what they are doing to their body & nervous system.
     
  7. Nagognog2

    Nagognog2 Iridium Member

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    Odd, but the studies implicating drugs such as thorazine causing TD are quite well known. It used to be called "The Thorazine Shuffle" due to the way people walked who were so afflicted. Who decided this was not the case? The pharmaceutical corporations ducking a few thousand lawsuits?
     
  8. Micklemouse

    Micklemouse Platinum Member & Advisor

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    Now a generic, but slightly nicer sounding, 'Neuroleptic Shuffle', covering all bases of the world of antispsychotics and the like !

    The fact that typical antipsychotics such as Chlorpromazine (Thorazine in the States, Largyctil in Briton) is implicated in TD is well accepted and documented.

    http://www.emedicine.com/neuro/topic362.htm#target2

    The fact that it is not an inevitability is sometimes forgotten. The use of antipsychotic medication is based very much on a risk:benefit assessment - they allow certain people to function in their life with as little mental, emotional and sometimes physical torment as possible, but there are risks. There are risks with everything.

    Would you deny a cancer patient chemotherapy because it might have serious adverse effects? No, because the potential benefits would appear to outweigh the risks. So why deny the relevant chemotherapy to someone going through a psychosis, or an acutely anxious state where other sedatives are not indicated, when the benefits could in actuallity outweigh the risks, and have been shown to prolong not only length of life but quality of life, on the basis of poor and over- prescribing of medication that was in it's infancy?

    I can't speak for the U.S., but I believe psychiatric prescribing practice in Briton at least is getting better, at least in acute care. Pharmacists and nurses are beginning to have more sway with the medical profession, playing a greater role in directing the care and advising on adverse reactions and potentially dodgy combinations. A Certain Mouse tells me that he sees less and less cases of TD, even amongst the older, long term recipients of antipsychotics, and that it is picked up on a lot quicker than it used to be, heightening the chances of recovery. Acute side effects are on the whole well managed, and patients are often as not educated as to what to look out for, and what to do. It is however with off-label prescriptions for anxiety, or the long term use of antipsychotics as antiemetics or for controlling Tourettes or Aspergers that the problems may yet arise with neuroleptics.

    Don't forget that many other drugs that act upon the cholinergic system are implicated in Tardive Dyskenesia, including many older antidepressants and a couple of SSRI's, antihistamines, amphetamines, anti-epileptics (which alongside lithium are also used as mood stabilisers in the treatment of mania and personality disorder), even the oestrogen oral contraceptives.... There will be alot more cases of TD from users of these classes of drugs in the not too distant future, especially the amphetamines if current prescribing is anything to go by...
     
    1. 5/5,
      detailed and thorough contribution on tardive dyskinesia
      Aug 2, 2013
  9. Nagognog2

    Nagognog2 Iridium Member

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    I'm certainly not saying don't prescribe such. The original question was what are the possible problems - and I think we have covered such.

    There are a few people I would like to see come down with a galloping case of TD! Did you know that during Watergate, President Nixon (this ratted out by the media) exhibited clinical symptoms of a person on thorazine (or similar) during his news conferences/speeches?
     
  10. Alicia

    Alicia Gold Member

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    Swim thought they in Britain anyway had 6 month period of assessment where they check on, how medication is effecting the patient etc notes on behavior. Or is that just to apply inpatients?
     
  11. Micklemouse

    Micklemouse Platinum Member & Advisor

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    Nag - apologies! I misread your sentiment I think... It's been a long weekend! There are however many who take the view that neuroleptics should never be prescribed, to whom I say come and spend a few months working on an acute ward and then tell me that these drugs don't have the potential to contribute to an improved quality of life when prescribed and monitored well.

    Regarding TD & politicians - have you seen the dystonic grin that My Little Tony (Blair, that is!) has had for the last few years... Scary!

    Alicia - after a period in hospital there is indeed a further period of assessment through outpatient appointments and Community Mental Health Team visits. Not only to monitor for unwanted effects, but also to provide support in a period of transition for the patient. This should last a year, at the end of which if things are going well, a reduction at least in medication is aimed for. Not always possible or appropriate of course - for some people the balance is very fine, and the slightest tinkering with medication will lead to either a relapse or a rebound psychosis requiring either intensive home treatment or further in-patient care. The problem arises with g.p.'s prescribing medication that they know very little about for what amounts to an easy life for them, with no thought for the long term effects, or actual changes in a persons mental state. It's a sad truth that chemical therapy is cheaper & easier to give out than time spent listening or referring to a talking therapy. All too often people are admitted to hospital because their g.p. (and sometimes psychiatrist!) hasn't accurately monitored them, or has prescribed the wrong medicaton at the wrong dose for a stupid amount of time without review, or hasn't given the patient relevant information about the medication they are taking.

    Psychiatry and Psychopharmacology are still very young and by no means perfect disciplines, and have a long way to go before they become accepted, especially by some of the people they aim to help. That said, they have come a long way in a short period also.
     
    Last edited: May 30, 2006
  12. mickenator

    mickenator Titanium Member

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    Previously I was on Depixol and that had some serious side effects the worst being parkinsons for which I was also perscribed prosyclodine, but my doctor changed this for a newer one called olanzapine and the only problems I get with this are the weight gain 15 stone and climbing, but Iam loathe to change this as Iam able to function relatively normal and hold a job down.
     
  13. OccularFantasm

    OccularFantasm Silver Member

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    I had no idea thorazine was an anti-psychotic. I do have to wonder though, is it even remotely feasable to do anything while on thorazine. I know I was couldnt get out of bed for over a day and a half. (a doctor of some kind gave it to me in the hospital, so everything was legal n such, or i would have definatly used swim.) Perhaps i was given a higher dose or something, i really have no idea.
     
  14. 2lovelyladies

    2lovelyladies Newbie

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    yes chlorpromazine is an anti-psychotic, and a nasty one at that. it turned me into a zombie. its also used as a sedative over here in australia. i hate the stuff. im currently on abilify (aripiprazole). its wonderful, no voices, and no zombieness.
     
  15. Perception Addict

    Perception Addict Gold Member

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    Swim's mother works with mentally ill children, and told Swim about a really depressing case. Her mother is currently working with a 9 year old child diagnosed with severe bipolar disorder, whose doctors keep the child sedated with thorazine for its alleged antipsychotic effects. According to her mother thorazine is rarely used anymore due to its severe side effects, but she doesn't know if this is true or not.
     
  16. OccularFantasm

    OccularFantasm Silver Member

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    That is quite unfortunate. the child is simply going to have more mood swings more intencely and frequently from the heavy drugs being given. Especially for people at such a young age, such drugs should never be given. Hopefully someone saves that poor little boy. He doesn't deserve that shit. God psychiatrists make me fucking sick.
     
  17. Perception Addict

    Perception Addict Gold Member

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    Agreed. The child is in a residential treatment facility, and the use of such uncalled-for drugs is currently being contested by my mother. We believe that it is a lazy way to deal with the child's problems, by sedating the child so fully that no problems can occur. Hopefully this can be changed, and that's what my mother is trying to do.
     
  18. chico

    chico Iridium Member

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    have you tried any of the newer antipsychotics, risperdol or abilify? I has many patient on abilify with no adverse rxns except wait gain.
     
  19. Perception Addict

    Perception Addict Gold Member

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    I just asked, and was told that abilify was first tried, with "insufficient" results. As for risperdol, my mom wasn't sure. Again, we have serious doubts as to the necessity of giving the child thorazine, but there isn't anything i can do. As for my mom, she'll continue to do her job and attempt to stop this mistreatment.
     
  20. OccularFantasm

    OccularFantasm Silver Member

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    I would suggest trying to find one of a few different things. Perhaps a compound pharmacist could be of service. Also see if maybe testing is available somewhere. If I live in New York, lying will be essential. (NYS made certain testings illegal for no reason) I know NIHA (national integrative health association) can do these testings. I went to the one in DC, but there may be more, I'm not sure. It is likely that some combonation of imbalences are creating the symptoms from which doctors are labeling diseases and disorders. If that isn't possible, perhaps see a doctor of alternative medicine. Also, acupuncture may prove to be helpful. Basically, without knowing whcih approach will help, just try anything else you can. Just stay away from psychiatrists. The little boy already has psychological problems from being told that he is broken and forced to take many unknown drugs. I can't imagine someone being able to handle this, especially at such a young age. Thorazine=bad. Risperadol=bad. haloperidol=super bad. abilify=unknown. I haven't tried or doen much research on abilify, so i cannot give an informed comment on it at such a time. Probably it won't do much good. Let the child go completely drug free for a few months and see how he reacts. Give him some weed or valium or something for probable anxiety attacks form trying to adapt to a less trippy and scary world.

    Also, as far as the psychologic troubles go, be careful when it comes to psychologists. In some people, talk therapy helps, especially in those whom have noone else to talk to. In others however, the person can actually be more traumatized by such bad times being brought up over and over again. Just be careful.

    Also watch out. a person can become very depressed when their world goes through a sudden change like that. Unfortuanatly, the child will also harbor a desire for independence, and to very simply just not be seen. This is very hard for the parents, and a very delicate balence needs to be established.

    I may also sugget if removal of other drugs does occur, to start on a regiment of some zince, some reaidly absorbable magnesium, some b-6, and some zinc. Also for the love of god avoid ritalin and other amphetamine stimulants. It will be harmful to the body so closely following antipsychotics. It would not provide permanent damage, but it would be unhealthy for the child, and noone wants that. I wish you good luck with this endeavor. Peace.