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Re: Tardive tic + mycolonus, risperdal, amisulpride

Posted by action_jackson on August 31, 2002, at 1:11:50

In reply to Re: Tardive tic + mycolonus, risperdal, amisulpride » action_jackson, posted by cybercafe on August 30, 2002, at 10:28:12

Cybercafe -

> so how long did you have EPS for before you stopped taking the AP?

I started beginning Jan, at 50mg amisulupride, terminated late Jan, tapering down over month 50, 25, 12, 10, 6 then stopped.

I was ignorant of "acute dystonic reactions" when it was prescribed to me. I started getting these acute dystonic reactions starting about 6 days after starting amisulpride, and at roughly 3-5 day intervals afterwards, but moreso toward late Jan. Foot tapping, then jaw dystonia, lips, tongue, neck, leg, quite a variety!!! :)

When I completely stopped amisulpride - the chronic stuff set in, which was mainly the orofacial region (jaw chatter, dystonic type repetitive movements of jaw and tongue). Much lesser and sporadic neck, back, leg movements.
My movements later (including some later appearing ones - all were considered "complex" and "atypical" - probably because of dopamine blockade combined with increased dopamine release (a feature of amisulpride, and also serotonin and DA agnoism in concurrent Nardil low dose I was taking at time). Plus I am relatively young male with affective distorder (SP) - the highest risk group for hyperkinetic, dystonic type movements (in my case "tardive dystonic tic" may be the most primary diagnosis of movements"

Well - I don't want to go into all the nitty gritty (I have already!! :) ), but the above seemed to perhaps improve a bit over 4 months - then in a moment of mental blackout I listened to a new Dr. who told me to take 2.5 Zyprexa at night which "helps tardive *antyhing*". Somehow, someway - I listened to this guy enough to take in sum 2.5mg total over 3 days (1/3 tablet over 3 different days). A week later I developed involuntary neck movements and additional movments extending to my limbs, trunk, etc.

I have no movement disorder history - and my SP has been quite well treated for over 6 years. I have worked steadily as a professional about 8 years - until last Jan - and probably will restart soon where I left off if things go OK as I now am going back closer to my SP treatment as it stood before. I got a movement diagnosis - which was not easy - those speciality neurologists (movement disorder specialists) are very very booked up - forget even getting into a good big clinic unless you have a year or 2 to wait...

.... and what exactly is a tic, is it possible to not notice that you have one or is it very noticable?

There are "simple" and "complex" tics - can be as simple as occasional eye blinking, complex as to include muscles all over the body, in contuinous repetitive patterns - is supprressible somewhat - up to a point only - and can include vocal (does not apply to me) - this most severe of "Complex Tic Disorder" is called "Tourette's Syndrome" which youu've probably heard of. People with Tourette's and no good treatment - well if you have seen it - you will know that it does not look very pleasant to have such a problem...

Movements disorders are really hard to learn about - I think in retrospect - the way to learn it quick is to see all kinds of stuff on video - the way Dr's probably learn it. Reading about it just is very very difficult. There are so many types of movements, and often there is combination anyway ("complex") - which was diagnosed in my case BTW. The easiest TD to see is the classic type that schizophrenics get after many years of high dose a/p. Those guys do not get TD easy - when they finally do - it takes a "classic" form usually - and is the kind that most Dr's are able to see and diagnosis - but is not the kind usually appearing in affective disorder patients getting TD or other Tardive Momvment Disorders after low dose use of A/P - even sometimes for extremely short period of time - such as with me.


> i find that zyprexa does wonders for my agitation and replaces it with a feeling of calm and peace... but of course i wonder if i might not be equally well on a safer 5HT2 antagonist like serzone/nefadozone or remeron/zispin/mirtazapine
>
a/p's are also called "major tranquilizers" - compared to benzodiapines like Xanax which are called "minor tranquilizers" - and both tend to have the qualities you describe...

Serzone does have some partial 5ht-2 blockade like zyprexa - but lacks D2 blockade - which is a big part of the antidepressant and antianxiety effect of Zyprexa. Serzone is probably better for anxiety than depression on average. I don't think it is really used much by itself for depression - is considered pretty weak for that purpose I believe, taken alone. I think some people find Serzone agititing rather than calming - seems like that varies person to person.
In my case, I found it axiogenic alone, but axiolytic with 50mg Zoloft ... and I always found Serzone pretty mild - more to tweak an SSRI or something than to use all alone.

Remeron is interesting but it seems like hardly anybody stays on it for very long due to various side effects which might appear right away or after several weeks of use...

Chad
http://www.socialfear.com


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