Posted by the kindling effect on February 12, 2006, at 11:21:47
In reply to Re: TA etc. » the kindling effect, posted by ed_uk on February 10, 2006, at 15:57:57
> Hi Ed
>
> >......years ago to attempt to replace the loraz.......was having panic attacks on it so I insisted on raising dose and frequency and seemed like akathisia......
>
> Perhaps you felt worse due to decreasing your dose of lorazepam, rather that due to the diazepam itself?I wish that were the case. Weren't panic attacks per se but that speedy chest feeking and intensity of time know all too well. We did 4 or 5 trials with diazepam. It's definitely a different benzo. I liked it but was miffed at the strange side effects. I had pulled muscles on it after exercising similar to clonazepam. I don't understand that, it having muscle relaxant properties, but my Pdoc of the time said it wasn't that usual. Although I'm sure the lack of lorazepam had some effect even though they're supposed to be cross tolerant.
>
> >I would try Librium even though Valium is a metabolite.
>
> Chlordiazepoxide (Librium) is not metabolised to diazepam (Valium). Chlordiazepoxide and diazepam are both metabolised to desmethyldiazepam however - their most important metabolite.Thank you for the clarification. My laziness and over-generalization again.
>
> >Haven't done well with trycyclics.
I don't understand why?!! Amitrip. was the worst.
>
> What about other ADs? Have you tried low-dose mirtazapine (Remeron)?Yeah. 7.5mg. back pre-EFXR and atypical APs.Was only only on it 2 days before pdoc pulled me off;he was worried about aggression with the over-sedation,something he'd read. It's a whole new game now however and mirtazapine was one of the meds I wanted to re-trial, possibly even a lower dose. If I recall it has 5HT2 antagonism and also benefits sleep architecutre.I'd probably try even lower perhaps. I know the higher doses NE kicks in and akathisia can be an issue. When I asked doctors to re-rial they just look at me like I'm nuts or say 'żou've already tried it.' But 2 days!?! It was sedating and found just sat it your stomch even though i hardly ate anything in 2 days.(similar to olanzapine in the in this regard; less appetite,more weight).Besides that I don't re-call any-many problems with it. Currently I have no doctor except a GP who will only refill my current meds.
How do Parkinson's patients handle mirtazapine?>
> >Anti-cholinergic are apparently a big no-no with TA and can worsen it quite a bit(even if it masks it at first.) No doc has suggested them.
>
> I wouldn't say there are any definite no-no's in TA because its treatment has been so poorly researched.
Very well put. I'd have to agree 101%. It's 2 different things discussing it however and haveing a doc who'll prescribe. THis is why I'm trying to find out who this Harvard doctor is so urgently(researching/treating TA). Do you have any idea how long Fenix is blocked for?Some patients may benefit from anticholinergics whereas other may find them detrimental. Pro-cholinergic drugs (such as donepezil, Aricept) might be useful for some, particularly for those who find that anticholinergics aggravate their symptoms.
Makes sense. My question is noalways, how long did they respond for. It looks like all I/we were doing was pften masking the TA unti it started coming through again. This could take weeks to months. Personally I still don't(can't) accept/believe that it's TA. It's so ^%$^% uncomfortable but some things don't fit, especially my reactions to beta blockers. Although there are an awful lot of things that are trademark TA and don't appear in anything else. Or as the ADD/OCD/Tics?tourettes neuro put it when they ruled tha out(except for OCD)'for seperate movement disorder nerologists have told you you've got TA in the past year(?). You'd better start accepting it. Now raise the dose of your propranolol'. Basically they seem to believe in Canada the only two possible treatments for TA are propranolol and Tetrabenazine. And I've been told if I can't handle the prop. I certainly won't handle the Nitoman.
There is more to it Ed. I don't know where your knowledge lies and if you have a good understanding of neurologoy or not(I sure don't, psychitric sure,neurology no) but I can try ,eventually to run down some of my more common symptoms for you. I understand you respond to many people on this board and only have so much time. All neurologists have also said more than TA obviously; depression , anxiety NOS(prob.definitely), mood disorder(this think is realated to the TA. I could even feel some of what I feel and act in the way fenix wrote.) This chages your whole being Ed. It scary sh*t. I remember the de-realization etc. from panic attacks years ago and they are a joke compared to this.
>
> A patient with TA responded to benztropine (Cogentin), an anticholinergic.......
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=1979500&query_hl=1&itool=pubmed_docsum
>
> >Cypro I tried to get but couldn't find it anymore here in Canada.
>
> Cyproheptadine 4mg tablets are available without a prescription in Canada. I doubt many pharmacies will stock it but I imagine they could order it in for you if you ask. Tell them you find it a good antihistamine for your allergies. Cyproheptadine is inexpensive.
>
> Cyproheptadine is an OTC (over-the-counter) drug in Canada......
>
> http://www.hc-sc.gc.ca/drug2/product/p40420.htmlYeah, I didn't look too hard. Actually someone else checked for me. I don't get out much. It makes tics movements worse and car rides seem to really aggravate the aka. couple hours post, sounds and movement can become overwhelming.A plane I had no problem with(only the delays before and after, trying to stand in lines without walking in circles and becoming agitated.Blah blah. I just want out of this hell.
I need a neuro on a regular basis, preferably who understands movement disorders anyone readng this.ASAP. Here in Canada our public system is bogged down. I'm on a year waiting list for a 20min. consultation with movement neuro in Toronto, who has already seen a videotape of me
and diagnosed TA and tardive tics.
>
> >This i have not heard (RE moclobemide). Do you have the report?
>
> Only the abstract.....
> Again, how long was the response? I say who cares, it's temp. relief but always look stupid and regret when the Aka. comes through again.
I know I'm being cynical. But I actually searched for my moclobimide notes and would try it again in a second.
The head of psychopharmacology for Mood Disrders Unit at Toronto Western told me my 'filter was broken and only Nardil would fix it'. And that's why background sounds and movements and urges were happening. He mentioned things I hadn't told anyone as well.So I hang on to this hope. Although he wasn't impressed when I told him my moclobimide reaction and dose. 'not enough to tickle your throat'as he put it. No doc will prescribe Nardil when I mention his take on it; even though they're all like "wow, you saw Roger Macintyre'. THat spooks me more. When I asy I saw so and so, whom I've never heard of, and doctors are like wow, but these big rep docs. haven't helped any, i don't know. It also seems to intimidate the other docs and sometimes I think they simply confirm a dx casue so-and so said so. I'm getting worked up, stop there.
This was at a follow up consult after he dxed 'some weird bipolar' and tried my on Trileptal which made aka, and movements/stiffness worse and I stupidly stayed on and even raised the dose and ended up with suicide attempts trying to stop the horrible restlessness but I was so tired at same time . I didn't have suicide attempts until about a year ago.I can't believe i 'm talking about this sh*t; after stalking here for 5 years.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=1687486&query_hl=7&itool=pubmed_docsum
>
> >
>
> When I tried Moclobimide about 5 years ago, pre-Efxr and pre-APs I was slow and shaky and drowsy with a bad startle response and weird anxiety/insecurity. I was so-out-of it but jumpy.Stiffness wasn't that bad.(besides usual serotonin side efxs which I don't count.
>
> :(
>
> >10mg propran. a day. i go higher and run into problems
>
> What sort of problems? Next e-mail.
>
> I wonder what the combined alpha/beta blocker carvedilol might do for you?Yes, I wondered too and have mentioned it when I had a doctor. Quetiapine has alpha 1&2 antagonism according to Stephen Stahl and it reaaly used to wipe out some of the huffing and hyperness, and accusations from Atenolol(only med to bring me close to paranoia, but I was aware of how I was acting so not true para. correct?)Atenolol in combo with EFXR and loraz too. Although I start seeing some similarities at higher doses of propranolo but way less serious. More just mean and sloppy, bad drunk like. Nadolol didnit do this. just slow profound, greyness, sadness, hopeless. Pindolol was very different. Every trial it made me so mentally wired and time so intense.
>
> >Any suggestions welcome, including vitamin suggestions.
>
> Have you tried vitamin B6 (pyridoxine)? It seems helpful in acute akathisia at least........No my B6 was just tested and I would try it but preferably with a doctor, esp. since B-complex seems to agrravate the situation now. A naturopath had me on HIGH dose B5 in the summer for 'anxiety' and it become a bad situation. She also had me on CU after the Wilson's testing showed low blood CU and abnormal ceruloplasmin.and her hair testing showed very low coppper but normal zinc and even higher iron.
THe CU supplements made me so cold in the summer and really nostalgic/crying but I sort of liked them because I tolerated music and could visualize things somewhat when I read. Akathisa got worse as well as tics and OCD stuff.Muscles spasms and cramping when try and go in pool. But i could remeber more recent thingsand feelings(ie.Latin America) Plus I was impatient and snapping at people apparently.I'm getting lost and rambling. THat time of day. Can feeel it building more in my legs. they are always crossed so tight now. Would love to be able to just sit with them sprawled and relaxed.
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> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15554771&query_hl=14&itool=pubmed_docsum
>
> B6 in TD.......
hose are massive B6 doses. Might be the way to go. Don't here much about the mega vit-E doses for TD anymore.
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10442256&query_hl=14&itool=pubmed_docsum
>
> This whole thing is so insane I kept expecting to hear conversion disorder. But no one has said that yet but me. And I just seem to keep getting myself in deeper.
What happens to biPolars etc. who end up with TA/TD and can't take their meds? Wha he hell do they do!?(ie. woman in Philly who got it from 4 or 6 mg. Risperidone and successfully sued ....don't recall company). So she has TD and flaming BPi now? So much TA/TD info is on schizophrenics and geriatrics.
I'd like to see an organization for people with TA, and reasearch and docs specifically for those people. WE MOVE seems to have everything except resources for TA. I've never even seen another person with TA (although I;ve seen just about every other movement disorder(except Wilson's) in clinics etc.
t hanks DAVE
poster:the kindling effect
thread:604046
URL: http://www.dr-bob.org/babble/20060212/msgs/608917.html