Posted by munificentexegete on February 11, 2007, at 18:53:18
In reply to Re: low dose risperdal -- linkadge, posted by linkadge on February 11, 2007, at 16:51:44
> For starters, nobody is forcing you to take any of these drugs. If you don't believe they are safe, then don't take them, no harm done.
true, however, most people will come into contact with these drugs on an involuntary basis at some point in their life such as in the foster care system, in a nursing homes, and even in the teen screen process.
>> many people have many hypotheses about many things, some people think including myself that time travel is possible, although there is no reproducable evidence supporting the cause of psychosis meaning it is merely an unsupported hypothesis at best, not scientific fact.
>I am not saying that any one identifyable cause of psychosis has ever been established, nor do I think there will ever be. I am simply saying that people's suffering is real. Considering the lack of viable alternatives, I think the judicious use of antipsychotics is warrented.
on a voluntary basis, with proper elucidation of the true risks, meaning proper independent long term studies, I agree with you. but that sounds like an alternative universe to the one we currently live in.
>> do you really think there is only one case of TD with risperdal. EPS, NMS, TD, dystonias, akathisia, parkinsonism its all there in risperidone and any side effect profile worth its salt points it out. I just pointed out that court cases have been won meaning it is also legal fact too.
> Yes. it is a legal fact that these drugs *can* cause neurological problems.
yes, it is an established medical and legal fact that all antipsychotics typical and atypical cause EPS including TD.
> Just as cases have been won on the issue of antidepressnats causing people to commit suicide.
sad isn't it when many studies conclude the risk of suicide is higher with an AD than without.
> Again, this does not conclude that everybody who takes these drugs will have this side effect.
however, everyone is exposed to the risk of developing serious neurological damage with these drugs. it is about calculating the probablities given the size of the dose and the length of treatment.
>> what disease?
> It really doesn't matter what you want to call it, disease or otherwise. If you are saying that suffering is not real just because it cannot be observed under a microscope then I think we have lost the point.
well if it isn't a disease, then that means it isn't a medical issue doesn't it?
>> most of the studies assume EPS including TD occurs and try to point out that it produces relatively less incidence of EPS/TD. They change the doses to make it seem this way.
> I don't understand.
for example EPS is generally thought to be a dopamine receptor issue, so they compare a dose of new antipsychotic that induces a dopamine block of 50%, to a dose of old antipsychotic that blocks 80%+ of dopamine.
although as a side note much EPS could also be due to anticholinesterase activity hence why atropine is often a successful treatment for things like dystonias.
>> i think it is fairly well established that risperdal causes EPS including TD.
> No. It is well established that risperidal *can* cause TD. The *numerical* indicence has not been established. I took risperidal, I did not develop TD. So therefore it is not true that risperidal causes TD in everybody.
however, you were exposed to a risk of developing TD. That risk is exacerbated by increased doses and the total amount of risperidone injested. actually you have almost certainly incurred brain decay from the risperidone, although you have not yet incurred enough damage for the damage to be obvious. As has been established, every milligram of antipsychotic causes progressive irreversible neurological damage, in the same way that a neurological disease would cause if say you had Parkinson's disease.
>> So the next issue it what is the max single dose that can induce serious eps, i think it is about aorund 5 to 6 mg depending on size weight and sex of the patient. Then what is the risk of tardive dyskinesias from long term treatment, it may be a 2% chance with 300mg, 20% chance @ 600mg and a 50% chance at 900 mg
> But, nobody takes that much risperidal.
every milligram injested causes neurological damage, if overtime the total amount of risperidone injested by a patient from the time they first start taking the medication is more than say 100mg, that would be taking 2mg for 50 days, there may be a 0.05% chance that neurological decay caused by the risperidone displays as TD.
with cumulative dose of 300mg, say 2 mg for 150 days the risk of TD may be 3%, and so on. 3% is a very high probablity given the seriousness of TD for only consuming 300mg, but that is the risk I have seen from some studies of risperidone in the elderly.
>> is psychosis even a medical issue?
> Maybe not. But unforunately, there are no other established treatments for the problem. If it is not a medical issue what do you recomend?Excorcism?
well if psychosis is not a disease it falls outside the ambit of the medical profession, as a result medical intervention can never be justified on an involuntary basis.
on a voluntary basis, by contrast, a person should be free to pursue as many different treatment alternatives, for whatever non disease they have, as they desire.
> Studies suggest that these problem tend to get worse over time.
what problem are we talking about precisely, a disease, or something else?
poster:munificentexegete
thread:730044
URL: http://www.dr-bob.org/babble/20070207/msgs/731910.html