Posted by yxibow on November 18, 2007, at 2:53:03
In reply to Re: Abilify caused a case of Tardive dyskinesia » Zyprexa, posted by clipper40 on November 17, 2007, at 17:26:14
> How do you know it was TD? I had shaky hands and muscle twitches from Prozac. I'm curious because I'm considering adding on Abilify but I'm really scared of TD.
It wouldn't surprise me to have such side effects from Prozac, it isn't the most clean SSRI being one of the earlier ones, but then a lot of medications can be said to correlate with twitching.
I continue to take Seroquel even after 6 years and a tic diagnosis. I'm sensitive to medications though, TD with atypicals is still rare but something that is informed consent, meaning you're informed about its true but remote possibility and you consent as opposed to being forced to take it in a hospital.
I worry about it too to the point of possibly obsessing about it (even though its a reality, yet my functionality is quite better) and wonder if eventually I will switch to Clozaril which has had to date nearly nil TD and TDy despite all the other problems that it carries (it actually can improve TD cases)
Statistics are hard to go on, some say atypicals carry 5% per year of TD risk, but only Risperdal has had a proven track record of TD so far, with isolated case reports in other atypicals. Then again I recall a BJP journal study of a number of patients on Zyprexa with 1/2% per year. Its true, there is no crystal ball, but regular AIMS exams, which are just subjective muscle tests by your doctor who should be familiar with it minimize the risk of developing potential cases.
It also takes a psychiatrist very familiar with movement disorders or a neurologist to determine what is a tic, TD, or TDy (Tardive Dystonia) and that's the problem with case reports -- they're not double blind studies, isolated opinions written in journals.
Generally TD is something that happens late in treatment (Tardive) -- the best advice from movement disorder experts is to use the minimum effective dose of any neuroleptic.
TD recovery has roughly 30/30/30 -- 1/3 will completely recover, 1/3 will stay the same, and 1/3 will unfortunately get worse in some way.
Ultimately it is a choice of functionality versus less function without it, depending on the reason for its use.
As for potency, its roughly (no real guideline) {Risperdal, Invega} -> {Geodon, Abilify}, Zyprexa* (does have high D2 blockade) -> and Seroquel.
poster:yxibow
thread:794017
URL: http://www.dr-bob.org/babble/20071115/msgs/795690.html