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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by JohnX2 on February 23, 2002, at 14:37:54
I picked up this hand clenching and twitching
while manic and drinking lots of caffeine and
clenching my fist driving my car a lot and
playing a lot of golf all last month. I was also
taking a whopper dose of Zyprexa to battle the
mania. After a while I started to get bad spasms
in my left hand while I was having these bad manias
and I got cramps in my hand concurrent with the activities
(holding my steering wheel or golf club).This problem seemed to come and go with the mania
and stimulant abuse and clenching motions and I
discussed it with my pdoc. We felt it was probably
just some sort of Klonopin withdrawl seizures. Well
now I stopped Zyprexa and I am getting off/on
clenching and twitching in my hands. Mostly off.
Like 95% of the day I am Ok. If I drink some caffeine
and do some clenching motions it may start up again
and I freak out. I have gotton twitches in my face
that have persisted for months and then vanished. Is this
just some sort of tardive dystonia like thingy that
is likely to go poof over a few months like my other
little twitches normally would? This one is much
bigger, my whole hand is involved, fortunately not
my dominant hand, but I'm still nervous.-John
Posted by Ritch on February 23, 2002, at 18:10:37
In reply to post zyprexa hand twitching and clenching????, posted by JohnX2 on February 23, 2002, at 14:37:54
>
> I picked up this hand clenching and twitching
> while manic and drinking lots of caffeine and
> clenching my fist driving my car a lot and
> playing a lot of golf all last month. I was also
> taking a whopper dose of Zyprexa to battle the
> mania. After a while I started to get bad spasms
> in my left hand while I was having these bad manias
> and I got cramps in my hand concurrent with the activities
> (holding my steering wheel or golf club).
>
> This problem seemed to come and go with the mania
> and stimulant abuse and clenching motions and I
> discussed it with my pdoc. We felt it was probably
> just some sort of Klonopin withdrawl seizures. Well
> now I stopped Zyprexa and I am getting off/on
> clenching and twitching in my hands. Mostly off.
> Like 95% of the day I am Ok. If I drink some caffeine
> and do some clenching motions it may start up again
> and I freak out. I have gotton twitches in my face
> that have persisted for months and then vanished. Is this
> just some sort of tardive dystonia like thingy that
> is likely to go poof over a few months like my other
> little twitches normally would? This one is much
> bigger, my whole hand is involved, fortunately not
> my dominant hand, but I'm still nervous.
>
> -JohnJohn,
When I get tremor from SSRI's it is always one-sided (my left hand, too), also left-eyelid fluttering (like a sty). I noticed that Remeron caused me to feel like I couldn't grip things properly and I would overcompensate by clenching. Seroquel did something similar like that, too. It could the 5-HT2C antagonism. You might try a little Benadryl to see if that quells the twitching-if it does-definitely tell your doc.
Mitch
Posted by TSA West on February 23, 2002, at 20:44:27
In reply to Re: post zyprexa hand twitching and clenching????, posted by Ritch on February 23, 2002, at 18:10:37
If one only gets relief from mania and other related symptoms from neuroleptics, and Olanzapine may have left some EPS, I think the only logical solution would be to switch to Ziprasidone (whose safety EPS-wise may rival only Clozapine).
Posted by JohnX2 on February 23, 2002, at 22:50:58
In reply to Re: post zyprexa hand twitching and clenching???? » Ritch, posted by TSA West on February 23, 2002, at 20:44:27
I'm off of Zyprexa and onto Serzone and am no
longer experiencing mania. It seemed to be triggered
by the Klonopin tapering. Maybe allergies played a role
, just a suspicion.Anyways, do you think this dystonia will vanish?
Like I said, it only bugs me less than 2-5% of the
day.Thanks,
John> If one only gets relief from mania and other related symptoms from neuroleptics, and Olanzapine may have left some EPS, I think the only logical solution would be to switch to Ziprasidone (whose safety EPS-wise may rival only Clozapine).
Posted by JohnX2 on February 23, 2002, at 22:59:59
In reply to post zyprexa hand twitching and clenching????, posted by JohnX2 on February 23, 2002, at 14:37:54
FYI,
I've been taking Zanaflex (tizanidine), which
is basically a Clonidine dirivative, a partial
alpha-2 noradrenergic agonist. The Zanaflex was
prescribed to help with myofacial pain a while
back. I subsequently got Topamax which worked
much better, but when I got down to tapering
the last few crums of Klonopin I restared the
Zanflex (shitty halflife requires multiple dosing)
and I noticed a substantial amerlioration of
the dystonia. clenching and twitching/tremor
virtually disappeared.I since read that Clonidine is a decent treatment
for TD and that there are thoughts that TD
can cause toxic incread turnover in catecholimines.
The Zanaflex being an Alpha-2 agonist decreases/stabilizes
catacholinergic transmission. I wish there was a
patch sustained release version of the medicine
like clonidine. It had no hypotensive side effects.-John
>
> I picked up this hand clenching and twitching
> while manic and drinking lots of caffeine and
> clenching my fist driving my car a lot and
> playing a lot of golf all last month. I was also
> taking a whopper dose of Zyprexa to battle the
> mania. After a while I started to get bad spasms
> in my left hand while I was having these bad manias
> and I got cramps in my hand concurrent with the activities
> (holding my steering wheel or golf club).
>
> This problem seemed to come and go with the mania
> and stimulant abuse and clenching motions and I
> discussed it with my pdoc. We felt it was probably
> just some sort of Klonopin withdrawl seizures. Well
> now I stopped Zyprexa and I am getting off/on
> clenching and twitching in my hands. Mostly off.
> Like 95% of the day I am Ok. If I drink some caffeine
> and do some clenching motions it may start up again
> and I freak out. I have gotton twitches in my face
> that have persisted for months and then vanished. Is this
> just some sort of tardive dystonia like thingy that
> is likely to go poof over a few months like my other
> little twitches normally would? This one is much
> bigger, my whole hand is involved, fortunately not
> my dominant hand, but I'm still nervous.
>
> -John
Posted by skills on February 24, 2002, at 7:33:59
In reply to Re: post zyprexa hand twitching and clenching???? » TSA West, posted by JohnX2 on February 23, 2002, at 22:50:58
I experienced similar problems after Zyprexa. I was also on a large dose. The problems it left went about a year later...i used 10 mg of procyclidine 3 times a day to ease the symptoms.
Posted by JohnX2 on February 24, 2002, at 10:04:06
In reply to Re: post zyprexa hand twitching and clenching????, posted by skills on February 24, 2002, at 7:33:59
Hi Skills,Thanks for sharing your experiencing, sorry it
was bad. Can you recap the magnitude of your
problem relative to mine. Was your dystonia/dyskinesia
something that bothered you the majority of the
day when you discontinued the medicine? Sorry to
have to drudge up painful memories, but I'm trying
to gage how seriously I should treat this, also
I don't want the paranoia to consume me.Thanks,
-John
> I experienced similar problems after Zyprexa. I was also on a large dose. The problems it left went about a year later...i used 10 mg of procyclidine 3 times a day to ease the symptoms.
Posted by skills on February 24, 2002, at 13:50:39
In reply to Re: post zyprexa hand twitching and clenching???? » skills, posted by JohnX2 on February 24, 2002, at 10:04:06
The problems were quite bad at first but they do not sound as severe as your symptoms. I think you so check it out, even if only for peace of mind. I had facial movement and constant muscle spams in both my legs. I also felt very wobbly on my feet and I only really began to be able to walk properly about 6 Months afterwards. It also took a while for me to become engaged socially again. I feel fine now but it was an unpleasant experience. Talk to the doc.....skills
Posted by Ray on February 25, 2002, at 1:08:39
In reply to Re: post zyprexa hand twitching and clenching????, posted by skills on February 24, 2002, at 13:50:39
Might not be a bad idea to get an opinion from an uninvolved Dr. I checked into this area about a month ago regarding neuroleptic movements. TD is the #1 lawsuit facing psychiatrists. I don't think a prescribing Dr. likes to diagnoses these usually.
Perhaps self educating as much as possible on this topic is not a bad idea.
Also, I noticed there is a new generation "atypical" soon coming out which works differently somehow to "lock" d2 dopamine levels to higher levels if too low or lower if too high. They called it "goldilocks"
Anyway - don't remember name of med but I think it's due out pretty soon and is unlike any current atypicals.
Ray
My understanding is TD usually goes away and is best to address ASAP. Taking another neuroleptic can make the problem disappear but on discontinuation down the line the problem may end up even worse.
Not meaning to scare but is something to definitely learn about when taking these meds.
Ray
Posted by Chloe on February 25, 2002, at 10:45:37
In reply to Re: post zyprexa hand twitching and clenching???? » skills, posted by Ray on February 25, 2002, at 1:08:39
Posted by JohnX2 on February 25, 2002, at 18:29:13
In reply to Re: post zyprexa hand twitching and clenching???? » skills, posted by Ray on February 25, 2002, at 1:08:39
Is this some sort of partial dopamine agonist?
Kinda like buspar, increase serotonin if too low
decrease if too high?Thanks for the info. I think I'll just stay
away from APs and concentrate on mood stabilizers
for now.-John
> Also, I noticed there is a new generation "atypical" soon coming out which works differently somehow to "lock" d2 dopamine levels to higher levels if too low or lower if too high. They called it "goldilocks"
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