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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by erik98225 on August 23, 2004, at 19:35:49
I have social phobia and my pdoc has recently suspected an additional diagnosis of Tourettes syndrome due to my odd speech patterns.
If I understand correctly the only way to diagnose Tourettes is to treat it and see if it works.
I am already on the following medications:
Paxil 40mg for social phobia
Klonopin 6mg for social phobia
Hydrochlorothiazide 12.5mg for hypertensionPdoc (this is a new pdoc as I've recently changed insurance providers) wants me off the Klonopin, even though it is more effective than Paxil, "because it is addictive". She is slowly taking the dose down by 0.5mg a week. I told her that I've never abused it but she is still benzophobic and insists that I stop taking it.
After trying Seroquel (which was a distaster -- I CAN'T STAND antihistamine/anticholinergic effects) for about 3 pills I saw my pdoc again today and demanded to be switched to a different medication.
She prescribed Haldol (Haloperidol) 5mg and Cogentin (Benztropine Mesylate) 1mg to be taken at bedtime.
I understand that Haldol is an antipsychotic (dopamine antagonist) just like Seroquel to treat Tourettes Syndrome, but what the h___ is the Cogentin for?
My pdoc said "it helps to eliminate sedation carrying over into the daytime" but I don't believe it. From what I read on the internet and the information sheet from the pharmacy, Cogentin IS AN ANTICHOLINERGIC (and will thus cause precisely the effects that made me hate the Seroquel so much), and it is also an anti-parkinsons drug (dopamine agonist) having precisely the OPPOSITE effect of the Haldol.
This makes no sense to me whatsoever. It sounds like taking a benzo then taking a stimulant!
Has anyone ever been on the combination of Haldol/Cogentin or knows anything about these meds? I'd like all the information I can get before I start taking them.
I'm also worried about the risk of the dreaded *TD* that is associated with all dopamine antagonists. Is 5mg a day of Haldol going to cause this? I'm only 22 and I don't want to have Parkinson's Disease for the rest of my life.
Posted by zeugma on August 23, 2004, at 19:48:27
In reply to Some ?s about Haloperidol and Cogentin, posted by erik98225 on August 23, 2004, at 19:35:49
Cognetin is an anticholinergic that is used to treat Parkinson's disease and the Parkinsonism that sadly comes with the territory of Haldol. I have read too much on this board about pdocs demanding that effective meds such as Klonopin be scrapped for Paxil or Lexapro or whatever that I will not be able to retain any objectivity if i consider what your pdoc said any further. I will only say that I had a CBT therapist say much the same about Klonopin, and of course we are going to get muddled in endless semantic points about addiction and dependence and so forth (as the WHO defines it, I believe Paxil qualifies as the most "addictive" or dependence-inducing" med of the world, and Effexor is 2nd or 3rd- Xanax is 12th or something).
I would not play around with Haldol or Cogentin if I were you. I am not knocking those meds, they are great in their place, but you may need a more compassionate pdoc.
Posted by erik98225 on August 23, 2004, at 20:05:06
In reply to Re: Some ?s about Haloperidol and Cogentin, posted by zeugma on August 23, 2004, at 19:48:27
> I would not play around with Haldol or Cogentin if I were you. I am not knocking those meds, they are great in their place, but you may need a more compassionate pdoc.
The other alternative is to live with the Tourettes -- as I have done for 22 years.
Posted by erik98225 on August 23, 2004, at 20:14:52
In reply to Re: Some ?s about Haloperidol and Cogentin, posted by zeugma on August 23, 2004, at 19:48:27
> Cognetin is an anticholinergic that is used to treat Parkinson's disease and the Parkinsonism that sadly comes with the territory of Haldol. I have read too much on this board about pdocs demanding that effective meds such as Klonopin be scrapped for Paxil or Lexapro or whatever that I will not be able to retain any objectivity if i consider what your pdoc said any further.
My old pdoc gave me Klonopin because I was drinking myself to sleep to overcome the agitation and insomnia caused by the Paxil. He said "benzos are alcohol pills and alcohol is a liquid benzo" and reasoned that it's better to be addicted to benzos than to alcohol.
Frankly I cannot figure out why anyone would want to abuse Klonopin, and it boggles the mind as to why it's a controlled substance. Yes it does make you drunk if you take too much of it, but it is not fun to take and doesn't cause the "whole-body orgasm" that alcohol causes.
The Paxil does help my social phobia but it keeps me up all night as mentioned above. The Klonopin was way more helpful.
Posted by Sad Panda on August 23, 2004, at 22:05:30
In reply to Some ?s about Haloperidol and Cogentin, posted by erik98225 on August 23, 2004, at 19:35:49
> My old pdoc gave me Klonopin because I was drinking myself to sleep to overcome the agitation and insomnia caused by the Paxil. He said "benzos are alcohol pills and alcohol is a liquid benzo" and reasoned that it's better to be addicted to benzos than to alcohol.
>
>If Paxil gave you agitation, you would have been far better off changing to a different SSRI.
>She prescribed Haldol (Haloperidol) 5mg and Cogentin (Benztropine Mesylate) 1mg to be taken at bedtime.
>There is absoulety no way any doctor should give you this stuff. I don't know which of these two doctors is worse. Risperdal, Abilify & Geodon should all be tried before Haldol, but really, you should change away from Paxil. Did you tell your current doc that Paxil causes agitation?
Cheers,
Panda.
Posted by erik98225 on August 24, 2004, at 10:32:51
In reply to I think you need a decent doctor! » erik98225, posted by Sad Panda on August 23, 2004, at 22:05:30
> If Paxil gave you agitation, you would have been far better off changing to a different SSRI.
> There is absoulety no way any doctor should give you [Haldol and Cogentin]. I don't know which of these two doctors is worse. Risperdal, Abilify & Geodon should all be tried before Haldol, but really, you should change away from Paxil. Did you tell your current doc that Paxil causes agitation?
No, because it doesn't now, but it did when I first started taking it last year.
The agitation I get now is benzodiazepine withdrawal when I forget to refill the rx.
Posted by HappyGirl on August 24, 2004, at 17:34:46
In reply to Some ?s about Haloperidol and Cogentin, posted by erik98225 on August 23, 2004, at 19:35:49
Hi:
>>>> I understand that Haldol is an antipsychotic (dopamine antagonist) just like Seroquel to treat Tourettes Syndrome, but what the h___ is the Cogentin for? <<<<--- Some pdocs. rx 'Cogentin' when you've been on Anti-psycho. med., particularly 'Ability,' one of the newest Anti-psycho. meds. and a most 'stimulating' A.P. Thus, Cogentin is good on both, 'Anxiety' and 'TD' which you may get from taking 'Haldol.'
As to the Haldol rx., .... in my guess, due to your intolerance on 'Seroquel' which is the weakest and mildest AP in comaprison to Zyprexa and Risperdal, your pdoc. might have suspected of your 'intolerance' other newer APs. Thus, your pdoc. rxed 'Haldol.'
This is my personal knowledge based on my experience on A.P.
H.G.
Posted by Sad Panda on August 26, 2004, at 7:30:41
In reply to Re: I think you need a decent doctor! » Sad Panda, posted by erik98225 on August 24, 2004, at 10:32:51
> > If Paxil gave you agitation, you would have been far better off changing to a different SSRI.
>
> > There is absoulety no way any doctor should give you [Haldol and Cogentin]. I don't know which of these two doctors is worse. Risperdal, Abilify & Geodon should all be tried before Haldol, but really, you should change away from Paxil. Did you tell your current doc that Paxil causes agitation?
>
> No, because it doesn't now, but it did when I first started taking it last year.
>
> The agitation I get now is benzodiazepine withdrawal when I forget to refill the rx.
>
>Is your social phobia under control with Paxil & Klonopin? There is no way you are going to like Cogentin either, as it is an anticholinergic.
Cheers,
Panda.
Posted by erik98225 on August 26, 2004, at 11:00:14
In reply to Re: I think you need a decent doctor! » erik98225, posted by Sad Panda on August 26, 2004, at 7:30:41
> Is your social phobia under control with Paxil & Klonopin?
Yes. The first dose of Paxil 20mg made me an instant social butterfly. :) But then it pooped out (meaning I was on too low of a dose) so my new pdoc doubled it to 40mg. This seems to work. The klonopin helps tremendously as well.
> There is no way you are going to like Cogentin either, as it is an anticholinergic.Yes, I figured that out the hard way. I think I am allergic to anything with anticholinergic effects (a child's dose of Benadryl makes me feel miserable for 3 DAYS).
I called my pdoc about it and she said to take only half of a Cogentin and if I still can't stand it don't take it at all. It is only there to ameliorate some of the side effects of the Haldol, but it has its own (much more unpleasant) side effects of its own.
Posted by erik98225 on August 26, 2004, at 11:05:59
In reply to Re: I think you need a decent doctor! » erik98225, posted by Sad Panda on August 26, 2004, at 7:30:41
> There is absoulety no way any doctor should give you [Haldol and Cogentin]. I don't know which of these two doctors is worse. Risperdal, Abilify & Geodon should all be tried before Haldol.
Haldol is the drug on which most of the Tourettes research was done so that's why she prescribed it instead of trying newer APs first.
This is the end of the thread.
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