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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Christ_empowered on June 30, 2016, at 17:51:00
has anyone seen or experienced this? how common is it, do you think?
Posted by linkadge on June 30, 2016, at 19:32:30
In reply to tardive dementia (?), posted by Christ_empowered on June 30, 2016, at 17:51:00
Probably more common with age, preexisting vulnerabilities and / or way too many meds used in conjunction.
Linkadge
Posted by Christ_empowered on June 30, 2016, at 20:09:04
In reply to Re: tardive dementia (?), posted by linkadge on June 30, 2016, at 19:32:30
so...you don't think an AP/AAP alone, or in a more standard cocktail, would result in dementia?
I just wonder sometimes...especially with so much off-label use of the atypicals, plus the use for depression...if some people are losing IQ points and such during treatment.
Posted by SLS on June 30, 2016, at 22:21:04
In reply to tardive dementia (?), posted by Christ_empowered on June 30, 2016, at 17:51:00
> has anyone seen or experienced this? how common is it, do you think?
Anticholinergic drugs are one suspect.
- Scott
Posted by rjlockhart37 on June 30, 2016, at 22:23:10
In reply to Re: tardive dementia (?), posted by Christ_empowered on June 30, 2016, at 20:09:04
i took zyprexa 40mg in the past, and i had uncontrollable jerking.....not sure if that was a side effect associated with TD but when i was also in the psych hospital, i was on 30ng of olanzipine and it made me jerk when i talked, i would talk and it was like i had the hiccups, i would speak and would jerk why i talked.....
but i think mainly TD in serious cases is from older generation anti-psychosis medications, they produce blockade of dopamine more and can make you have lowered dopamine levels, also Parkinson's Dieasese is a condition from a lack of dopamine, you shake and it's difficult to keep a steady posture.....but not sure if AP's are associated with Parkinson's......but i like i said olanzipine at 40mg made me jerk and feel unsteady.....which i know was blockade of dopamine
Posted by linkadge on July 1, 2016, at 13:54:29
In reply to Re: tardive dementia (?), posted by rjlockhart37 on June 30, 2016, at 22:23:10
There is some evidence that antipsychotics can lead to cortical thinning / brain atrophy. Studies done in monkeys given typical and atypical antipsychotics showed some evidence of this. I think there was a study suggesting that certain supplements (i.e. vitamin e, melatonin) could offset this to some extent.
I believe in taking the lowest dose possible, and experimenting with lower doses and / or alternatives. Of course, with severe illness, this should be done with supervision.
Dopamine and serotonin help regulate brain plasticity. Blocking neurotransmitter receptors for years on end might be expected to reduce this plasticity. Atypicals too, could increase the probability of glucose dysregulation in the brain, which could affect cognition.
If you need AAP's then you need them. However, if I had to take Zyprexa, I'd be asking myself. Can I get away with 10mg less by adding vitamin C / niacin, melatonin etc. Can I get away with less by exercising, dietary changes, quitting smoking, therapy, sleep hygiene etc?
Linkadge
Posted by Christ_empowered on July 1, 2016, at 15:29:39
In reply to Re: tardive dementia (?), posted by linkadge on July 1, 2016, at 13:54:29
good responses.
I get worried. I'm doing Orthomolecular--megadoses of all kinds of B vitamins, C, e, etc.--so I'm hoping (and praying) that helps enough.
Posted by linkadge on July 2, 2016, at 9:07:30
In reply to Re: tardive dementia (?), posted by Christ_empowered on July 1, 2016, at 15:29:39
My big wakeup call came when I lost my insurance (now pay for all drugs out of pocket).
On paper, I am on venlafaxine, lithium, remeron and methylphenidate. However, the pharmacy looks at me a bit funny when I only pick up the drugs a few times a year.
I take them at doses much less than prescribed and then try to tackle my problems with cheaper alternatives.
Surprisingly, I would say I'm probably doing better than when my parents plan paid for me to be on about 5 drugs.
Now, mind you, now than I'm done school and have some form of employment (not optimal employment but employment nonetheless) I would say I have been able to stay stable on less meds.
Linkadge
Posted by Christ_empowered on July 2, 2016, at 10:30:32
In reply to Re: tardive dementia (?), posted by linkadge on July 2, 2016, at 9:07:30
ahhhh, employment...that's the goal. Its funny, in my case...I said "I think I have Bipolar" and they said: "You have ((NPD, ODD, OCD, ADD, etc.))"
Now, I've said "Maybe Szasz is right" and the new experts say? "You have Bipolar I."
I'm stable on the same meds for over 1 year now...4 daily, 2 on hand just in case (almost never need them, Praise God), and...I'm vastly improved. Maybe I could get a jobby job and start reducing some doses soon-ish.
Posted by linkadge on July 2, 2016, at 10:37:25
In reply to Re: tardive dementia (?), posted by Christ_empowered on July 2, 2016, at 10:30:32
If you need the medications then you need them.
I'm not an advocate of stopping meds for the sake of stopping meds - only questioning meds, questioning doses, and cautiously exploring alternatives and adjuncts.
Linkadge
Posted by SLS on July 2, 2016, at 11:01:19
In reply to Re: tardive dementia (?), posted by Christ_empowered on July 2, 2016, at 10:30:32
I am an advocate of the medical model of mental illness - even "purely" psychogenic ones. I'll let others debate this, though.
It would be a disservice to you if you have not yet been evaluated for schizoaffective - bipolar type. Of course, this condition does not preclude your having other comorbid psychiatric conditions. Based upon your descriptions over the years, I don't know how a schizoid disorder hasn't been considered.
Have you ever tried Abilify, Trileptal, and Klonopin at the same time? Even using lithium in place of Trileptal is a reasonable alternative. However, if anger or impulse control are issues, I would stay with Trileptal and add lithium if necessary. I haven't researched any of this, so I could be way off. However, it makes sense to treat the schizoid, bipolar, and anxiety components concurrently.
- Scott
Posted by SLS on July 2, 2016, at 11:03:02
In reply to Re: tardive dementia (?), posted by linkadge on July 2, 2016, at 10:37:25
Posted by Christ_empowered on July 2, 2016, at 12:26:44
In reply to Re: tardive dementia (?) - Schizoaffective (?) » Christ_empowered, posted by SLS on July 2, 2016, at 11:01:19
my current counselor (I think he's the main one doing the diagnosing...its community mental health) says its Bipolar I, although sometimes he'll mention schizoaffective, so I guess I'm somewhere in there...
...my shrink always asks about "manic symptoms," so I guess Bipolar is what they're going with.
I assumed the diagnosis would be either schizoaffective or some kind of schizophrenia w/mood disorder or mood component. I think part of the issue is that the shrink who diagnosed severe Bipolar was from Europe and trained in Germany, and they diagnose differently in Europe. Many Schizophrenia and Schizoaffective labeled people in the US would be given a label of some sort of Bipolar in Europe.
I dunno. Benzos are out. Its community mental health, they don't do that, and also...Klonopin has caused depression with me, complete with early morning anxiety and agitation. Not fun. Good idea, though...I bet with other meds on board that could work...
The only GABA drug I can use (except for depakote, which was a nightmare) would be neurontin. I'm Rx'd 100mgs up to 2x daily. For this clinic, that's actually unusual; they're apparently wary of gabapentin for some reason. I was on 300 x 3 daily in an attempt to stabilize my mood, but it made me loopy and didn't work all that well.
Thanks for your suggestions.
Posted by jonhed on July 2, 2016, at 17:03:20
In reply to Re: tardive dementia (?), posted by Christ_empowered on July 2, 2016, at 10:30:32
Just a question, can you have bipolar and still be tired if you sleep too little in the manic phases?
Cause i have periods when i'm extremely irritated, and it fits the irritable-mania, but without being alert from 3 hours of sleep.
Posted by SLS on July 2, 2016, at 17:27:46
In reply to Re: tardive dementia (?), posted by jonhed on July 2, 2016, at 17:03:20
> Just a question, can you have bipolar and still be tired if you sleep too little in the manic phases?
>
> Cause i have periods when i'm extremely irritated, and it fits the irritable-mania, but without being alert from 3 hours of sleep.Some people with hypomania can need 8 hours of sleep in order to function. I imagine this would be most true in mixed-states. My sister falls into this category.
- Scott
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