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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Jeroen on July 21, 2008, at 8:12:57
i think i have TD from Clozapine
i swallow difficult and more and its disturbing feeling plus the drool and getting choken in my own water mouth
this is very disturbing, its becoming very clear of this pseudo science is nothing more then burning an evil witch
Posted by Racer on July 21, 2008, at 8:58:51
In reply to i think i have TD from Clozapine, posted by Jeroen on July 21, 2008, at 8:12:57
Jeroen, I'm sorry that you're having so much trouble. It sounds as though you're still taking the clozapine? What is your current dose? Is it helping more now? And are you still in hospital?
I hope things get better, and the increased salivation eases.
Posted by Jeroen on July 21, 2008, at 9:48:04
In reply to Re: i think i have TD from Clozapine » Jeroen, posted by Racer on July 21, 2008, at 8:58:51
im having so much trouble because i am a man
a girl doesnt suffer this much in psychiatrya girl doesnt get pooped out effects from meds, TD, and other things
Posted by Phillipa on July 21, 2008, at 10:47:05
In reply to Re: i think i have TD from Clozapine, posted by Jeroen on July 21, 2008, at 9:48:04
Jeroen women have the same problems as men sometimes worse. What brought you to that conclusion? Just cursious and are you still in the hospital? Love Phillipa
Posted by Jeroen on July 21, 2008, at 10:50:26
In reply to Re: i think i have TD from Clozapine » Jeroen, posted by Phillipa on July 21, 2008, at 10:47:05
they want to admit me forcible to the hospital, ive been there 2 months straight now with clozapine
and i dont feel any better, and they havent checked my blood leaving me with fear of death
im sick of it, tomorrow when i have the chance ill look for another hospital
Posted by Phillipa on July 21, 2008, at 20:17:26
In reply to Re: i think i have TD from Clozapine, posted by Jeroen on July 21, 2008, at 10:50:26
Jeroen so your out of hospital. What happened that they want to forcibly put you back in? Phillipa
Posted by yxibow on July 22, 2008, at 3:43:21
In reply to i think i have TD from Clozapine, posted by Jeroen on July 21, 2008, at 8:12:57
> i think i have TD from Clozapine
>
> i swallow difficult and more and its disturbing feeling plus the drool and getting choken in my own water mouth
>
> this is very disturbing, its becoming very clear of this pseudo science is nothing more then burning an evil witch
You do keep mentioning this and Racer and I and others -- and I really don't want to be pejorative -- have tried to indicate that if you don't stay on a particular medication, regardless of the side effects you will NOT achieve the benefits and if the benefits outweigh the risks, micro analyzing every aspect is not helpful and can detract from a medication's use.What you are describing is an unfortunate side effect of Clozaril. A number of people do drool from clozapine and have all sorts of problems related to that, which the swallowing would sound consistent. That is not TD.
(And by the way, other atypicals such as Seroquel and Zyprexa and the like can also rarely cause drooling as well though not like clozapine).
Unfortunately because you either have TD or a related condition, the normally available options for drying out the saliva are slim. Anticholinergics and related drugs are usually the ones of choice and could aggravate whatever neurological condition you do have.There are options I believe of using Botox or making some sort of operation on the salivary glands, I'm just guessing but that is a pretty heavy duty thing to consider.
It is not to say that one can never get TD from Clozaril, but in all the years that people have taken Clozaril, almost none have gotten TD, certainly none who have taken it exclusively. In fact, most people improve.
Now the blood testing part -- if your doctor(s) are not doing their job and sending labs, that's something to get on their case. It is protocol in the countries that dispense clozapine to maintain registries and follow at least a 6 month tight regime of blood testing followed by a more lax lifetime regime of it.
-- best wishesJay
Posted by bleauberry on July 22, 2008, at 20:13:11
In reply to i think i have TD from Clozapine, posted by Jeroen on July 21, 2008, at 8:12:57
I still have drooling in my sleep after being off of zyprexa a couple years. And a slight eye twitch. And trembling during movements of exercise, such as doing a push-up.
Hey, I don't think it is realistic for any of us to enter the world of powerful psychiatric drugs and come out of it the same way we went in. That is probably most especially true with antipsychotics. I'm not sure you can point the finger at clozapine because you've been on a bunch of others and high doses to boot. Things were probably already in the works but didn't elevate to the level of noticing them a lot until it was clozapine's turn to join in.
Or it could be side effects that will go away after being off clozapine for a while.
In any case, I hope your doctors are trying to think of ways to get you off the antipsychotic merry-go-round and do some other stuff. If destined to stay on them though, hey, I saw at pubmed where refractory patients were improved with a combination of Risperdal and Zyprexa.
Antipsychotics and TD. Length of time and size of dose.
Posted by yxibow on July 23, 2008, at 1:06:04
In reply to Re: i think i have TD from Clozapine, posted by bleauberry on July 22, 2008, at 20:13:11
> I still have drooling in my sleep after being off of zyprexa a couple years. And a slight eye twitch. And trembling during movements of exercise, such as doing a push-up.
It is a very hard thing to view -- and you may be right, you may have these things because of Zyprexa, just as I still have stiffness. But there is a strong theory in psychiatry that causality is not necessarily causation.
That is while x was taken or procedure x was done or one felt in x way at a certain time, y may not be 100% of the reason or relation to x.
Also these things may take a very long time to remit or may remit very quickly. It depends on the person, genetics, unforseeable consequences that have never been seen yet in the general population, and other factors.
> Hey, I don't think it is realistic for any of us to enter the world of powerful psychiatric drugs and come out of it the same way we went in. That is probably most especially true with antipsychotics. I'm not sure you can point the finger at clozapine because you've been on a bunch of others and high doses to boot. Things were probably already in the works but didn't elevate to the level of noticing them a lot until it was clozapine's turn to join in.
>
> Or it could be side effects that will go away after being off clozapine for a while.
>
> In any case, I hope your doctors are trying to think of ways to get you off the antipsychotic merry-go-round and do some other stuff. If destined to stay on them though, hey, I saw at pubmed where refractory patients were improved with a combination of Risperdal and Zyprexa.
>
> Antipsychotics and TD. Length of time and size of dose.Partially. And also very different whether a person has an affective (mood) disorder or a disorder that has psychotic features (schizophrenia -- not schizoaffective, and some forms of bipolar that are more complicated than an affective disorder).
Basically it is now known that old line antipsychotics can produce TD up to 25% a year for an unknown length of time, but a number of them are far less potent than that.
Also it is generally accepted that atypicals as a conglomerate will produce TD possibly about 5% a year for an unknown length of time, with Risperdal being the only one with a proven number of cases at the moment. Seroquel and Zyprexa are probably 0.25% to 0.5%. Clozaril is unique that it has never been truly shown to produce TD for those who have never taken or have not taken many antipsychotics. In fact it improves TD in patients.
Also those with schizophreniform disorders for reasons not quite understood can have choreiform movements that mimic TD but are actually not TD, but a part of the way the brain works in those individuals.
People with affective disorders, such as myself are much more sensitive to APs, although that varies wildly. A number of BP I/II people live lives stabilized on APs.
Also TD, unlike TDy (Tardive Dystonia) remits at least 30% of the time if not more, remains the same in 30% of cases, and unfortunately for reasons not quite understood becomes worse in 30% of the cases. However, though some forms of TDy may not remit except for 10% of the cases, there are far more palliatives for TDy than TD.
Unfortunately some people do still need APs -- it becomes a "merrygoround" too when people do not stay on their medications even though there is some undesirable side effect which can be mitigated. Dropping one cold can cause unknown consequences but at least withdrawal dyskinesia, that I am sure of as I have experienced it at least once.
I wish we were at a stage in schizophrenia, more than 50 years after Thorazine, that we had medications that did not produce TD. To this date, clozapine is the closest we have, and a "gold standard", with many side effects that Jeroen has experienced -- drooling being one many people experience besides somnolence. There are receptors still in the experimental stage, sigmoid, etc.
There will come a time when this doesn't happen to many people but it may take a number of years, just like other frontiers that have a long way to be explored. For better or worse, we are still in the "middle ages" of psychiatry. Medication works for a number of disorders without a lot of side effects, and unfortunately for many, there are consequences.
Ultimately, it is, is the condition better worth living with without treatment, or does the benefits outweigh the risk. This is the case with all medicine. Hard choices. Very hard choices when you feel alone in a corner. I don't like to carry a flag that bears that or turn my disorder into the only thing that is myself, which is a place that people fall into in secondary depression due to a complex case, but I do feel alone a lot of the times because I have a very rare disorder.
-- Jay
This is the end of the thread.
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