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rant, because i can. i have to bitch about it just a little bit because i deserve it.

ok, so i love seroquel. it has enabled me to hold down a full time (and more!) job, i finally get a circadian rhythm, (albeit artificial but i'm not quibbling), i am spared the worst of the crippling panic that turned me into a hermit.

i am taking the whhhooooppppping dose of 25mg a night. 25 mg!

now i have frequently suffered EPS from other APs, especially the typicals. but seroquel! it's Diet Antipsychotic! it's the last resort for us poor over-pyramid-ed saps.

but no ... fucking great.

i'm getting akathisia and dystonia - i actually didn't realise it because i'm usually completely out to it by the time it starts - the sedation precedes the spasms. ohhhhh yeah.

i raised this with my shrink. he was quite alarmed. neither of us want to stop the seroquel - it is just too good. i have cut it down to 12.5mg, but i am still getting, albeit less, symptoms if i keep myself awake through the sedation. goddamn cyp3a4! i need to get myself genotyped.

i guess i could add benztropine.

i guess i could try another AP.

i guess i could keep on keeping on and hope that it doesn't get any worse.

i guess i could staple myself to a frisbee and fling it over a rainbow...

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wish i could claim that line as my own - it's from black books. i use it several times a day, usually in response to those questions which indicate just how dirty the gene pool is.

down under it's difficult to get offlabel drugs. most of the shrinks stick very closely to our subsidised drugs list. i would love to try something like strattera or even adderall, but anyone prescribing it for me would suddenly become subject to review by the prescribing authorities. i smell soylent green... i could buy it at full label - i already do for the seroquel, but i need the piece of paper that says give me drugs...

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When I was on seroquel I had the same thing as you: knocked me out fabulously for nighttime sleeping, but if I forced myself to stay awake I got (the general consensus from asking around on here) akathisia. This might sound dumb, but rather than add another drug, why don't you just let yourself go to sleep, then the akathisia won't be an issue? That's what I did - but perhaps there's stuff about akathisia that I don't know and that was in fact a foolish and dangerous thing to do...? *shrugs*

xx

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wish i could claim that line as my own - it's from black books. i use it several times a day, usually in response to those questions which indicate just how dirty the gene pool is.

down under it's difficult to get offlabel drugs. most of the shrinks stick very closely to our subsidised drugs list. i would love to try something like strattera or even adderall, but anyone prescribing it for me would suddenly become subject to review by the prescribing authorities. i smell soylent green... i could buy it at full label - i already do for the seroquel, but i need the piece of paper that says give me drugs...

Yeah I'm in Australia too and while I have been given off label Zyprexa the doc had to give me samples all the time because I would have had to pay the full prescription price which is like 140 bucks for 30 pills. Stupid Australia *shakes fist*

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i guess my main issue here is that i am worried it will turn into a more serious, and more permanent epse. i am really worried about getting td, i know it's horribly rare but dammit! i am the poster child for depression! i need my beautiful face! (all my irl friends are laughing right now because i have a face like the back of a bus). i haven't yet decided whether i am prepared to risk a progression of it into something far more serious.

the other thing that is bothering me is not the akathisia - hell, i've had more of that than i have had icecream - but the dystonic spasms of my back and legs. grrr. when i go on call, i simply can't turn up to be magical dr stinky if i'm halfway through an oculogyric crisis. at least my muscles are getting a good workout ... i'd hate to see my ck.

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  • 3 weeks later...

yeah! go team frisbee!

shit shit shit! i need these drugs to be Successful! isn't that what society wants from me?

i'm worried it's going to turn into TD. does anyone know how often EPSEs progresses from vanilla to foxglove flavour?

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oh krapppp

Am J Psychiatry. 2006 Aug;163(8):1438-40. Tenback DE, van Harten PN, Slooff CJ, van Os J

Evidence that early extrapyramidal symptoms predict later tardive dyskinesia: a prospective analysis of 10,000 patients in the European Schizophrenia Outpatient Health Outcomes (SOHO) study.

... About half of patients who developed tardive dyskinesia had earlier extrapyramidal symptoms. CONCLUSIONS: Although the association of tardive dyskinesia and extrapyramidal symptoms is significant, extrapyramidal symptoms do not robustly identify individuals at high risk for tardive dyskinesia. PHEWWWW!

but ...

Aust N Z J Psychiatry. 2004 Jun;38(6):445-9. Sachdev P

Early extrapyramidal side-effects as risk factors for later tardive dyskinesia: a prospective study.

... Nine (11.5%) subjects were diagnosed with TD, predominantly manifesting as oro-facial dyskinesia. They had greater severity of parkinsonism and akathisia at baseline, and a larger neuroleptic load, than those who did not develop TD ...akathisia severity at 2 weeks was also a significant predictor of later TD. CONCLUSIONS: Acute drug-induced parkinsonism and akathisia are both predictors of TD, with parkinsonism having greater predictive value.

stinky hides under the house, whimpering ...

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