remedy48 Posted July 5, 2009 Share Posted July 5, 2009 Has anyone ever got akathesia in there arms and hands before. I'm on invega and am thinking that thats what's causing it. Its literally impossible to write or hold anything. It feels weird and awful. I just have to shake my hand alot. Are there any other side effects that you can get on this medication. I'm thinking that I will have to switch again. Link to comment Share on other sites More sharing options...
Silver Posted July 5, 2009 Share Posted July 5, 2009 Invega is interchangeable with Risperdal (risperidone) in terms of side effects. Yes, akathisia is a possible adverse effect of it. Generally worse at higher doses. Same as the Stelazine/trifluoperazine you list in your sig line. eta: side effects are generally interchangeable with risperidone. Looks like Invega may be slightly worse in terms of EPS at the higher ranges of the two drugs, if you look at the PI sheets. Invega is more likely to cause a rapid heart rate than risperidone, and it does have more electrocardiac effects - it's actually got a noticeable QTc effect (unlike risperidone), which matters if you have certain heart arrhythmias or if you're on other meds that prolong QTc interval, because those effects can stack up. Those are the main differences. Invega is cleared mainly through your kidneys, rather than being metabolized by your liver, so it's preferred in the cases of some interactions (but not in cases of renal disease.) Link to comment Share on other sites More sharing options...
remedy48 Posted July 5, 2009 Author Share Posted July 5, 2009 Wow this information makes me want to just quit the med. Probably will ask my pdoc anyways though. Link to comment Share on other sites More sharing options...
Silver Posted July 6, 2009 Share Posted July 6, 2009 Music05, it's not any scarier, as it sits, than any other atypical antipsychotic. Quite a bit less so than many. As with all meds, there are risks and benefits. Always a good idea to discuss this stuff with your psychiatrist. Presumably she thought about all this stuff before she wrote for it. How's it working for your brain? Link to comment Share on other sites More sharing options...
Silver Posted July 6, 2009 Share Posted July 6, 2009 Just read your sig again. You're on Tegretol (sorry, I didn't catch that before, I really am trying to do too many things at one time), which might well be why your psychiatrist selected the Invega. Tegretol is quite an active drug in terms of interactions, and it induces the hepatic enzymes responsible for clearance of, among other things, Abilify, Seroquel, Risperdal, and Geodon.) So there weren't a lot of options left in the atypicals, at least not without ramping up the doses a lot. Co-administration with Tegretol is actually a pretty darn good indication for Invega, I'd suggest. Link to comment Share on other sites More sharing options...
remedy48 Posted July 6, 2009 Author Share Posted July 6, 2009 "Co-administration with Tegretol is actually a pretty darn good indication for Invega, I'd suggest." What do you mean? Sorry I don't understand is invega bad in conjunction with invega or good? Link to comment Share on other sites More sharing options...
Silver Posted July 6, 2009 Share Posted July 6, 2009 Sorry! That was pretty unclear of me. Tegretol plus Invega is good in that it is not a major interaction. Since Tegretol interacts with many things, that's a major plus for Invega. Tegretol and Invega both affect QTc, but if the doses are both reasonable, the combination doesn't show up as a major risk (or moderate risk.) You can ask your psychiatrist about it. Tegretol plus the other AAPs I listed above would be potentially tricky in that the prescriber would have to adjust the dose significantly of the AAPs and dose-finding would be difficult. The combination of Tegretol and each of those other AAPs would be not necessarily bad, just tricky. Combining them would make it much more difficult for the prescriber to know where the target dose range was, and it would be hard to predict some other effects (because drugs are cleared by more than one system, and the metabolites of those drugs are cleared by other systems.) I'm trying to not keep going on about this. I can, if you want me to, but I'll leave it at "potentially tricky, not ideal, not bad." Link to comment Share on other sites More sharing options...
remedy48 Posted July 6, 2009 Author Share Posted July 6, 2009 Wow you know a lot about this stuff. I do some research myself but you know this well. Link to comment Share on other sites More sharing options...
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