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Dr. Bob is Robert Hsiung, MD,
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Posted by Honore on January 17, 2007, at 17:17:16
In reply to Re: I'm stopping all meds » Clockwork Ange, posted by Deneb on January 17, 2007, at 16:41:14
Deneb, it makes more sense to try to figure out what's causing the tremors, than to stop everything-- especially all at once, and also especially without talking to your pdoc.
If the tremors are bad, of course it makes sense to switch meds. Just don't act precipitously, and possibly to your own detriment. I know it's disturbing, but try to slow down on the change.
Is it possible you don't respond well to SSRI's? From what you said, you've always been on an SSRI when you got the tremors and twitches. Maybe you shouldn't be on those. It could be that the Wellbutrin wasn't the problem.
Whatever it turns out to be, maybe you should schedule an appointment with your pdoc, or talk to her over the phone before stopping anything.
Sorry it's gotten so bad. {{Deneb}}
Honore
Posted by Clockwork Ange on January 17, 2007, at 17:21:19
In reply to Re: I'm stopping all meds, posted by Deneb on January 17, 2007, at 17:10:44
every drug and every combination is different, but I have never heard of someone going cold turkey and having a good experience- I just want to be honest about that...
for me withdrawl has- made me suicidal, hear voices, sweat like a pig, migraines, horrible dizziness, vomit violently, grind my teeth to the point of breaking one, horrible diarherra (sp?), shake, insomnia... nothing good :(
Posted by Deneb on January 17, 2007, at 17:31:56
In reply to cold turkey withdrawl » Deneb, posted by Clockwork Ange on January 17, 2007, at 17:21:19
OK, you've convinced me to take a less drastic route. I've lived with the tremors for this long, I guess I can live with them a few more weeks. I just hope my meds are the cause of my tremors and I don't have essential tremor.
I'm just going to change one thing. I'm going to reduce my Celexa to 30 mg for now. I see my pdoc on Tues. I'll let her know then.
Deneb*
Posted by Quintal on January 17, 2007, at 17:48:29
In reply to I'm stopping all meds, posted by Deneb on January 17, 2007, at 16:24:01
Deneb, when you mentioned tremors and jerkiness the first thing that went through my head was "Is she taking an antipsychotic?". Movement disorders are classic side effects of these drugs - so on that tenuous basis I'd recommend you try reducing the dose of Risperdal and perhaps taking some Benadryl - the anticholinergic effects of Benadryl help with some EPS symptoms which may be what you have. Some antidepressants can cause EPS as well, but as others have said, quitting all those meds cold turkey would likely send you directly to Hell.
I don't know why doctors play dumb about this. Even when I worked in a nursing home one lady developed a stiff neck and tremors soon after starting Risperdal - classic symptoms of drug-induced Parkisonism - yet there was still much head scratching and denial going on about Risperdal being the likely cause. The problem disappeared when she quit Risperdal but her hostility and aggression returned.
Anyway, hope you manage to get the tremors under control. Keep us posted.
Q
Posted by Deneb on January 17, 2007, at 17:56:44
In reply to Re: I'm stopping all meds » Deneb, posted by Quintal on January 17, 2007, at 17:48:29
OK, I'll keep the Celexa and Prozac the same then and stop the Risperdal. I just took 25 mg Benadryl to see if that helps. Is 25 mg enough? Do I need more?
Posted by linkadge on January 17, 2007, at 17:59:20
In reply to Re: cold turkey withdrawl, posted by Deneb on January 17, 2007, at 17:31:56
I'm no expert, but cold turkey withdrawl from those meds at those doses will cause a lot more than just tremors.
If you want to get off meds you're going to need to taper.
Linkadge
Posted by Phillipa on January 17, 2007, at 18:00:05
In reply to Re: I'm stopping all meds » Deneb, posted by Glydin on January 17, 2007, at 16:42:21
Deneb I agree with Glydin l00%. You should not dump your meds. That could hurt you badly and you would be in a worse situation. you know I care. Love Phillipa
Posted by Phillipa on January 17, 2007, at 18:05:34
In reply to Re: I'm stopping all meds, posted by Deneb on January 17, 2007, at 17:10:44
Deneb not to say it might not be the resperidol but didn't that start the beginning of you getting better? Maybe the pdoc could give you something to counteract the tremors or change a med? Cold turkey is not good. Call your pdoc now and tell him how your're thinking now. Love Phillipa
Posted by Deneb on January 17, 2007, at 18:06:22
In reply to Re: I'm stopping all meds, posted by Deneb on January 17, 2007, at 17:56:44
Actually, now that I think about it I've had the tremors for a lot longer than a few months. I don't know when they started and I don't remember what I was taking when they started. I just hope this isn't permanent.
Deneb*
Posted by Phillipa on January 17, 2007, at 18:09:53
In reply to Re: I'm stopping all meds, posted by Deneb on January 17, 2007, at 18:06:22
Deneb so are you saying you're over reacting? Love Phillipa
Posted by Deneb on January 17, 2007, at 18:18:16
In reply to Re: I'm stopping all meds » Deneb, posted by Phillipa on January 17, 2007, at 18:09:53
> Deneb so are you saying you're over reacting? Love Phillipa
No, I'm not over-reacting I could barely bring a fork to my mouth today. I was shaking that badly. Walking down the stairs I felt stiff and jerky and thought I would fall. My writing has deteriorated, it used to be nice and smooth.
Today the shaking in my hands was especially bad, but most days I get a tremor. I feel weird walking down the stairs all the time now and my writing is bad now.
Deneb*
Posted by Quintal on January 17, 2007, at 18:22:29
In reply to Re: I'm stopping all meds, posted by Deneb on January 17, 2007, at 17:56:44
Deneb, I worry it may destabilize you mentally to stop the Risperdal altogether and tremors are a common side effect of abrupt withdrawal anyway. A small reduction in addition of Risperdal to the Benadryl may help if it is the Risperdal that is causing this problem. I remember you posting elsewhere about excessive, involuntary blinking - that was you wasn't it? That in combination with the jerkiness and tremors is suggestive of some EPS though. Have you noticed (or has anyone else noticed) involunatry movements of your tongue or lack of facial expression?
If you've had this problem for a while then there could some other cause. For example, is your blood sugar healthy? Do the tremors improve after eating? A beta-blocker may also help with the tremors.
Q
Posted by Quintal on January 17, 2007, at 18:25:25
In reply to Re: I'm stopping all meds » Deneb, posted by Quintal on January 17, 2007, at 18:22:29
Sorry Deneb, I meant:
>A small reduction of Risperdal in addition to the Benadryl may help if it is the Risperdal that is causing this problem. I remember you posting elsewhere about excessive, involuntary blinking - that was you wasn't it?
Q
Posted by Phillipa on January 17, 2007, at 19:32:39
In reply to Re: I'm stopping all meds » Phillipa, posted by Deneb on January 17, 2007, at 18:18:16
Deneb okay I believe you. Now get yourself to an ER ASAP and call your pdoc on the way. Love Phillipa
Posted by Deneb on January 17, 2007, at 19:58:45
In reply to Re: I'm stopping all meds » Deneb, posted by Phillipa on January 17, 2007, at 19:32:39
I don't need to go to the ER. The tremors aren't that bad all the time. I've lived with them for a long time now, it's not an emergency.
Deneb*
Posted by Llurpsie_Noodle on January 17, 2007, at 20:49:48
In reply to Re: I'm stopping all meds, posted by Deneb on January 17, 2007, at 19:58:45
Hi Deneb,
I also have tremors sometimes. I get these big jerking spasms when I fall asleep, and often I notice that my handwriting is really shaky. I have excessive eye blinking sometimes too, and occasionally I will have a spasm in my jaw when I am at rest or falling asleep and I might bite my tongue a little bit. I think these effects are from seroquel, which is an atypical antipsychotic and mood-stabilizer. (It may be in a similar class to risperdal, but I'm not sure)So, here are some things that I've learned about the tremors.
1) They are better when I am well-rested.
2) They get worse if I start a new exercise program, but after a week or so, I get used to using my new muscles and so the jerks will become less frequent
3) Shaky hands are really affected by caffeine. If I drink even one cup of coffee I have the hands of my Nana.
4) Tremors are worse when we think about them too much. If you can get out and do something active (like window-shopping) or get engrossed in something else (like watching a movie) you will not be bothered as much by the tremors.
5) a small dose of klonopin helps a LOT. I'm talking about .5mg every 2 days, or even half that much.
6) If you want to do the benedryl test, (one time my pdoc asked me to, since I had this awful lump in my throat for 2 weeks, we wanted to rule out dystonia) take 50 mg and within an hour or two you should notice dramatic reduction in your symptoms.
****
You say that you've had these tremors for a while ((((Deneb)))) I'm sorry. It's not FAIR! You're so young! you shouldn't have to deal with shaky soup spoons and such. Think very carefully about the pros of taking risperdal (did I even get CLOSE?!? to the right spelling). How was your quality of life before, and how is it now? How was your clarity of thought? Your control over your emotions? Are you able to make better decisions now, or before? Are you able to concentrate better now or before?
now think carefully about the consequences of changing your medication-- I know *I* am. :(
You may feel unstable for a few days or a few weeks. You may feel withdrawal symptoms, like others have described above. You may have to get used to a brand-new drug, and develop tolerance to side-effects. You may feel sick and have to miss class some days. You may behave differently than you usually do. You may need to schedule extra therapy sessions to help keep you "on track" and prevent you from making poor decisions, while supporting you through a difficult adjustment period.
Having said that, you OWN your body. You are strong enough, and smart enough to be able to make decisions about your own body. You should also be smart enough to consult with an expert (your pdoc) about changing your internal chemistry. Ask her what your options are. Don't be afraid, it's YOUR body. You should also be frank with your T (yeah, I know, pdoc and T are one and the same), because making a med change due to severe side-effects is a big decision. It's a challenge, and you deserve support.
((((((hugs for you))))))))
{{{{{{{shaky hugs for you too}}}}}}}this evening I'm a mixture of smooth hugs and shaky hugs, 'cause I drank too much caffeine earlier. oh well. At least I'm not a surgeon, right? ;o)
-Ll
Posted by mindevolution on January 18, 2007, at 4:07:53
In reply to Re: I'm stopping all meds, posted by Deneb on January 17, 2007, at 19:58:45
> I don't need to go to the ER. The tremors aren't that bad all the time. I've lived with them for a long time now, it's not an emergency.
>
> Deneb*sounds like minor parkinsonism, essentially the antipsychotics are most likley to be causing the problem, but then again a lot of the antidepressants have akathisia as a side effect meaning they have anticholinergic effects too. if you can go without your meds then that is the lowest toxicity route, but I have no idea of your mental problems. they say that 80% of people with drug induce parkinsonism improve over the next 2 years after stopping the aps, but that also means 20% have parkinsons for life.
anyway least toxic to most: antidepressants, benadryl due to anticholinergic effect, and antipsychotics win for being the most toxic psych drug available hands down.
Posted by blueberry1 on January 18, 2007, at 5:12:48
In reply to I'm stopping all meds, posted by Deneb on January 17, 2007, at 16:24:01
Just based on side effect profiles in literature, risperdal is the one most likely causing the tremors. If it is, they should go away without risperdal, but sometimes they can linger for weeks afterwards. Sometimes they are permanent. Not to worry you though. I would stop the meds too, except I would do it slower and not cold turkey. Cold turkey is dangerous. You could crash real hard or go through a serious withdrawal that is worse than the worst flu you ever had. And tremors can actually get worse during the withdrawal.
Prozac is possible too. I actually think Celexa is the least likely. But celexa and prozac is a strange combination, so no telling what's up there.
I was on prozac for 8 years and had no tremors. But in year 9 and year 10 I did start getting tremors. They got worse as I withdrew from prozac. Now a couple months later they are gone. But it took a while.
I thought zyprexa was the cause. And it probably did play a hand. But I determined through experimentation that it was primarily the prozac that did it, and it had something to do with longterm usage.
I understand stopping meds for concerns like yours. If you do it cold turkey, be real careful, expect a bad experience (but hopefully not), and don't be afraid to reintroduce a smaller dose to then begin a slower weaning withdrawal.
Posted by Deneb on January 18, 2007, at 21:10:18
In reply to Re: I'm stopping all meds, posted by mindevolution on January 18, 2007, at 4:07:53
Parkinson's tremors are resting tremors. Mine aren't resting tremors. I don't get tremors when I'm just resting my hands. I have to be doing something.
Anyways, last night I didn't take Risperdal and I took 30 mg Celexa instead of 40 mg. I couldn't fall asleep and felt crappy during the morning and ended up skipping class. I hope I can fall asleep tonight.
I got upset today and shook really badly for a while. Stress makes the tremors worse. I just hope they aren't permanent.
Tonight I'm only going to take 20 mg Celexa.
Deneb*
Posted by Deneb on January 18, 2007, at 21:25:44
In reply to Re: I'm stopping all meds, posted by mindevolution on January 18, 2007, at 4:07:53
I'm scared. I'm scared my tremors are permanent. How long will it take? I still get them. What if it's not the meds at all? What if I have essential tremor?
I'm scared. I don't know what to do. I'll never be able to work with my hands.
Deneb*
Posted by Phillipa on January 18, 2007, at 21:37:46
In reply to Re: I'm stopping all meds, posted by Deneb on January 18, 2007, at 21:25:44
Deneb you're acting like you're a doctor and you are not . So call your pdoc now as you're getting too agitated. You didn't sleep cause you didn't take the resperidol which has a calming effect. Love Phillipa
Posted by Deneb on January 18, 2007, at 21:55:31
In reply to Re: I'm stopping all meds » Deneb, posted by Phillipa on January 18, 2007, at 21:37:46
Kind of scared now. What if I really need my meds? Am I undoing everything right now?
I just don't know.
I don't want to deal with this. I don't know what to do. Scared. Don't know what to do today. What should I do?
Deneb*
Posted by Quintal on January 18, 2007, at 21:58:24
In reply to Re: I'm stopping all meds, posted by Deneb on January 18, 2007, at 21:25:44
>What if it's not the meds at all? What if I have essential tremor?
It can be easily treated with a beta-blocker such as propranolol.
>I'm scared. I don't know what to do. I'll never be able to work with my hands.
Yes you will. This can be treated whatever the cause but it sounds like time to call the pdoc and explain your concerns. Have you asked him whetehr the Risperdal might be causing the tremors? Does he have any suggestions?
Q
Posted by Deneb on January 18, 2007, at 22:04:19
In reply to Re: I'm stopping all meds » Deneb, posted by Quintal on January 18, 2007, at 21:58:24
> >What if it's not the meds at all? What if I have essential tremor?
>
> It can be easily treated with a beta-blocker such as propranolol.
>
> >I'm scared. I don't know what to do. I'll never be able to work with my hands.
>
> Yes you will. This can be treated whatever the cause but it sounds like time to call the pdoc and explain your concerns. Have you asked him whetehr the Risperdal might be causing the tremors? Does he have any suggestions?
>
> QI've done some research on essential tremor and propranolol only helps the tremors, it doesn't eliminate them.
My pdoc doesn't think it's the Risperdal because it is such a low dose. She thinks it's the combination of meds that is causing the tremors. I haven't made a big deal out of the tremors in the past because they didn't bother me too much. I just sort of grew used to them.
I don't know what to do tonight. Should I take my meds as prescribed? What should I do? I see my pdoc on Tues.
Deneb*
Posted by Deneb on January 18, 2007, at 22:17:53
In reply to Re: I'm stopping all meds » Quintal, posted by Deneb on January 18, 2007, at 22:04:19
I think I over-reacted. I got scared. Phillipa, you're right I'm not a doctor and I have no idea what the hell I'm doing. I'm afraid of getting worse. I'm going to take my meds as prescribed tonight and talk to my pdoc about this on Tues.
Deneb*
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