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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Jeroen on January 25, 2009, at 16:58:37
Zotepine - an atypical anti psychotic?????
is it available here? worth it?
im out of options here
Posted by bleauberry on January 25, 2009, at 17:58:37
In reply to Zotepine - an atypical anti psychotic?????, posted by Jeroen on January 25, 2009, at 16:58:37
Hi Jereon,
I don't know anything about zotepine.
But, I've been bored and depressed and surfing through pubmed all day. I was mainly looking at anything MAOI related. But in doing that kind of surfing you always stumble onto a bunch of other stuff, mostly uninteresting, but sometimes real interesting. I saw one study asking what the options are for treatment resistant psychosis accompanied by depression. I thought of you. Just like you, clozapine did not always work.
Anyway, the best things that did work were:
Seroquel + TCA
Seroquel + ParnateApparently somehow those particular antidepressants also worked against the psychosis, not just the depression. I thought it was interesting seroquel was the companion, since it is the one you originally responded to. Just thought you might find it interesting.
Maybe one of those select antidepressants is the missing key in your case? I would think about that. According to what has been done around the world with people just like you, you are absolutely NOT out of options.
Posted by sam K on January 25, 2009, at 18:14:53
In reply to Zotepine - an atypical anti psychotic?????, posted by Jeroen on January 25, 2009, at 16:58:37
have you tried lithium? Lithium calmed my paranoias somewhat. what about geodon? Haldol? I tried haldol and it made me extremely paranoid. What about all the Phenothiazines or the Thioxanthenes? What about Amisulpride? sorry I just want you to get better.
Posted by Jeroen on January 26, 2009, at 2:21:29
In reply to Re: Zotepine - an atypical anti psychotic????? » Jeroen, posted by bleauberry on January 25, 2009, at 17:58:37
i tryed Trazodone and made my paranoia and psychosis nightmare
thats a TCA right?
Posted by yxibow on January 26, 2009, at 4:10:43
In reply to Re: Zotepine - an atypical anti psychotic?????, posted by Jeroen on January 26, 2009, at 2:21:29
> i tryed Trazodone and made my paranoia and psychosis nightmare
>
> thats a TCA right?No, its a drug in its own class, the only relative is Serzone (nefazodone) which is not as "sleepy" a medication as Trazodone is. Should have liver tests frequently on Serzone though.
Posted by yxibow on January 26, 2009, at 4:11:51
In reply to Zotepine - an atypical anti psychotic?????, posted by Jeroen on January 25, 2009, at 16:58:37
> Zotepine - an atypical anti psychotic?????
>
> is it available here? worth it?
>
> im out of options hereIts an old atypical that doesnt seem to be related to anything. May be available in Japan and possibly Germany.
-- Jay
Posted by Jeroen on January 26, 2009, at 4:51:42
In reply to Re: Zotepine - an atypical anti psychotic????? » Jeroen, posted by yxibow on January 26, 2009, at 4:11:51
i think its worth a try maybe, im out off serious options, even their miracle drug for schizophrenia Clozapine didnt kick in, it gave me 2 months psychotic attacks
Posted by desolationrower on January 26, 2009, at 11:21:24
In reply to Re: Zotepine - an atypical anti psychotic?????, posted by Jeroen on January 26, 2009, at 4:51:42
don't remember exactly right now, but i thought various posters, we've made a few suggestions in the past for things that could be quite effective for you
-d/r
Posted by Zyprexa on January 27, 2009, at 1:42:57
In reply to Re: Zotepine - an atypical anti psychotic?????, posted by Jeroen on January 26, 2009, at 4:51:42
Posted by Jeroen on January 27, 2009, at 2:30:23
In reply to Re: Have you tired perphenazine yet????? (nm) » Jeroen, posted by Zyprexa on January 27, 2009, at 1:42:57
i wish i could try that one but i have tardive dyskinesia from geodon, it will only make it worse
Posted by SLS on January 27, 2009, at 13:25:51
In reply to Re: Have you tired perphenazine yet?????, posted by Jeroen on January 27, 2009, at 2:30:23
> i wish i could try that one but i have tardive dyskinesia from geodon, it will only make it worse
Is your TD in the form of facial tics?
- Scott
Posted by Zyprexa on January 27, 2009, at 20:08:14
In reply to Re: Have you tired perphenazine yet?????, posted by Jeroen on January 27, 2009, at 2:30:23
How do you know it will give you TD? I take it and don't have that problem. You can take cogentin to get rid of TD. I take a little of that with it, not even sure I need it.
Posted by yxibow on January 28, 2009, at 2:37:46
In reply to Re: Have you tired perphenazine yet????? » Jeroen, posted by Zyprexa on January 27, 2009, at 20:08:14
> How do you know it will give you TD? I take it and don't have that problem. You can take cogentin to get rid of TD. I take a little of that with it, not even sure I need it.
I hate to edge in here, but Artane and Cogentin and the discontinued Akineton are a set of possible things to cover EPS, which may include pseudoparkinsonism (tremors), stiffness, akathisia (intense feeling to move) and other such effects, and propranolol and sometimes amantadine.
EPS is another way of describing a cluster of side-effects, not -late- forming -possibly- long lasting or permanent effects such as TD and TDy (tardive dyskinesia and tardive dystonia).
To this date there has been no proven solution for TD, other than taking the MED (minimum effective dose) of a AP, taking a new generation atypical which reduces the risk about 5 fold theoretically, or discontinuing a medication that shows signs of possible movement disorders on an AIMS exam.There has been a limited study with tetrabenazine, which did show some promise at the expense of possible lasting or permanent iatrogenic pseudoparkisonism.
Other things have been tried, such as Vitamin E at large doses, Buspar at incredible doses, and a variety of things. There haven't been double blind trials and it unfortunately still remains inconclusive.
Still, there is a chance that Clozaril (with all its problems) can cover, reverse, alter changes while on the medication, and that lower risk atypicals such as Seroquel may be a better choice if treatment has to continue anyhow.
Sometimes treatment still has to continue though because the medication keeps a patient in a stable state.
Tardive like symptoms can also prevent as a manifestation of schizophrenic spectrum disorders, and TD generally remits at least in 30% of the cases of discontinuation, stays about the same in 30% and may possibly become worse in the other 30%.
I didn't want to make a heavy response, but this is unfortunately still the case and it is something that is in the back of my mind for the use of Seroquel (for an unrelated, unknown orphan condition) that I take.
Taking anticholinergics such as Cogentin with TD (not TDy) generally aggravates the symptoms of TD and does not stop the manifestations.
-- Jay
Posted by Zyprexa on January 28, 2009, at 4:29:47
In reply to Re: Have you tired perphenazine yet????? » Zyprexa, posted by yxibow on January 28, 2009, at 2:37:46
You have me thinking that I might need the cogentin. I'm hopefull!
This is the end of the thread.
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