Updated (Movement disorders from antipsychotics [mainly] -Extrapyridimal side effects)

[Ami]

Update: Went to GP last night. looked a bit silly weaing sunglasses in the dark but i just fancied some annomonity.

Since ive stopped the meds, (Dr certainly doesnot reccomend it, but I told her anyways.) I have to drop down to 10mg procyclidine until side effects go from the poison. She said I should just reduce the antipsychotic doses ... but i said that im not taking low dose poison.

She said i need to take my meds to 'improve my mood, and reduce these thoughts.' So i asked her why the psychiatrist(poison man) poisoned me. She told me to discuss that with him.


I told her she was in denial about the *truth*, or just being stupid. I think it was the former because doctors are usually smart.

She says I am paranoid, and have a 'definite need' for anytipsychotics; but I don't, obviously.

I was about to lose it with fustration; so she says she will refare me to day hospital for extra support and theraputic activity. So she is going to write to the psych about the med situation and i will be seeing him next week, but i am not getting a prescription for poison, i Shall just be wondering what his crack is.

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Hiya

Does anyone else get these? They are mainly induced by antipsychotics and can include parkinson-like symptoms, shaking, twitching, and twisting and getting stuck (dystonia).

I've had them on pretty much every antipsychotic, and now im even getting them from my sickness pills (metaclopramide) and i reckon also my antidepressant sertraline - as ive just started it again and my tremmors are just not fun. My combo of meds is just accumulating the side effects - sertraline, haloperidol, metaclopramide, procyclidine, pill, propanolol and the occasional diazepam, and the combo of the first 3 just hurts, bah.

Am just so restless, it feels like itchy blood, like every muscle hurts and needs stretching or moving or flapping around, and keep twisting in silly positions, shaking, painful muscle tightenings and twitchings. Its embarressing especially in public. and anxiety makes it 10 times worse.

Its a shame cos I feel if i could tolerate these meds, the haloperidol is the only thing ive found to work best. Ive been on a fair amount of meds and constantly feel sick so need the antisickness pills. but they have started doing the same.

Anyone else had / get this? What you find helps? What can i do?
xx

[Steel Maiden]

I think you should talk to your psych about this. All people have different bodies and hence different reactions to meds, but yours sounds especially severe. What dose of procyclidine are you on? Metoclopramide can cause EPS too. You are on a lot of meds too, making interactions more complex. Also you're at risk of tardive dyskinesia so please talk to your psych

[Ami]

Its not the worst I've ever had (that was amisulpride)! But its getting quite silly. I actually find haloperidol rather useful which is so annoying because i dont find anything else as effective, even if its just a bit.

With procyclidine, I was taking 2, now im taking 3 (so 15mg).

Do EPS getting worse with continued treatment, do you know Oly? Or does the body 'get used to it' so it goes away? Im assuming the first because of tardive dyskinesia, that usually starts after a little while.

I have a psych appointment a week on monday, the 11th, will defo mention it. I might actually ring up, on this upcoming monday. Arhhh so frustrating. Have you ever had akathesia or the other types of movement things ?
take care x

[Steel Maiden]

I think EPS can get worse and besides if you're getting those side-effects then it really can't be good for your neurological and psychological health. Please do tell your psych. 15mg procyclidine is a higher dose than I ever took so I would be concerned. If you notice anything severely alarming go to A&E. What was amisulpride like for you? Thanks.

[Ami]

Hiya.

Considering its a 'common' problem, I would have expected more people to get em. I dont know anyone else ever who actually gets these, except me. lol

Regarding amisulpride, pretty much the same but more severe, like my muscles all clench and contract involuntarily, and shake around literally every second. On amisulpride I got about 2 hours sleep a night, and on risperidone and zuclopenthixol, i got the occucugolor crisis or whatever it is called. (where your eyes point up and being stuck with arched back, and mouth open.)

Does clozapine do this type of stuff? Because I know it has a lower risk of tardive dyskinesia. And It *may* be a possibility.

But i haven't got treatment-resistance schizophrenia, just antipsychotic intolerance, lol. But BNF says something about 2 or more Anti-ps to be ineffective or unable to tolerate.

but am not sure, whether you 'need' a schizophrenia diagnosis due to the risks, monitoring, etc etc. I read on the dr's screen under current and past problems - 'delusional disorder, unspecified psychosis, bipolar, moderate depressive episodes' which i have not been informed about some of em :/... Im sure its all just speculation as opposed to 'real' diagnosis, as im sure delusional disorder is an actual specified psychosis and depression comes part of the bipolar package.

Bah!

[Ami]

Oh yeah, got an appointment with gp on monday. I guess stopping them as opposed to covering up with more anti-cholinerginerics. ><

[Steel Maiden]

I think seeing your dr is a good idea. I am not entirely sure if you "need" to be treatment-resistant schizophrenic (because I am so I don't know otherwise) for clozapine, but be warned that clozapine has side-effects of its own. Oculogyric crisis sounds horrible. Update me on what your dr says. I will try to respond to your PM but I can't do it on my phone (what I generally use for the internet here) as my network is unpredictable, so when I next get onto the computer on the ward I'll respond. I hope your dr will be able to help

[not_so_insig]

Quote:

Originally Posted by Steel Maiden

I think seeing your dr is a good idea. I am not entirely sure if you "need" to be treatment-resistant schizophrenic (because I am so I don't know otherwise) for clozapine, but be warned that clozapine has side-effects of its own.

I am considering clozapine at the moment, and you do not neccessarily have to be treatment resistant. The qualifying criteria is that you have had to had at least two antispsychotics before they can prescribe it for you. At the moment quetiapine is keeping me reasonably stable (and have been for nearly a year now, before that it was 3 years), so if I decide against clozapine I will continue with the quetiapine. My psych also suggested injectable antipsychotics as an alternative to clozapine, but I decided against those because I would have to go to the clinic once a week and the truth is I cannot be bothered. If I was allowed to have the injection at home and always the same person doing it, I would be more likely to take it up. So I am not considered treatment resistant, as the quetiapine is working (though with horrible muscle stiffness, and due to the fact it makes me extremely tired/dopey I have to be very strict with when I take the pills - within 10 mins otherwise I will suffer!!).

As for your original post, I would seek advice. When I took Risperidone, after 3 months I developed Parkinsonism and painful muscle spasms. I had an emergency appointment with my GP, who told to immediately stop taking it and prescribed me lorazepam in the meantime. It took over a week to recover fully. During that time, I could not do anything on my own - that included going to the toilet and getting dressed (which as an adult was highly embarrassing). So one of the antipsychotics may be causing that. Quetiapine I have been on for nearly 7 years now, and has not caused (other than the stiffness) any muscle effects.

You also mention sickness. Until Jan this year I was on Sertraline, and I found that one particular brand (marked Sertraline Aurobindo) of Sertraline made me sick and dizzy. Other companies (for example Generics UK) did not make me sick and dizzy. Unfortunately due to my chemist always getting in the company's Sertraline which disagreed with me I had to discontinue as it was working extremely well as in the end I was not taking it for weeks. My CPN also told me a couple of months ago about another patient of hers who had the same problem as me - so it wasn't just me. So it could be the Sertraline that could also be making you sick! I have tried other antidepressants, and none of the others made me sick, with the exception of mirtazapine. However I do think part of the reason why mirtazapine was making me feel sick is that it was a dissolving tablet - where I was living I could not drink the tap water as it was foul (and I didnt have enough money at the time to buy bottled), so I dont think diet coke agreed with it!

That is my opinion, I may be wrong, but that is what I discovered when I had symptoms similar to yours.

[Ami]

Thanks for your replies

I would hate a depot, because i get these side effects relatively quickly, i would need to wait about a month for the *most likely* side effects to wear off. they tried to put me on risperidone consta injection because im 'non-compliant'.

But to be fair who is going to be compliant with all muscles contracting and twisting and akathisia? in my defence
My fingers do it as well .. clench like playing a piano.. only i'm not. ><

Im glad quetiapine is working for you ... and regarding the sertraline and sickness, i cant believe i hadnt thought of that, its like the most common side effect. And i have got a random brand lately. I also have diazepam so although I avoid to try and take it everyday, I can take 2 pills a day says the dr. That may help.

Clozapine, you need weekly blood tests I think? I hope one of the recovery team could help me with appointments cos i will forget. It also apparently decreases suicide ?

I tried to kill myself last week because i was getting sick of messages everywhere and people coming after me to poison me so i will tell them the truth and the meds are trying to control me so im not sure if i should even take them. They make things quieter though.

and secret cameras and I know this secret that im not supposed to, but i figured it out by codes, but they know I know. Obviously I cant say, because they're everywhere. But scary because theres people ccoming after me. And i figured it was best to kill myself before they got the secret. or killed me. Its ****. Obviously i failed

Anyways sorry bout the ramble. *off to take diazepam*
Thanks for help x

[not_so_insig]

Quote:

Originally Posted by Ami

Im glad quetiapine is working for you ... and regarding the sertraline and sickness, i cant believe i hadnt thought of that, its like the most common side effect. And i have got a random brand lately. I also have diazepam so although I avoid to try and take it everyday, I can take 2 pills a day says the dr. That may help.

Clozapine, you need weekly blood tests I think? I hope one of the recovery team could help me with appointments cos i will forget. It also apparently decreases suicide ?

Because Sertraline is made by one company, this new brand may be disagreeing with you. Sertraline in the UK is made by at least 4 different companies (Bristol Labs, Dr Reddy's, Generics UK and Aurobindo). My CPN seemed to think in both our cases, that in our case because both the same brand gave the same symptoms that they were mixing it with some chemical that the other companies werent using, and that we were both mildely allergic to it. When we swapped to our regular companies (in both cases it was the same brand) we stopped feeling sick and dizzy.

I also take Procyclidine which is also made by at least 3 different companies (again Generics UK, Glaxosmithkline and Teva UK), but fortunately they dont cause me any unpleasant side effects (though I find Glaxosmithkline's ones not as effective). Similarly I am prescribed diazapam, which to date I have only tried two different companies (Teva UK and the other I forget), and none have caused unpleasant side effects either.

As for clozapine, well according to the leaflet I do have, the blood tests are once a week, but that is for the first 18 weeks only. Once the 18 weeks are up (and provided nothing bad has shown up on my blood tests, which warrants them discontinuing it), then I go to every fortnight. Once a year has passed (again, if nothing bad shows up), I only have to have blood tests once a month. Again, in my case it means that I have to go to clinic. But I am slightly easy about this, because I know that the frequency I will have to attend will get less as the weeks pass on, and if the blood tests show anything nasty, then my psych will discontinue it. My psych didnt say anything about suicide, but like you, have heard that it does decrease the risk of suicide.

Whereas with the injectable antipsychotic, then it means that I will have to attend once a week for the rest of my life (or however often I have to go, obviously it depends on which product my psych puts me on), with no chance (unless I refuse to go, or are changed to another antipsychotic) with the visits becoming less frequent. It also doesnt change the fact that I have to attend clinic with yet another bunch of strangers injecting me (I have trust issues, so that is not an option) rather than that home with only one person responsible for injecting me.

[Ami]

hey, So how comes you may go on clozapine, if quetiapine is working? Clozapine is more effective though.

By any chance is there such thing as 'tardive parkinsonism' or is tardive dyskinesia like an umberella term for movement problems after/late occuring antipsychotics?

metaclopramide has a short half life approx 4 hours so i believe and haloperidol about 24 hours so hopefully it wont take long for it to wear off.

To be fair, i understand why you would rather have one person at home injecting you. It would be very daunting to have to 'get used' to loads of different people, and how can you build up a trusting relationship when you would be seeing someone random every week!

[Angel2fire]

I get restless leg syndrome... it started at the same time I began taking quitiapine.

[not_so_insig]

Quote:

Originally Posted by Ami

hey, So how comes you may go on clozapine, if quetiapine is working? Clozapine is more effective though.

To be fair, i understand why you would rather have one person at home injecting you. It would be very daunting to have to 'get used' to loads of different people, and how can you build up a trusting relationship when you would be seeing someone random every week!

Well to be honest, I said to my psych that I was fed up of taking medication that the whole clozapine issue came about. Rather than me discontinue taking meds without his say so, I think his thinking that because clozapine is taken only once a day (and why he also mentioned depot antipsychotics as an alternative, because it would mean a jab once a week rather than me taking 4 tablets a day of quetiapine). If I were to go on clozapine I would only take the majority of tablets at night (and to be honest when I forget it's always the morning dose). If muscle stiffness was not a problem with clozapine, then I would only have to take clozapine and lofepramine at night, and nothing in the morning.

At the moment I take 2 tablets of Quetiapine in the morning, 1 sometimes 2 of the Procyclidine. At night I take 2 tablets at night of the quetiapine, 1 of the Lofepramine. So it would reduce the amount of tablets I have to take throughout the day, so it would seem less of annoyance, which in turn would make me less fed up of taking meds. Both me and my psych realise that not taking any form of antipsychotics is not an option at the moment. He thinks it is the best solution, rather than me take nothing and land myself back in hospital. I hope that makes sense.

I am glad that you understand about trust and injecting me. My CPN is trained to give injectable antipsychotics, I would be willing to try one if they let her give me it and only have to attend clinic when she is ill/on holiday. But my CHMT rules are that I have to attend clinic, of which any random person (who is trained) to give the actual injection, and if going to the clinic is not an option (say that I am too paranoid or physically ill), then they give at home. Even if I refused to go to clinic, some random person would come to my home rather than the CPN. Which sucks.

The only other option he mentioned is the XL version of quetiapine (which wasnt available when I first was prescribed quetiapine), but because of the bad reaction I had to risperidone, if I am going to change medication, I would rather it be something different entirely. I hate swallowing capsules, so the XL version of quetiapine is an option I definitely dont want.

I see my CPN later on this week and she said to think about the clozapine/injectable antispsychotics. I will discuss about how I dont want to go to the clinic so hopefully she will have some suggestions about it.

[Ami]

I'm actually lactating toady, as I discovered when I woke :/

Good that Im seeing the GP later!

[Ami]

updated first post :)