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peacelizard
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Member Since Oct 2014
Location: Boston, MA
Posts: 257
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Default Aug 08, 2018 at 01:27 AM
 
Quote:
Originally Posted by still_crazy View Post
hi. i take a moderate dose of abilify. as tranquilizers go, im glad its available. the only older tranquilizer ive taken was haldol, in a hospital. -nightmare- hardcore akathisia. the solution? perphenazine (trilafon, an older tranquilizer). no, thanks.

the TD advantage of the 'atypicals' really depends on the individual drug and the other drugs in the line up. if you look at conversion charts, taking a standard dose 'atypical' is like taking a low to moderate dose of older drugs. one big problem...

for whatever reason(s), back in the day, shrinks would call lots of people "Schizophrenic," and proceed to drug them up with massive doses of old tranquilizers. it was worse in hospitals, but common in outpatient, too. 20mgs/Haldol was once standard. thing is...that's roughly the equivalent of 1,000mgs/Thorazine, and most people only need 200-600+/- Thorazine (or equivalents) daily. some need less, some need more, but...overall, it really doesn't take much to help with agitation and psychosis.

abilify is somewhat unusual in that its really similar to the older drugs in terms of where it goes in the brain cells, but the D2 partial agonism thing often equals improved tolerability (overall, not for everyone). -all- the other tranqs gave me akathisia, then abilify got the job done w/o the crushing depression and akathisia. and yet...

even abilify has downsides. i had stiff gait, until I started popping massive doses of antioxidants and B-vitamins. that helps, tremendously. plus, because abilify has a unique mechanism of action, weird things can happen, especially with other psych drugs in the mix.
Second generation antipsychotics are, at best, no better than first generation (just different side effect profiles) and as worst, worse due to going from movement/parkinsonism side effects to metabolic/cardiac

Also, it's actually pretty difficult to accurately and fairly compare "potency" between typical and atypical antipsychotics largely due to typicals being 95-100% D2 antagonism/blockade vs. atypicals, which are either much less D2 antagonism (or none at all) and more broad-spectrum including 5HT2A agonism/antagonism/cholinergic/histaminergic, etc.
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