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Originally Posted by still_crazy
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TD, EPS, akathisia, NMS, etc. can and do still happen on seroquel, of course. I have only rudimentary knowledge of this, but it seems that when a neuroleptic/tranquilizer is in the mix, more drugs=more problems. So...for instance...I take Abilify. When I briefly tried Depakote with Abilify, I had EPS and akathisia that persisted even -after- the Depakote was discontinued. True story. Lithium is, from what I've read+heard, even worse.
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Well, the Seroquel was taken out of the picture and in its place, Rispiridone - though it stands to reason that many of the (possible) side effects will still be the same.
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Originally Posted by still_crazy
gabapentin might be worth looking into. old school shrinks--I had one once, she was actually fairly awesome--use sedatives (gabapentin, lyrica, benzodiazepines) to help keep the tranquilizer/neuroleptic dose a bit lower. They can also be used to ease tapering off of neuroleptics (and other psych drugs), although the benzodiazepines can have nasty effects after long term use, especially at higher doses (I think "high dose" is anything above the equivalent of 40mgs/valium daily, but I might be wrong about that).
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I'll have to look it up but I take it that a 'sedative' is not the same thing as a 'tranquilizer' - which would be a good thing, as we were thinking we'd have to rule out
all tranquilizers/sedatives on account of how he reacted to the sedation/tranquilizing properties of Seroquel.
I'd mentioned gabapentin to his PsyMD but she ruled it out immediately, stating something about it not being suitable for AS conditions and mentioned some sort of side effect that I didn't catch.
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Originally Posted by TicTacGo
As still_crazy mentioned, Seroquel can be extremely sedating. I can vouch for that; we have played with the dosage for a while to get it balanced between symptoms and sedation. That being said, it may work for him!
Extrapyramidial side effects (EPS) such as akathisia is another thing you'd want to avoid. Trust me, it sucks. I did not have it with Seroquel, but did experience it with Risperdal to some extent.
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Right, we'd thought we'd seen possible signs (tremors, muscle weakness/rigidity) with the Seroquel near the end of his first trial run.
As he's on Rispiridone now, with the same possibility on the horizon, when it comes to observing symptoms and being so many of the symptoms of EPS, TD, Akathisia, NMS, etc overlap, at least in the initial stages - what exactly do you look for and when exactly do you say 'might need to mention to doc' and when do you say 'we're stopping right now!'?
Obviously high fever, delirium, scary numbers from vital signs, etc - (and images of cartoon cats emerging out of the light to perform your last rites, of course) but its unlikely a person will start out with full fledged symptoms, though I've heard with NMS, once it gets going, it develops really fast and as you said, you want to avoid getting to that but neither do you want to yank a potentially helpful med over symptoms that will resolve over time.
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Originally Posted by TicTacGo
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Lamicatal seemed to work for me, but I know that it can be unpleasant and they will (are obligated to) warn you of a possible skin reaction, which may sound scary, but a good doctor tapers up very slowly!
(in my case, increasing 25 mg every two weeks starting at 25 mg)
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Yes, the dreaded and very disturbing photos of Stevens-Johnson Syndrome sufferers.
We actually had our son tested for a gene that supposedly signifies if one is likely to be highly susceptible to developing it (his mum being of Asian descent) but I've really not looked into how dependable the test is with respects to determining the likelihood a given medication will cause it.
Thanks so much!