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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by tancu on January 24, 2003, at 18:47:25
Thanks for being here. My wife has been in the hospital for 2 weeks now, her third in-patient stay in the last 8 months or so. During her 1st stay she was diagnosed as bi-polar. The SSRIs don’t seem to help much at all, and neither does wellbutrin or neurontin. They started her on effexor about a week ago, but she complained that she felt like she was “coming out of” her skin. I guess it made her feel too anxious. So, they started her back on imipramine, and they’ve also added seroquel—on the 13th day since she was admitted. She’s obviously not doing well, but insists that she’s leaving “soon”. I talked to her on the phone yesterday, before I went to see her, and I could tell she was really stoned. That’s when she told me about the seroquel. I’m hoping the main reason they’ve started her on it is to help her control her anger/hostility (I’ll be sure to ask her doc specifically about this). I’m very concerned about seroquel’s potential to cause tardive dyskinesia. She seems to already be experiencing tremor in her legs—she told me today that her legs were restless last night as she tried to sleep. So, here are my questions—how prevalent is the side-effect of involuntary movements as a result of taking seroquel?,,,and, are there any particular symptoms or personality characteristics or physical characteristics that are associated with the development of TDK in patients taking seroquel? Thanks for taking the time to give me your thoughts and for posting any links to recent seroquel studies.
Posted by xjs7 on January 24, 2003, at 20:17:40
In reply to seroquel question, posted by tancu on January 24, 2003, at 18:47:25
Hi Tancu,
Seroquel is an antipsychotic agent, and is prescribed mainly to treat psychosis and mania. It is estimated that about half of people diagnosed with bipolar disorder experience psychosis.
There are two types of movement disorders associated with drugs in this class. Extrapyramidal symptoms are the most common and occur in 10-30% of people treated at average doses of the newer antipsychotics. Tremors, muscle stiffness, and difficulties walking are common extrapyramidal symptoms. These symptoms can be treated with anticholinergic medications, such as Cogentin.
The second kind of movement disorder associated with antipsychotic meds is tardive dyskinesia. This occurs most often in people who have been treated with AP's for several years at high doses. Newer medicines like Seroquel cause this problem much less often than older drugs. The probability of getting tardive dyskinesia from the newer AP's has been estimated to be 0.1% per year of exposure. Sometimes, this condition is irreversable. Common symptoms of tardive dyskinesia include involunatary tongue and mouth movements, and sometimes movements of the limbs. There are no personality characteristics associated with tardive dyskinesia.
From your message it sounds like your wife is experiencing extrapyramidal symptoms. Sometimes these are temporary and will resolve themselves without any extra medication, and sometimes an anticholinergic like Cogentin is used to eliminate them. They are not permanent like tardive dyskinesia sometimes is.
I hope this helps.
xjs7
Posted by tancu on January 24, 2003, at 21:22:58
In reply to Re: seroquel question, posted by xjs7 on January 24, 2003, at 20:17:40
thank you xjs7...one other question--will she continue to be so "stoned" concurrent with seroquel?
Posted by xjs7 on January 24, 2003, at 21:44:10
In reply to Re: seroquel question, posted by tancu on January 24, 2003, at 21:22:58
Usually the sedation associated with these drugs lowers as people become used to them. So, I would say that no, she will probably not seem so "stoned" for more than a few weeks or at most months, unless the dosage is too high.
This is the end of the thread.
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