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Switching Generic Brand During Taper


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#31 fishinghat

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Posted 19 November 2017 - 06:52 PM

Thank you so much Gardenlady for the kind words. In hind sight I think maybe the good Lord put me through that Cymbalta withdrawal experience so I would be better able to help others. With my anxiety I lead a quite life (which is OK with me, lol). This website offers me a way to fill a need and to feel of some value in life. It has helped my self esteem considerably plus there has been so many gifted dedicated people on this site over the years I just had to pick up where they left off.

 

Thanks again.


#32 gardenlady

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Posted 21 November 2017 - 09:07 PM

Not sure why I'm posting except that I don't have anything else to do...and...the Thanksgiving holiday is making me depressed since I'll be spending it alone for the first time in my 65 years.  

 

I cut to 1.67 mg valium tonight.  I'm feeling very sad and weepy, but I think it's mostly due to loneliness vs withdrawal.  


#33 gail

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    5 months on cymbalta, scary side effects, never felt good.
    Needed understanding and support, and a place where I was not alone. To read others stories and realizing that I was not the only one going through all that crap.
    In hope that one day, I can return the favors in some kind of way.

Posted 22 November 2017 - 03:36 AM

Hello Garden Lady,

You are at the right place for sure.and you're not alone. I we only knew the number of people all around the Earth that feel that way. It makes me sad. Loneliness and fear about what's to come next, how to manage to do simplest things that require so much courage specially when you are alone. Lucky me, I have 3 wonderful men in my life to support and help me. Deep down, I feel alone just the same at times, the thing is that they are not God and nobody can fill this gap!

Garden Lady, I'm also tapering the Valium! In the last weeks, I have been holding still. Too many things are wrong at the moment concerning my health.I don't want to add oil to the fire.

I'm up since midnight, the back pain is excruciating. It took a while to figure out how to manage that pain. I go into a kind of panic mode when this happens, it reminds me of the pain I had before the surgery. The oncologist thinks that the disease is coming back, just a possibility.

Friday is an emergency Scan. Something is going on inside my body. My suitcase is ready if it comes to that. This is only the fourth day of extreme pain and prior to this, I had a six day long night fever. Yes, I'm tired. As for the fever, many blood tests were made to find out where infection was located. To no avail. 50% of the time, they can't find out.

Rambling on and on. You have given me the chance to do this by writing your post, so thank you Garden Lady! As you see, you are not alone in all this. With love, Gail

#34 gardenlady

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Posted 22 November 2017 - 10:20 PM

Gail, Goodness....I had no idea you were suffering so badly....and that you had cancer!  I'm so very, very sorry.  And now this excruciating pain, fever on top of benzodiazepine withdrawal!  How wonderful that you have the three men in your life to help and support you...as you need it so desperately.   If you are ever up for it, I'd be interested to know more about your story.  

 

How much valium are you on and how are you tapering?  Are you on other psych meds?  I hope I'm not being too nosey....just concerned and interested.  I hope you'll let me know how your scan on Friday goes if you feel up to it.  I'm praying for you, sweet Gail, that God will heal you and relieve you of your pain. On this eve of Thanksgiving, I'm thankful for you and fishinghat.  Sending my love your way. 


#35 gardenlady

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Posted 04 December 2017 - 09:31 PM

How long after jumping off of valium do I need to wait to restart my Cymbalta taper?  I'm down to 1.31 mg valium now and if I keep up the current rate, I should be finished by Jan 16.  

 

Since Cymbalta capsules have varying numbers of beads in them even within the same prescription bottle, how can you take out x number of beads per day?  I counted beads in my Teva brand 60 mg capsules and they all had varying numbers.  The average was 315 beads.  Just wondering how this bead-removal method works in this situation.

 

I tried to decrease from 48 mg Cymbalta to 46.5 mg using the bead-weighing method in October and it was horrible...I was a shaking, nervous wreck with akathisia and anxiety off the charts.  I lasted only one day and had to go back to 48 mg. It took me 2 weeks to recover just from that one-day tiny drop.  Of course, I was tapering valium so my CNS was/is unstable.  But, I'm scared that it won't ever be stable enough again for me to taper the Cymbalta.  Any advice?  


#36 fishinghat

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Posted 05 December 2017 - 09:16 AM

I would wait 2 months before starting the Cymbalta withdrawal after finishing the valium. Research on benzo withdrawal suggests that it takes your nerves and brain up to 2 years to fully recover from a benzo withdrawal that is why they suggest not using another benzo for at least 2 years after coming off a benzo. With what I have seen with other members 2 months provides enough time for most.  A 48 to 46.5  mg drop is approximately a 2.5% drop of your original dose and we normally suggest not to exceed 1% and that is without going through valium withdrawal at the same time. Unluckily with the variation in the number of beads with Teva you have little choice but to use the weight method. I would suggest  to try dropping about 0.5 mg each time. I think that without the valium withdrawal it shouldn't be so bad. Of course most of this is based on my experiences with myself and other members over the years and is not written in stone but hopefully it may give you a starting point.


#37 gardenlady

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Posted 05 December 2017 - 02:55 PM

Thanks, FH.  How long between each cut of 1% do you recommend?  I'm afraid it'll take years to get off this stuff at this rate and I've been agitated ever since I started taking it.  I dread having to feel this way for a very long time. 


#38 fishinghat

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Posted 05 December 2017 - 03:13 PM

There may not be a choice GL. Some  can come off the stuff in a couple months and some take a couple years. All you can do is go as fast as your body allows.

 

I always say no more than 1% per day at the most. For some it has been as slow as 0.2% per day. Start at the !% and then listen to your body. Slow down or speed up from there depending as your body can handle it. Don't be afraid to stop for a couple of weeks and let your body catch up if you need to.

 

Time and patience.


#39 gail

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    In hope that one day, I can return the favors in some kind of way.

Posted 05 December 2017 - 06:10 PM

Gail, Goodness....I had no idea you were suffering so badly....and that you had cancer!  I'm so very, very sorry.  And now this excruciating pain, fever on top of benzodiazepine withdrawal!  How wonderful that you have the three men in your life to help and support you...as you need it so desperately.   If you are ever up for it, I'd be interested to know more about your story.  
 
How much valium are you on and how are you tapering?  Are you on other psych meds?  I hope I'm not being too nosey....just concerned and interested.  I hope you'll let me know how your scan on Friday goes if you feel up to it.  I'm praying for you, sweet Gail, that God will heal you and relieve you of your pain. On this eve off Thanksgiving, I'm thankful for you and fishinghat.  Sending my love your way.

Oh GardenLady, I'm so sorry, I had not seen your post. Just did.

All has been back to normal in the last seven or nine days. The fever was caused by the chemo pill so they lowered it by half. Pain was neuropathic. I really thought that the metastasis we're back and kind of munching on my spine. I was sure. Scared me half to death.

The scan reveiled nothing other than the other scan taken five or six months ago. Meaning that I have stabilized. Thank God! What a relief. What goes through the mind at those times...you can't imagine.

To bring you up to date, last year, the removed my left kidney. I was cured, but they didn't know that since the surgery, the cancer had spread to my spine...I was in pain since last March, they could not find anything wrong on the scans. And in June, that was a fluke, the scan showed a vertebra, a real sick one. The other scans stopped right below this one...so it was a fluke! A lucky one! And not a pretty picture.

Emergency surgery, because I was on the verge of paralizing. Fusion of five vertebras.

Back to your questions. I went from 20.6 Valium, and now to nine tenth of 10mg. I just cut it since they have it in 2mg. Have stopped tapering since the fever. I should be back at it this week end.

Psych meds. Paxil 20 mg. Which I don't know if they work since they began giving me gabapentin for neuropathic pain in July, all anxiety vanished. They also gave me hydromorphone for the pain, depression vanished. Still on it, I would say low dosages twice a day.i must add that I have suffered from both in more than 10 years. My doctor agrees that if it is what it takes to make feel "normal", go for it. We've tried everything under the sun in the last 4years.

So GardenLady, this is my story! Your prayers are greatly appreciated, thank you.
I'm bushed, will have supper, then the friendly bed awaits. Love to you, Gail xxx




#40 gardenlady

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Posted 09 December 2017 - 05:08 PM

FH, Do people do this daily micro taper that you suggest with a scale?  If so, that means I'd have to weigh my dose everyday which concerns me as the scale isn't very reliable and I wonder about the accuracy with cuts this small.  Currently, I weigh a month's worth of capsules at once so there is less variability as I'm weighing them all at one sitting.  But, turning the scale off and on affects consistency...these are cheap scales and you get what you pay for.  

 

The only other way I see to do this is to count beads, but it is so tedious at the dose I'm on.  All the generic brands have varying numbers of beads in them so you have to get an average and then count the exact number to put back into each capsule.  Honestly, my eyes aren't good enough to do that everyday not to mention how tedious it it with such a huge number of beads.  

 

Just wondering how people have managed to do this in your experience.  Thanks for your help!


#41 fishinghat

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Posted 09 December 2017 - 05:36 PM

It is done with a scale. I know that many used scales from Amazon and a couple mentioned jeweler scales but a good quality scale is essential. If the scale is good quality then turning it off and retaring it (zeroing it) should be consistent.


#42 gardenlady

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Posted 11 December 2017 - 08:30 PM

I'm nearing the end of a benzo taper and am having episodes of tardive dyskinesia (TD) that started in 2014 when a psychiatrist poly drugged me with Seroquel and Trazadone because she was clueless that I was in benzo withdrawal for 2 mg clonazepan she prescribed for insomnia.  I rapid tapered off the clonazepam when I realized it was equivalent to 40 mg valium. The TD started when I took Trazadone & Seroquel during benzo withdrawal, although I was on them only for a few months.   I've had it episodically since then and would like to know if it's something that ever goes away.  Anxiety and extreme emotional distress triggers it and, of course, when we are in benzo and/or AD withdrawal, we are in a constant state of PTSD and so are prone to conditions like TD that are triggered by stress.  

 

 

It's a horrific condition and I'd like to know if there is a treatment for it.  And, I'd like to hear of others' experiences with it.  There was someone on the SA forum awhile back named Wiglet (I think)  who had a terrible time with it and it never did resolve, even years after being off of the offending meds.  Other than that, I can't find much about this condition on any forum.  Any insights or experience?


#43 fishinghat

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Posted 12 December 2017 - 09:23 AM

You are right on with your description of the issue. I have had restless leg on and off for years. Those of us who suffer from chronic stress, anxiety or depression have been found to release extra calcium and magnesium during these periods of stress and that contributes to TD. You need to go to your dr and have a serum blood test for calcium and magnesium. If either is near the lower limit than a supplement of that material should help. CAUTION - Calcium competes with magnesium in the blood stream. So, for example, if you start taking 100 mg of magnesium and it brings relief FINE! BUT, it will slowly deplete your calcium until it gets too low and you will then have trouble with TD again.  I was low in magnesium and took 100 mg a day and the restless leg was gone. After a year or so it started coming back and sure enough my calcium was too low. So now when I have a problem I take 100 mg of calcium carbonate and I get relief in 15 to 30 minutes. I only take it when needed. By the way, with magnesium the best is amino acid chelated magnesium which has no stomach issues and is absorbed easily.  Magnesium glycinate also works well. I now have my serum calcium and magnesium checked every 6 months. If you want details on this let me know. I think I have some information hiding somewhere.  lol


#44 gardenlady

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Posted 12 December 2017 - 11:54 AM

Thanks, fh.  I would like more info on this if you don't mind hunting for it.  I have osteopenia and so take 600 mg of calcium/day as well as 1000 units of Vitamin D.  I don't take magnesium as I was afraid it would make my benzo withdrawal worse.  I took magnesium a couple of times and it seemed to make me more anxious, although it could have been completely unrelated.  

 

I did have restless leg when taking Remeron for a short time, but when I discontinued it, the restless leg problem went away.  

 

I will have my serum blood level checked for these minerals next time I go for bloodwork.  Until then, what do you suggest I take when these TD/akathisia episodes flare up?  It manifests itself in an almost violent drumming of the leg & foot, a swatting-like movement of the hands and grimacing of the mouth.  It's truly scary and makes me think I'm insane.  A friend observed it once and looked at me in wide-eyed horror and said, "You need to be committed (inferring, to a psych hospital)!"  She has steered clear of me since then and stares at me from a distance in disgust. 


#45 fishinghat

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Posted 12 December 2017 - 12:31 PM

Considering your high intake of calcium I would imagine it is your magnesium that is low. ANY good dr know that if you are on a high dose of calcium you need routine monitoring of magnesium. Anyway, I always feel better if I get to pick on a dr.  lol  If you can feel it approaching take 100 mg of the amino acid chelated magnesium.
 
I will try to find that info on the calcium.magnesium/restless leg and anything I can find associating that to tardive dyskinesia.


#46 gail

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    5 months on cymbalta, scary side effects, never felt good.
    Needed understanding and support, and a place where I was not alone. To read others stories and realizing that I was not the only one going through all that crap.
    In hope that one day, I can return the favors in some kind of way.

Posted 12 December 2017 - 06:39 PM

Hello GardenLady,

Just a few words about your last paragraph. This woman knows nothing about compassion, she has not suffered a great deal to say something so stupid. Her behavior is beyond words.

I know that you live alone, even feel lonely and that it's hard on us at our age not to have someone close by to give us a hand and support. I found an organization that gives me rides for medical appointments, i would say cancer rides, at a really low cost because I have a low income. And when I reach 65 in April, other organizations are there for me.

I do hope that you have those services where you live. With love xxxx

#47 fishinghat

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Posted 13 December 2017 - 08:54 AM

Gail is right. I believe Tennessee has an Office on Aging in nearly every major city. They are wonderful in providing help. I know at least 2 members who when going through b ad withdrawal could get volunteers once or twice a week to help around the house. NAMI also provides a lot of services to those diagnosed with mental health issues.
 
By the way, I have come up with some interesting information on tardive dyskinesia and treatments and should be done with it later today.


#48 gail

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    Needed understanding and support, and a place where I was not alone. To read others stories and realizing that I was not the only one going through all that crap.
    In hope that one day, I can return the favors in some kind of way.

Posted 13 December 2017 - 11:22 AM

Fishingbrain, that should be interesting. I'm taking a lot of notes here.

One question, dystonia and dyskenisia and atakisia are all described as movement disorders.
Are they all the same? Atakisia (Greek, not to sit) has a difference, difficulty in staying still. Besides that difference, they seem all the same. Thank you sir!

#49 gardenlady

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Posted 13 December 2017 - 12:51 PM

Thank you, Gail & FH.  I checked with the services you recommend and from what I can tell, they are designed for people with low income.  Thankfully, I'm not in that category.  But, that means I don't qualify for their services.  

 

My real problem is lack of emotional support....I am completely alone with no one to talk to.  My friends and siblings are burned out and don't want to hear about my issues anymore.  They don't even check on me anymore....they stay away.  It's hard living in a world with no love or caring....what's the point in living?   I'm so depressed I don't know what to do.  I desperately need someone to talk to in person about my spiritual problems as that is what is causing me the most grief.  But, I've worn out every pastor I can find and there's no one left.  

 

I cry out to God every day, all day, but get no comfort or response.  I am SO blind....if only I could grasp the Truth of what Christ has done for me in my heart I'd have peace.  But there is so much fear getting in the way that I can't apprehend it.  I'm seeing a Christian psychologist, but he's stumped and doesn't know what to say or do.  I need supernatural intervention.  But it doesn't come.  I keep reading stories of how other people with broken lives called on God and were freed, but I must be a really resistant case as I don't know how to get past the terror and fear.  Being in an altered state of reality with these horrific drugs just makes the bondage all the stronger.  I am desperate. 


#50 fishinghat

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Posted 13 December 2017 - 02:09 PM

Garden Lady, I don't k now what to say. I am like so many others you know. I am at a lost for words. I know that many just have a leap of faith. You certainly can't force God's help. He will help but it is just in his own time and way. It says in the bible that tribulations develops patience. strength and faith. Keep praying and rely on His wisdom. Believe.

 

Also, like Gail said, you are not alone here. Let it out on us. We don't mind. It is so lonely to be in a position like yours. It makes the depression worse but lean on us and continually talk to God. Not just pray for help but tell Him your problems, your worries, your suffering.

 

God bless and hang in there.


#51 fishinghat

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Posted 13 December 2017 - 05:04 PM

                                                          Tardive Dyskinesia

Causes;

Tardive dyskinesia (TD) is an involuntary neurological movement disorder caused by the use of dopamine receptor blocking drugs that are prescribed to treat certain psychiatric or gastrointestinal conditions such as;

Chlorpromazine (Thorazine)
Fluphenazine (Prolixin)
Haloperidol (Haldol)
Thioridazine (Mellaril)
Trifluoperazine (Stelazine)
As well as;
Metoclopramide (Reglan)
Prochlorperazine (Compazine)
Benzhexol
Biperiden
Ethopropazine
Orphenadrine
Procyclidine
MAOIs: phenelzine
SSRIs: fluoxetine, sertraline
Trazodone
TCAs: amitriptyline, amitriptyline-perphenazine, amoxapine, doxepin, imipramine
Carbamazepine
Ethosuximide
Phenobarbital
Phenytoin
Various Antihistamines
Chloroquine
Bromocriptine
Carbidopa-levodopa
Levodopa
Alprazolam
Dopamine
Lithium
Estrogens
Amphetamine
Methylphenidate
Stimulants, have been associated with TD. Stimulants include caffeine, nicotine, guarana, ginseng, legal amphetamines, ephedrine, and illicit amphetamine and methamphetamine.


More likely to get it if you;
Are a woman who has gone through menopause
Are over age 55
Abuse alcohol or drugs
Are African-American or Asian-American

Treatments
There are two FDA-approved medicines to treat tardive dyskinesia:
⦁ Valbenazine (Ingrezza)
⦁ Deutetrabenazine (Austedo)

Both of these medicines work in similar ways to regulate the amount of dopamine flow in brain areas that control certain kinds of movements. Both of these medicines can sometimes cause drowsiness.

Natural treatments
Ginkgo biloba
Melatonin
Vitamin B6 (Note - Vitamin B5 has a half life of 25 days and is easy to develop Vitamin B6 toxicity with supplements)
Vitamin E

Studies are ongoing to determine possible new drug therapies for the treatment of tardive dyskinesia. Choline, lithium, bromocriptine, baclofen, methyldopa, valproate, clonidine, propranolol, amantadine, clonazepam, and nifedipine have occasionally been helpful but in most cases do not improve dyskinesia. Tetrabenazine is often useful for symptomatic treatment of tardive dyskinesia and is currently available for use in the US. However, it carries the risk of causing or aggravating depression. Other experimental drugs are being tested to reduce or eliminate the symptoms of tardive dyskinesia.

Other therapeutic agents for which there is some anecdotal support include, levodopa (see carbidopa/levodopa), benzodiazepines, botulinum toxin, reserpine, tetrabenazine, and dopamine-depleting agents. Ondansetron, a selective 5-hydroxytryptamine-3 antagonist, has helped some individuals with TD. Discontinuance of anticholinergic therapy may relieve TD. A controversial strategy for treating TD is to continue or increase the dose of the dopamine antagonist.

updated information

https://www.ncbi.nlm...les/PMC5472076/
Medication-Induced Tardive Dyskinesia: A Review and Update (2017) (excellent document to read)
Treatments;
Medications and Supplements Used to Treat Tardive Dyskinesia
A number of medications and supplements have been identified that ameliorate TD symptoms.

Cholingergic Agents.
Cholinergic agents are used as muscle stimulants to diagnose myasthenia gravis and to treat glaucoma. These agents can also improve the Parkinsonian features of TD. Donepezil, a reversible acetylcholinesterase inhibitor, is currently the only cholinergic medication that has shown benefit against TD.109 Overall, however, cholinergic agents are not a widely accepted treatment for TD as sufficient evidence is lacking to suggest they are more helpful than other treatments.

Clozapine, Quetiapine, Olanzapine, and Apomorphine.
Clozapine, a serotonin and dopamine receptor antagonist, is an atypical APD used to treat schizophrenia. Clozapine is the best current medication recommended for patients who require antipsychotics and simultaneously have TD,111 as clozapine has been reported to reverse TD symptoms.112,113 Clozapine has been linked to TD; however, the incidence is much lower compared to other atypical APDs.114 Drugs with similar mechanisms of action such as quetiapine, a weak striatal dopamine antagonist, and olanzapine, a dopamine and serotonin receptor antagonist, have also been shown to be effective in ameliorating TD symptoms.115 Apomorphine, a dopamine receptor antagonist, can be given in conjunction with L-DOPA to decrease dyskinesias.

Tetrabenazine Analogs.
Tetrabenazine, a vesicular monoamine transporter inhibitor, decreases the severity of TD symptoms.14 However, tetrabenazine is rapidly metabolized and therefore needs to be administered frequently.117 Analogs of tetrabenazine such as valbenazine, a (+)-α-isomer of tetrabenazine, have been approved for clinical trials for the treatment of TD. In a phase IIb randomized, parallel, double-blind, placebo-controlled clinical trial of patients with moderate to severe TD, 67% of patients treated with valbenazine reported a “much improved” or “very much improved” Abnormal Involuntary Movement Scale score compared with 16% of patients taking placebo.

Clonazepam.
While certain benzodiazepines can cause TD, evidence suggests that some may be beneficial in treating TD.118 Sharma's proposed guidelines for treating TD include clonazepam and were successful in a patient who presented with TD symptoms after long-term treatment with trifluoperazine (a typical APD), citalopram, trihexyphenidyl, and propranolol.119 A case report published in 2001 related that 2 mg/day of clonazepam for 1 year successfully alleviated the TD symptoms of a 66-year-old female, and she did not develop tolerance during the 1-year period.

Propranolol.
Propranolol is a beta-adrenergic receptor antagonist used to treat high blood pressure, cardiac arrhythmias, and migraines. A retrospective study of 47 patients with TD that persisted for 17 months after discontinuation of APDs reported that low-dose propranolol appeared to be well tolerated in this patient population, and 64% of the patients saw an improvement in their TD symptoms.

Amantadine.
Amantadine is a noncompetitive glutamate receptor antagonist. It is postulated to work by increasing presynaptic release of dopamine and blocking presynaptic dopamine reuptake. Amantadine has been shown to be effective in treating L-DOPA–induced TD in patients with Parkinson disease.

Branched-Chain Amino Acids.
Some evidence suggests that an inability to clear ingested forms of the amino acid phenylalanine is associated with TD. Branched-chain amino acids (BCAAs) are reported to decrease TD symptoms123 because they decrease plasma phenylalanine by stimulating protein synthesis and insulin release.124 BCAAs also decrease the accumulation of tyrosine, another amino acid and an important precursor to dopamine, that reduces overall dopamine synthesis in the nervous system.124 Most important, BCAAs also seem to be effective at decreasing TD symptoms while an APD medication is still on board or the patient has a history of APD exposure.123 BCAAs are available over the counter in a flavored powder preparation to mix with water, so they may be a promising, practical, and inexpensive treatment for TD.

Ginkgo Biloba.
The American Academy of Neurology recommends clonazepam and ginkgo biloba, an extract of the ginkgo biloba tree leaf that is used as a dietary supplement, to enhance cognitive function to treat TD.

Antioxidant Medications and Supplements.
Because evidence suggests that oxidative stress may contribute to TD, several antioxidant medications and supplements are increasingly being used to treat TD: zonisamide, yi gan san (a Chinese herb), levetiracetam, melatonin, omega-3 fatty acids, piracetam, resveratrol, vitamin B6, and vitamin E. A comprehensive update on these medications is available in a 2015 review by Lerner et al.118

Specific Medical research on alternate treatments
Melatonin
https://www.ncbi.nlm...pubmed/21950196
A randomized, double blind, placebo controlled design was used to determine the effectiveness of MEL (20 mg/day) during 12 weeks in 7 patients with TD. Six patients with TD were treated with placebo. In two patients treated with MEL a significant improvement (more than 60%) of the values of AIMS was detected. In the remainder five, as well as in the patients treated with placebo, no difference was observed during the 12 weeks.

https://www.ncbi.nlm...pubmed/10982197
Nineteen patients chronic DSM-IV schizophrenia of 31.3+/-7.0 years' duration, were randomly assigned in a double-blind, placebo-controlled, crossover trial to receive slow-release melatonin, 2 mg/day (low dosage), or placebo for 4 weeks. Supraphysiologic doses of melatonin do not positively affect tardive dyskinesia.

https://www.ncbi.nlm...pubmed/11695951
Using a double-blind, placebo-controlled, crossover study, we evaluated the efficacy of 10 mg/d of melatonin for 6 weeks in 22 patients with schizophrenia and TD. The decrease in AIMS score was 2.45 for the melatonin and 0.77 for the placebo treatment groups. This is the first clinical evidence for efficacy of melatonin in the treatment of TD.

Propranolol
https://www.ncbi.nlm...pubmed/27622970
Forty-seven patients were analyzed, mean age 63 years. Neuroleptics were discontinued in all patients and duration of TD at the time propranolol was initiated 17 months. Propranolol resulted in improvement in 64% and 77% of those had a moderate to complete or near-complete response. Mean daily dose was 69 mg and duration of therapy 14 months. Three patients stopped the propranolol due to adverse effects: hypotension (2), nightmares (1). Severity of TD and duration of propranolol therapy were associated with response.

https://www.ncbi.nlm.../pubmed/6124534
A double-blind, intensive case design was used to study the effect of propranolol on tardive dyskinesia. No short-term improvement was observed, but two of the four subjects responded to long-term propranolol use.

https://www.ncbi.nlm...01471-0028b.pdf
In October 1979 I thought itnmmight be worth trying propranolol to modify the annoying mouth movements. Initially, I prescribed 10 mg to be taken four times a day; I soon increased the dose to 40 mg to be taken twice a day. Over approximately 6 weeks the mouth movements decreased; propranolol was continued at 80 mg/d. I last saw the patient 1 week before the time of writing, when she stated that she had run out of the propranolol and had not bothered to renew the prescription. She found that the mouth movements returned quite rapidly; therefore, she immediately began taking propranolol again, 40 mg twice a day.

Branched-Chain Amino Acids
Definition - A branched-chain amino acid (BCAA) is an amino acid having aliphatic side-chains with a branch (a central carbon atom bound to three or more carbon atoms). Among the proteinogenic amino acids, there are three BCAAs: leucine, isoleucine and valine.[1] Non-proteinogenic BCAAs include 2-aminoisobutyric acid.
https://www.ncbi.nlm...pubmed/12777270
Long-standing tardive dyskinesia were randomly assigned to receive branched-chain amino acids or placebo. Treatment frequency was three times a day, 7 days a week for 3 weeks. A robust and highly significant difference was observed between patients who received high-dose branched-chain amino acids (222 mg/kg of body weight t.i.d.) (N=18) and those who received placebo (N=18) in the percent change in tardive dyskinesia symptoms from baseline to the end of the 3-week trial. Significant and marked differences were seen between the two groups at the >/=30% and >/=60% levels of decrease in tardive dyskinesia symptoms.

https://www.ncbi.nlm...pubmed/10367552
A 2-week trial of a BCAA medical food administered three times a day was conducted in nine men with long neuroleptic treatment histories. Frequency counts of TD movements were collected by videotape throughout the trial and these tapes were analyzed in blind random sequence for both patient and time for TD symptom level changes subsequent to completion of the trial. A statistically significant decrease in the level of TD symptoms was observed for the sample. The symptom changes were also clinically significant in that six of the nine subjects had symptom decreases of at least 58%, with all subjects having a decrease of at least 38%.

https://www.ncbi.nlm...pubmed/14744176
TD evaluation at baseline and after 1 and 2 weeks of BCAA treatment given in the form of a drink administered 3 times daily. TD symptom decreases were substantial in 5 of the 6 participants, ranging from 40% to 65%. Two of the subjects received an additional course of treatment, and further reductions in TD symptoms over those seen in the 2-week trial were observed.

Omega-3 Fatty Acids
I found two research articles that both said there was no improvement in TD with the use of Omega 3 fatty acids.

Calcium
https://www.ncbi.nlm.../pubmed/3227974
Serum calcium levels were measured in 25 chronically ill psychotic inpatients with involuntary movements, in comparison with 25 otherwise indistinguishable patients without such a syndrome. Those with involuntary movements were significantly more likely to have a serum calcium level below the normal range.

http://globalresearc...Article 019.pdf
Laboratory studies include....
B. Serum electrolytes- to omit abnormalities of sodium and calcium metabolism that may cause movement disorders.

https://pdfs.semanti...8f7d29d4683.pdf
The blood test showed a light hypermagnesaemia (2.5 mg/dL) not related to a large ingestion of magnesium nor with any symptom of renal failure and levels of calcium of 9.70 mg/dL, which are in the upper levels of normal concentration (normal values: 8.89 - 10.0).

The only treatment was removal of haloperidol treatment.

Forty-eight hours after hospital admission, the patient was discharged. At that time the levels of magnesium in blood were slightly reduced. The blood test was showing an haloperidol concentration of 0.4 μg/L, a maintained leucocytosis and anaemia. Calcium level was of 9 mg/dL, and blood magnesium levels were of 2.1 mg/dL, being both
value considered normal.

Our suggestion is to control the calcium and magnesium levels in
patients receiving a chronic haloperidol treatment to prevent these
crises.

http://europepmc.org...ct/med/18363098
There is involvement of calcium in triggering the oxidative damage and excitotoxicity, both of which play central role in haloperidol-induced orofacial dyskinesia and associated alterations.
Results of the present study indicate that haloperidol-induced calcium ion influx is involved in the pathogenesis of tardive dyskinesia


Magnesium
https://www.ncbi.nlm...pubmed/27816557
The co-administration of haloperidol and Mg supplementation prevented RS generation in cortex, striatum and SN, and PC levels in the SN.These outcomes indicate that Mg supplementation may be a useful alternative to prevent movement disturbances resulting of classic antipsychotic pharmacotherapy as haloperidol.

Also see above.


#52 fishinghat

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Posted 13 December 2017 - 06:01 PM

Gail

"One question, dystonia and dyskenisia and atakisia are all described as movement disorders.
Are they all the same?"
 
Simple answer - No

Dystonia - Dystonia is a neurological movement disorder syndrome in which sustained or repetitive muscle contractions result in twisting and repetitive movements or abnormal fixed postures. The movements may resemble a tremor. Dystonia is often intensified or exacerbated by physical activity, and symptoms may progress into adjacent muscles.
The disorder may be hereditary or caused by other factors such as birth-related or other physical trauma, infection, poisoning (e.g., lead poisoning) or reaction to pharmaceutical drugs, particularly neuroleptics.

Note - A neurological condition that affects the muscles.

Dyskenisia - Dyskinesia refers to a category of movement disorders that are characterized by involuntary muscle movements, including movements similar to tics or chorea and diminished voluntary movements. Dyskinesia can be anything from a slight tremor of the hands to an uncontrollable movement of the upper body or lower extremities. Acute dyskinesia is a sustained muscle contraction that sometimes appears soon after administration of antipsychotic medications.

Note - An uncontrollable muscular contraction brought on by side effects of certain medications.

Akathisia - Akathisia is a movement disorder characterized by a feeling of inner restlessness and a compelling need to be in constant motion, as well as by actions such as rocking while standing or sitting, lifting the feet as if marching on the spot, and crossing and uncrossing the legs while sitting. People with akathisia are unable to sit or keep still, are prone to feelings of restlessness, and they may also fidget, rock from foot to foot, and pace.

Antipsychotics (also known as neuroleptics), particularly the first generation antipsychotics, are the leading cause of akathisia. When antipsychotic-induced, akathisia is an extrapyramidal side effect. Akathisia is also a symptom of psychosis, bipolar disorder, and agitated depression. Akathisia is a component of the repetitive movements in some cases of autism and intellectual disability. Other known causes include side effects of other medications, and nearly any physical dependence-inducing drug during drug withdrawal. It is also associated with Parkinson's disease and related syndromes.

Note - This is very similar to dyskenisia but may be caused by a variety of situations not just medication. The movement seen with akathisia is very repetitive and can last long periods of time, even hours. The movements with the other two conditions can be more violent and usually occurs as episodes which usually last less than an hour.

 

There is still a lot unknown about these 3 conditions. Especially what are the physical differences in the conditions. It is very difficult for the dr to make a specific diagnosis with these conditions because he/she only has the pattern of the movements to go by. Treatments are similar for all three but not exactly the same. All are effected by calcium and magnesium levels (those two elements control muscle contraction) as well as occasionally by potassium and sodium levels.


#53 gail

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    Needed understanding and support, and a place where I was not alone. To read others stories and realizing that I was not the only one going through all that crap.
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Posted 14 December 2017 - 03:46 PM

Thank you so much sir. All was written down, while writing all this, I thought to myself that a doctor must have quite some difficulty differentiating all this.

Now, the student will take a break well earned.

#54 gardenlady

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Posted 14 December 2017 - 06:44 PM

FH & Gail, Thank you both for your understanding, patience and helpfulness as I navigate this terrible time.  I am experiencing a lot of agitation, anger (bordering on rage) and irritability.  It was triggered today by a conversation I had with a lifelong friend who lives in another city and is a psych nursing professor at a very prestigious university.  She is clueless about the dangers of benzos and ADs.  When I talk to her, she constantly advises me to "up my dose" of AD....the worst advice imaginable.  She defends ADs saying that she can cite all kinds of research as to how helpful they are.  She also told me to avoid online forums as they are, in her opinion, full of people with borderline personality disorders who have nowhere else to go.  

 

I can't tell you how angry all of this made me.  I told her how psych drugs had wrecked my life and she said she'd like to see scientific research showing that they are dangerous/don't work.  FH, is there anything you can provide?  It's so frustrating when people in the medical community are so uninformed and clueless about the suffering these drugs cause.  How should I respond?  I really would like to send her some info, but am not in a mental condition to round it up.  Thanks in advance for any help you can offer. 


#55 fishinghat

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Posted 14 December 2017 - 07:09 PM

Hi GL

 

There are literally thousands of negative research articles on the dangers of ADs. The best thing to do is to print off the drug inserts for these drugs and highlight the danger. I am afraid she would say "oh that is possible but I have never seen it happen.". I have experienced that before. I must admit that I have seen a lot of mis-information on medical blogs/forums. That is why I always try to post links to the medical journal articles I am referring to. I have also had drs look at some of the medical journal articles I have brought to them and they say "You printed that off the internet. It doesn't mean anything."  Even though it is from prestigious journals. They are medical professionals and know everything. (Sorry to speak ill  of your friend).

 

If you wish a copy of the drug inserts for the ssri and snri and the articles I have in my library let me know and I will send them to you in a PM. (If I am smart enough to figure out how.  lol)


#56 gail

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    In hope that one day, I can return the favors in some kind of way.

Posted 15 December 2017 - 09:52 AM

GardenLady,

My goodness, a psych nurse professor??? Who would think? Her advice must have sent you to the roof!

FH is right about the drug insert and highlighting the dangers. Of course, not everyone suffer from this. Many many people do good on antidepressants, and many suffer from it.

It makes me sad that her vision is quite SO SIMPLE, up and down. Makes me sad as Fishingbrain devotes a lot of time to help people. It's just not out of his head, so many research from his part and always links to provide the information he posts.

He has walked the walk, and that is enough for me. GardenLady, we will always be there for you, anytime, even just to vent. We love you xxx

#57 fishinghat

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Posted 15 December 2017 - 10:34 AM

I was thinking more about this last night. The psych clinic I go to is fairly large (11 psychiatrists) and they have a policy statement on their wall.

 

1 - Benzodiazepines will not be prescribed unless all other options have been explored.

2 -Xanax will not be prescribed.

3 - Antidepressants are commonly prescribed but all efforts will be made to reduce/eliminate the amounts of ADs used after the patient has been stable 6 months.

 

Maybe she needs to meet these drs. lol


#58 gardenlady

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Posted 21 December 2017 - 08:23 PM

I'd like to taper off of the 80 mg valsartan I've been taking for about 18 months as the risks are significant.  I never had HBP till withdrawal nor any family history.  My valium taper will end soon so how do I taper off the valsartan?  Should I halve the tablets for a week or so and then quarter them? What if any side effects should I expect?  I have a BP machine at home.   Is is stupid to get off of the valsartan while in benzo withdrawal?  My main benzo withdrawal symptoms are depression and some dp/dr. 


#59 fishinghat

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Posted 22 December 2017 - 09:31 AM

I would strongly urge you to wait until at least 2 months after completing the benzo withdrawal. You will have a much better chance of success. even though you may feel fine after coming off the benzo your nervous system is still very sensitive.
 
I will check into the valsartan withdrawal.


#60 fishinghat

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Posted 22 December 2017 - 10:51 AM

Most withdrawals cause high blood pressure, especially benzos.
 
Working on valsartan now.



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