dopetalk
Core Topics => Drugs => Antipsychotics / Neuroleptics => Topic started by: Chip on June 19, 2025, 09:53:43 AM
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🧠 Why Does My Hand Shake on Clopixol?
🔬 Root Cause: Extrapyramidal Symptoms (EPS)
Clopixol (Zuclopenthixol) is a first-generation antipsychotic known for strong dopamine D2 receptor blockade, especially in the nigrostriatal pathway — the brain circuit responsible for movement control.
Mechanism:
- ↓ Dopamine in motor regions
- ↑ Parkinsonism-like symptoms:
- 🫱 Hand tremors
- 🪑 Slowed movement
- 💀 Muscle stiffness
- 🧍 Stooped posture
🧬 Why It Happens After Long-Term Olanzapine Use
- 25 years of Olanzapine = adapted D2 sensitivity
- Clopixol = stronger D2 blocker → dopamine crash
- Result: EPS symptoms like tremors, rigidity, bradykinesia
📉 EPS Risk Comparison
Olanzapine: Low–Moderate
Clopixol (oral): Moderate–High
Clopixol Depot: High
✅ How to Manage the Hand Tremor
1. Dose Adjustments
- Lower Clopixol dose
- Try AM/PM split dosing
2. Add-on Medications
- 🧠 Benzatropine (Cogentin)
- 🚶 Procyclidine or Trihexyphenidyl
- 💓 Propranolol (for tremors)
- 🧃 Vitamin B6
- 💊 Amantadine (dopaminergic)
🚨 When to Worry
Seek help if:
- Tremors get worse
- You feel internal anxiety (akathisia)
- Neck spasms, jaw tension, tongue rolling
🔄 Long-Term Solutions
Try:
- Atypicals with less EPS: Aripiprazole, Quetiapine, Lurasidone
- Depot Clopixol? Use very low dose and protect with anticholinergics
💬 Summary
Hand tremors = Clopixol's D2 blockade overcorrecting your dopaminergic system after 25 years on Olanzapine. It's treatable, but act early to prevent permanent damage.