SoS: Dopamine Antagonist Withdrawal Syndrome – Carole’s Story

[Chip (OP)]

source: http://rxisk.org/sos-dopamine-antagonist-withdrawal-syndrome-caroles-story/

SoS: Dopamine Antagonist Withdrawal Syndrome – Carole’s Story



The dopamine antagonists include the antipsychotic, anti-nausea, anti-itch and other groups of drugs.

The antipsychotics were the first of the modern psychotropic drugs to be linked to severe withdrawal, but even so few doctors today are aware that there can cause dependence and withdrawal or how bad the problems can be. These drugs are linked to one of the most severe examples of tolerance and dependence leading to a debilitating legacy effect – tardive dyskinesia. My first brush with the fact that dopamine antagonists can cause withdrawal came when Carole came to see me in 1996.

for the full article, go to http://rxisk.org/sos-dopamine-antagonist-withdrawal-syndrome-caroles-story/

Symptoms on stopping – antipsychotics

The Table below gives some sense of the Symptoms on Stopping these drugs.

A few points to note. Some of these drugs like amisulpiride and sulpiride are available in Europe only and this is why they come up with zero values across the board. Some of the older drugs such as perphenazine shows as having lower withdrawal problems than Zyprexa (olanzapine) or Seroquel (quetiapine). It likely is better than either of these two newer drugs when it comes to withdrawal problems but the main reason they show up as worse is that the data here is based on FDA data from 2004 and perphenazine, trifluoperazine, chlorpromazine and older drugs were being used much less by then.

The Clozapine group of drugs that includes Zyprexa and Seroquel are noted as having some of the worse withdrawal problems. We are missing data on Clozapine at the moment but will add that data and others in due course. Lilly may have received marketing authorization to claim Zyrexa was useful in the maintenance treatment of Bipolar Disorders largely on the basis that it causes withdrawal problems and not stopping leads to an impression it is providing some help in maintaining wellbeing when in fact the drug is the problem that the drug is often treating.

Quite strikingly the relatively recently released Paliperidone (Invega) comes with significant dependence and withdrawal problems. The haloperidol group of drugs of which Paliperidone and Risperidone and Ziprasidone are included all have problems.

The missing data may give the impression that DAAWS is not as common as withdrawal from benzodiazepines, mood stabilizers or antidepressants but it is in fact every bit as bad. In addition to tardive dyskinesia, these drugs produce a well recognized tardive dysthymia and tardive akathisia along with the kinds of stress intolerance, temperature dysregulation and other problems that Carole had. See the RxISK Guide: Antipsychotics for Takers at http://rxisk.org/antipsychotics-for-takers/

again, refer to the source link.

[Chip (OP)]

I noticed the abuse numbers, highest for Seroquel, Resperidine and then Olanzapine^Wiki.

oh shit !

[candy]

Quetiapine (Seroquel) was given to me to help with sleep. Off-label use as the doctor put it.  It worked quite well for a while, helping me fall asleep and stay asleep, but if I missed a few doses it was quite unpleasant.
I ended up stopping the Quetiapine (Seroquel) by weaning myself off over a few months.  I was getting the 100 mg capsules at the time and would take 200 mg at night to sleep.  I was able to decrease to 100 mg nightly until I ran out. I never expected how bad it would be once I stopped and the withdrawals lasted for months. Nothing at all like withdrawals from opiates or benzos.
Seroquel, an antipsychotic, is being used off-label for those suffering from sleep disorders and that is just one off-label use.  It is not an appropriate drug for someone who has trouble falling asleep or for someone who wakes up a few times a night and it should not be used long term as a sleep aid.

As stated in the article" The antipsychotics were the first of the modern psychotropic drugs to be linked to severe withdrawal, but even so few doctors today are aware that they can cause dependence and withdrawal or how bad the problems can be."
Well I disagree and believe that most doctors are aware of the dependence and withdrawal that these drugs can cause, especially now. There is much more information available on these drugs than there were in the 70's, not to mention the amount of drugs now available.
They certainly don't want to write a script for Xanax, Ativan, or Klonopin for a patient who is experiencing anxiety or panic attacks. Just give them some antipsychotic or antidepressant for their anxiety instead. Never mind they take a few weeks or more to begin working or to achieve the desired affect the dosage needs to be increased.

These drugs are prescribed far too often and I would venture to guess that a majority of patients taking them either don't really need them or get no help from them at all. And when one drug doesn't work, well there is a list as long as your arm to choose from. 

Sex doesn't really sell anymore, it's the cure for your bi-polar depression that sells.
"Don't you want your mommy or daddy to come outside and play with the rest of your family? Well she could if only she was on Pristiq!"

[Chip (OP)]

oh dear, i'm in for a rough ride and i suspected that when i ran out one day.

it's so much easier to just keep on taking them as no doctor i have ever met had any problem prescribing 6 months worth at a time.

i'm not even much bipolar (or is it the drug ?), i just used them to handle stimulant crashes these days.