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Question
Posted by: Rob28 | 2010/02/27

The state and its meds.. urgh..

Dear Doc,

I hope this finds you well? Over the last couple of months, I have sadly become unable to support myself financially anyhow. Consequently I have had to resort to the state for help in managing my disorder (Bipolar I). Some of the meds that I was on they had, like lithium and valproate, but others like Seroquel they didn''t.. so I was given Haloperidol (2.5mg in place of 300mg Seroquel XR) and given something called Phenerine (not sure why) and oxazepam 15 mg in place of flunitrazepam 1mg. However, I find that I wake up and my neck and upper portions of my back are in pain (for lack of a better word) and I''m having trouble getting to sleep.. although the feeling doesn''t last forever, it''s still a bugger getting up. I do however wake up at more or less the same time every morning unaided. And mostly, it feels like I''m getting flu.. I even developed a cough complete with snot. I phoned my private psych and she said that she doesn''t think haloperidol is appropriate for me and they should''ve given me zyprexa instead.. But I''m not sure that they keep second generation anti-psychotics. She also mentioned that she believes haloperidol is neurotoxic. Fan-bloody-tastic.

I would value your input doctor,

R.

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Our expert says:
Expert ImageCyberShrink

TO reply, with that time-honours nurses phrase, you find me : " AS well as can be expected"
Of course it rather depends on who is doing the expecting !
I don't recognize "Phenermine" and am not managing to guess what it might be. The others sound like standard bipolar treatments, and potentially effective.
I do wish that private psychiatrists would discuss financial situations with patients, and, where someone might anticipate financial dificulies, that they would try to stabilize the person on drugs also available on the state drug lists.
The sumptoms you describe are worth discussing with the state shrink who has examined and assessed you, as they could be related to an unwanted effect of one of the drugs.
I think some second-generation antipsychotics are available through the state, and Zyprexa might be amongst them, but one would have to check with the particular clinic.
I don't think there's good reason to consider haloperidol as more "neurotoxic" than any other of its group of drugs, and it has helped and still does help, a great many people over the years. As an early member of its family, it usually has a higher incidence of extra-pyramidal and movement problem side-effects than some of the more modern ones ( which can also have such effects ) but not usually severe in most cases, and of course anti-Parkinsonian drugs can be u8sefully added to counter those specific side-effects.

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2
Our users say:
Posted by: Liza | 2010/03/01

This ''unknown'' drug they are giving you is orphenidrine. This is an anti-Parkinsonian drug to decrease side effects of older-generation anti-psychotics like Haloperidol and Stelazine. Its'' basically just a muscle relaxant to reduce trembling caused by the anti-psychotics. When I was still using state facilities, I was using it too, although I was given Stelazine and not Haloperidol.

Another anti-psychotic - Clozapine(Cloment) is one of the the first of the second-generation anti-psychotics like Seroquel. Not sure whether the state distributes it, but since its'' on the basic medical-aid PMB formulary the chances are good that they do. State medication stabilized me enough that I could start working again. Some of the side-effects were terrible, which is why I''m glad I''m on a medical aid again that pays for my meds, but if it weren''t for state help - I''d probably be 6 feet under right now.

Good Luck
Liza

Reply to Liza
Posted by: cybershrink | 2010/02/28

TO reply, with that time-honours nurses phrase, you find me : " AS well as can be expected"
Of course it rather depends on who is doing the expecting !
I don't recognize "Phenermine" and am not managing to guess what it might be. The others sound like standard bipolar treatments, and potentially effective.
I do wish that private psychiatrists would discuss financial situations with patients, and, where someone might anticipate financial dificulies, that they would try to stabilize the person on drugs also available on the state drug lists.
The sumptoms you describe are worth discussing with the state shrink who has examined and assessed you, as they could be related to an unwanted effect of one of the drugs.
I think some second-generation antipsychotics are available through the state, and Zyprexa might be amongst them, but one would have to check with the particular clinic.
I don't think there's good reason to consider haloperidol as more "neurotoxic" than any other of its group of drugs, and it has helped and still does help, a great many people over the years. As an early member of its family, it usually has a higher incidence of extra-pyramidal and movement problem side-effects than some of the more modern ones ( which can also have such effects ) but not usually severe in most cases, and of course anti-Parkinsonian drugs can be u8sefully added to counter those specific side-effects.

Reply to cybershrink

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