Jerry 10-Dec-1999

There is great promise that a drug will be developed to treat HD. Today there are no proven drugs to treat HD. Treatment now is only for the symptoms. Many of the symptoms of HD can be made worse by drugs. Drugs are often incorrectly and over prescribed. Haldol in particular should never be prescribed for HD.
Antipsychotics are often used as chemical restraints. To learn of the abuse of drugs and the rights of patients see the Report on Nursing Homes.

The following is from the 1997 Physicians  Desk Reference (PDR). Dangers listed represent  only  some of the  potential side  effects that may  occur with the  administration of  these medications.  Drug Name Use Danger Antipsychotics Schizophrenia or other psychoses. Thorazine Mellaril, Haldol Prolixin, Risperidal, Zyprexa. Used to decrease agitation, provide sedation, faciliate improvement of thought processing and to reduce or eliminate hallucinations, and delusional thinking. Potentially irreversible, involuntary movements of the face, hands and trunk. (Tardive Dyskinesia) Increased heart rate, low blood pressure and EKG changes. Cases of sudden and unexpected death have been reported. May also cause high fevers, muscle rigidity, altered mental states and instability of blood pressure and pulse; potentially fatal. (Neuroleptic Malignant Syndrome) Clozaril Same as above. Life-threatening low white blood cell count. (Agranulocytosis) High risk of seizures. Antidepressants Clinical depression, panic attacks. Tricyclics (Elavil, Sinequan, Toframil, Norpramin, Aventyl and others) Used to faciliate improvement in mood and to alleviate insomnia, decreased appetite, poor concentration, fatigue, loss of interest, hopelessness, suicidal thinking and other symptoms associated with depression. Overdose may cause cardiac rhythm disturbance, stupor, coma and death. May result in heart block, hypertension and postural hypotension. Also may cause coma, seizures, hallucinations, delusions and tremor. Desyrel Same as above. Priapism (prolonged and painful erection) requiring surgical intervention, may result in permanent impairment of erectile function or impotence.  Wellbutrin Same as above. Seizures may exceed those of other marketed antidepressants by as much as two fold. Serzone Same as above. Interacts with certain other medications. MAO Inhibitors (Parnate, Nardil, and others) Same as above. Sometimes fatal hypertensive crises. Serotonin Reuptake Inhibitors (SRIs) (Prozac, Paxil, Zoloft, Luvox and others) Same as above. Caution advised with patients with disease that could affect metabolism or hemodynamic response. Can increase blood level of other medications to toxic levels.  Effexor Same as above. Increased blood pressure at high doses. Tranquilizers Generalized anxiety/panic attacks. Valium, Ativan, Xanax and others. To decrease agitation, anxiety and tension and to both treat and prevent panic attacks. (Schedule IV Controlled Substance) May provide psychological and physical dependence. Withdrawal symptoms similar to those noted with barbiturates and alcohol (convulsions, tremor, cramps, vomiting and sweating) can occur with abrupt discontinuance. Can decrease coordination and memory. Hypnotics  Insomnia. Halcion, Dalmane, Restoril and others To facilitate sleep. Potentially Lethal if taken in combination with other drugs or with alcohol. Maybe habit forming. May increase risk of depression in depressive-prone persons. Lithium Carbonate Bipolar disorder (manic depression) and other mood disorders. Risk of toxicity is very high with lithium in patients with dehydration or renal disease. Mood stabilizers  Depakote, Tegretol, and others To decrease manic excitement in the immediate situation and to prevent mood swings when used over a longer period. Tegretol may cause agranulocytosis (life threatening low white blood count). Depakote may cause liver damage, particularly in children. Stimulants Ritalin and Dexedrine & others Used in children with attention deficit disorder. Used in narcolepsy. (Schedule II Controlled Substance) Amphetamines have been extensively abused by adults. Tolerance and extreme psychological dependence have occurred with adults. Although a causal relationship has not been established, suppression of growth has been reported with long term use in children. Cylert (Schedule IV Controlled Substance) Cylert is associated with liver disease. Antiparkinsonian Cogentin, Artane and others.    To reduce or eliminate certain side effects caused by major tranquilizers. Paralysis of the bowel, high fevers and heat stroke have occurred in patients taking antiparkinsonism drugs in combination with antipsychotic or tricylcic antidepressant medications.

 

Dear Phyllis,
I am a pharmacist that practices in LTC. We have been seeing a huge
increase of swallowing disorders in our patients using Risperidal, which
is an antipsychotic. I would be interested in your input or experience
with this. Thanks Rick. 

If you are taking either Prozac, Effexor, Paxil, Serzone or Zoloft you should read this article. Unless your interfacing with a psychiatrist or neurologist who is well informed of the depression symptoms associated with HD, you may find yourself with a physician who will just "prescribe" something to help alleviate immediate problems without considering the longer term affects of that medication. The best thing you can do is educate yourself on the medication BEFORE getting a prescription filled. A good place to find out information on mental health associated drugs is at:

www.mentalhealth.com/drug/

Arm yourself with knowledge of any medication prescribed and question the physician's rational for prescribing it, how long they feel treatment with this medication will be required, the dosages, side affects and withdrawal symptoms!

6/2/98 St. Petersburg Times
The People's Pharmacy

The Downside of New Anti-depressants

When Prozac was introduced in 1987, it almost went unnoticed. The Eli Lilly company was still reeling from a scandal caused by the arthritis drug Oraflex, which was taken off the market because people were dying from kidney and liver damage. Perhaps as a reaction, Lilly cautiously promoted Prozac to psychiatrists at first.

Initial sales were strong but not spectacular; the first year it sold $125 Million. But by the next year, consumers paid more for Prozac than for all other anti-depressants put together.

Prozac has been joined by a number of related compounds. Last year, sales of Prozac, Effexor, Paxil, Serzone and Zoloft amount to more than $5 Billion. The incredible popularity of these drugs can be attributed in part to their ability to relieve depression without many of the side effects associated with previous anti-depressants.

Another reason these serotonin boosters have become so widely prescribed is that they are being used for so many other problems; obsessive-compulsive disorder, bulimia, anorexia, alcoholism, kleptomania, attention deficit disorder, headaches, Tourette's, premenstrual syndrome and shyness.

Despite the enthusiasm, some of these drugs have an unexpected complication. People who suddenly stop taking Paxil, Effexor or Zoloft may experience withdrawal symptoms. Prozac appears less likely to trigger this difficulty.

One reader told us of his wife's experience. "My wife took paxil for six months to help with anxiety. When she was able to deal with the stress, her doctor told her to cut back the dose. Although she followed his instructions, she suffered a living hell of withdrawal symptoms, including constant intense headaches that couldn't be relieved with aspirin or Advil, hot flashes alternating with chills, exhaustion, bizarre dreams, dizziness and 'Paxil head", which is hard to describe but feels like the brain is sloshing around. I am really upset with her doctor's cavalier attitude toward this drug. The withdrawal symptoms are so severe that the decision to prescribe the medicine should be more deliberate. My wife suffered more from the withdrawal than she ever did from the panic attacks."

Other readers have described similar experiences with Effexor and Zoloft as well as Paxil. Nausea, dizziness, night sweats, weird dreams and tremors are often experienced.

One patients said "I've had flulike symptoms, feelings like electric shock going through my limbs and a whooshing sound in my head. This is worse than I felt when I was depressed." Some people who have gone through this wonder why they weren't warned about withdrawal before they started taking the drug.

We have written about the benefits of these drugs and the largely unrecognized withdrawal syndrome. Anyone who would like to know more may request our "Guide to Antidepressant Pros and Cons." Please send $2.00 with a long (No. 10) stamped, self addressed envelope to:

Graedon's People's Pharmacy
No MD-896
PO Box 52027
Durham, NC 27717-2027

Gradual tapering is recommended by many psychiatrists familiar with this syndrome. Some physicians switch their patients to Prozac first, since it is longer-acting and less likely to precipitate problems when discontinued.

Millions of people benefit from these medications. But, doctors need to inform their patients about all the potential risks, including difficult withdrawal, before they write the prescription.

Jean E Miller