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MN Psychiatrist
MN Psychiatrist, Psychiatrist
Category: Mental Health
Satisfied Customers: 792
Experience:  Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.
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I am not expecting much of an answer here, but here goes: Im 45 w/ schizoaffective

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I am not expecting much of an answer here, but here goes: I'm 45 w/ schizoaffective dx, that has been on meds since 27, seroquel for the last 14 yrs. I was working on a masters in classical guitar performance and the illness killed my career. I am positive that the meds affect my fine motor skills by inhibiting dopamine, is there anything I can do or take that will help. The problem with my right hand is very subtle and would not be noticed by other musicians except finger picking guitarists and harpists. I can move my index and middle fingers in the air no problem, but add the resistance of the string and fingernail and I can't play. I know its the medication because I lost my ability to play classical guitar when my Dr increased my seroquel to 600mg and now I have only taken 300mg for the last 8wks and my right is improving everyday but my positive symptoms are beginning to become noticeable. How can I take an adequate dose and lessen the unmusical trade-off?
Hello, I am a psychiatrist.
I'm sorry that you are having this struggle.
One option would be to try a dose of Seroquel somewhere between 300mg and 600mg daily.
Another option would be to try Clozaril (clozapine); this is another medication in that class that might not be as problematic for you with regard to muscle movement as the Seroquel is. However, people taking it can develop a problem with blood cell development, so it is necessary to have your blood checked every week the first year you're on it, and every two weeks thereafter. That is a hassle, but it is worth discussing with your doctor.
Benadryl may work if the problem is that you are having too much dopamine blockade; the easiest way to tell is to simply try some Benadryl, which is over-the-counter. However, benadryl is much more apt to work if you are experiencing muscle spasms (called dystonias) than if you are having strength problems.
It might also be well worth your while to seek out a neurologist who specializes in movement disorders (use that term when asking around); if you find one, he/she may be able to offer more help in this regard than the average psychiatrist.
Does this make sense?
Customer: replied 4 years ago.
Any idea why plucking a string would be "that different" from depressing a piano key, other than it is more punctuated. I don't have any problems with my left hand pressing down a string and can play electric with a pick, of course. I can do any repeating right hand plucking pattern except for the most important: imim or pimi (where i=index, m=middle, p=thumb.)
I'm sorry, but I don't know the answer to that.
Customer: replied 4 years ago.
Just one more question: this issue seems even to me a little idiosyncratic, but are there other musicians out there that have had problems related to psychiatric medications? Is there a history or any documentaion?I know that mellaril, navane and risperdal can or have affected my ability to play an instrument either by memory, physically or motivation/anhedonia (w/ risperdal), and that the new atypicals are much better, but I am able to find nothing about how other musicians, especially technically accomplished ones like concert pianists and violinists, are affected by their medication. Most people out there just don't care. Only your friends and family do.
I don't have any musicians in my practice now, but years ago I came across a pianist who had been put on Depakote for some mental-health-related reason; he didn't like it because he felt it impacted his ability to "hear" musical notes n his head, which made it harder for him to play. I don't know about other musicians, unfortunately.
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