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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4661
Experience:  MD Psychiatry
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My wife is 40 years old and has a history of schizophrenia.

Resolved Question:

Hello, my wife is 40 years old and has a long history of schizophrenia. She has been on almost all the newer antipsychotic meds and at least one {TRILOPHON} older one . I have a serious concern and I am not sure where to go for an answer. My wife was taking 80 mg of GEODON last summer after a hospitalization when her lower jaw started moving from side to side without her being able to control it. Her doctor at that time lowered it to 60mg but it did not help. This concerned me because I am aware of the tardive dyskinesia that can be caused my meds. My wife got sick again and I had a new doctor switch her to a new med because I was concerned. After 6 weeks in the hospital the movements come back. She was taking 30 mg ABILIFY and 10 mg ZYPREXA. Her med have been slowly decreased to 5 mg of ABILIFY and 10 mg of ZYPREXA. but there is no change. Her dr. says the alternative of taking her off her meds is worse. Is this common and what can I do, I don't want this to be permanant. Thank you.
Submitted: 8 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 8 years ago.

Hi there ,

Welcome to Just Answer !

Well, i am really sorry to know about the condition of your wife and all the mental trauma you and your wife have been going through.

Now, before any thing else, i must tell you that those movements of her jaw from side to side , as you suspected are a part of Tardive dyckinesia( involuntary repetitive movements) which is a side effect of ANTIPSYCHOTICS , and in her case although she has been placed on atypical anti psychotics which are shown to have a lesser predisposition to this side effect , but the fact that she has been placed on 3 Anti psychotics , all of which can cause this side effect, answers the question quite well, as to why she developed tardive dyskinesia in the first place, but also to mention that it is not uncommon though , in cases of people who have been on antipsychotics for a long duration.

And what amazes me is that besides using 3 anti psychotics , the psychiatrist has not even thought of placing her on a mood stabilizer such as Lithium or valproate or carbamazepine, which themselves act as good anti psychotics and are very much needed in Schizophrenia for not only stabilizing mood swings but also as adjuvants to treat and prevent psychoses , and donot cause tardive dyskinesia.

Now , coming to the present problem , well the usual convention in treatment, in such a case of schizophrenic patient who has developed tardive dysknesia as a side effect to the use of anti psychotics , is to STOP ALL THE PSYCHIATRY DRUGS , and if the schizophrenic symptoms are bothering enough then let the patient to be placed on only 1 Mood stabilizer such as lithium or valproate or carbamazepine,but it should be low to moderate dose and preferably lithium to be used . Since Tardive dyskineia is self limiting and after stopping all the anti psychotics which are nothing but precipitants of it, the tardive dyskinesia will slowly resolve , and once it is no longe there the psychiatrist shall start on anti psychotics again.

So, i suggest that in your wife's condition ask her Psychiatrist to stop all the psychiatry drugs , that is the two antipsychotics -- Abilify and Zyprexa , and any other drug , let only her be placed on lithium or valproate all this while , and once her tardive dyskinesia resolves , she again may be started on anti psychotics , but it will be better if she is placed on 1 anti psychotic such as Zyprexa ( olanzapine) or risperdal ( risperidone) or clozapine , as these anti psyhotics have lesser propnsity for causing tardive dyskinesia, and along with this antipsychotic, THE MOOD STAILIZER IS TO BE CONTINUED.

I wish your wife rapid recovery to the best of health.

I hope my answer serves your query according to your satisfaction.


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