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What Causes Involuntary Twitching In Legs And Hands After Having Clopixol?
Question: My sister is on clopixol depot every two weeks. She is experiencing continual persecutory thoughts and involuntary twitching of legs and sometimes hands aswell.Her diagnosis is paranoid schizophrenia since 2003.
Brief Answer:
extrapyramidal side effects.
Detailed Answer:
Hello
Welcome to HCM.
I can understand your concerns for your sister.
Clopixol contains antipsychotic zuclopenthixol.
The twitching of hands and legs is most probably due to extrapyramidal side effects of clopixol.
Also, she has tried haloperidol, largactil earlier.
All these drugs are typical antipsychotics which can such symptoms.
In my opinion, depot and these drugs should be withdrawn and trihexyphenidyl (prescription drug) should be started to her. This will reduce the twitchings.
Atypical antipsychotics like risperidone, olanzapine, clozapine etc should be given to her as the donot have such side effects.
Kindly discuss this with her doctor.
Another issue is that she still has persecutory thoughts. I think this suggests partial response to drugs.
Can you please mention how much maximum dose of clozaril has been given to her?
This will decide what drug needs to be given to her in future.
Hope to hear from you soon.
Thanks.
extrapyramidal side effects.
Detailed Answer:
Hello
Welcome to HCM.
I can understand your concerns for your sister.
Clopixol contains antipsychotic zuclopenthixol.
The twitching of hands and legs is most probably due to extrapyramidal side effects of clopixol.
Also, she has tried haloperidol, largactil earlier.
All these drugs are typical antipsychotics which can such symptoms.
In my opinion, depot and these drugs should be withdrawn and trihexyphenidyl (prescription drug) should be started to her. This will reduce the twitchings.
Atypical antipsychotics like risperidone, olanzapine, clozapine etc should be given to her as the donot have such side effects.
Kindly discuss this with her doctor.
Another issue is that she still has persecutory thoughts. I think this suggests partial response to drugs.
Can you please mention how much maximum dose of clozaril has been given to her?
This will decide what drug needs to be given to her in future.
Hope to hear from you soon.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi,
Thank you for your kind response.
XXXXXXX is on Clopixol depot 500mg every two weeks.
We are meeting with her doctor next week to review her medication.
Thank you again,
XXXXX XXXXXXX
Thank you for your kind response.
XXXXXXX is on Clopixol depot 500mg every two weeks.
We are meeting with her doctor next week to review her medication.
Thank you again,
XXXXX XXXXXXX
Brief Answer:
anticholinergic drugs
Detailed Answer:
Your welcome dear XXXXXXX
I think this dose of clopixol is causing her symptoms of twitching in hands and legs.
In my opinion, she would need anticholinergic medications like trihexyphenidyl or benztropine to control these side effects.
If possible, a dose reduction of depot and change to a safer drug should be considered (as I mentioned earlier).
Kindly discuss this with your doctor.
Hope this helps.
Feel free to discuss further.
Kindly close the discussion if you have no more queries and give your valuable feedback.
Take care.
Thanks.
anticholinergic drugs
Detailed Answer:
Your welcome dear XXXXXXX
I think this dose of clopixol is causing her symptoms of twitching in hands and legs.
In my opinion, she would need anticholinergic medications like trihexyphenidyl or benztropine to control these side effects.
If possible, a dose reduction of depot and change to a safer drug should be considered (as I mentioned earlier).
Kindly discuss this with your doctor.
Hope this helps.
Feel free to discuss further.
Kindly close the discussion if you have no more queries and give your valuable feedback.
Take care.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi,
So If she reduces the clopixol depot and changes to a safer drug. Would you recomend seroquel ?
I think it suited her before.
Also do you know about the neurotransmitter Gaba. ( It can be taken as a supplement ) I have just read an article about it in the University of XXXXXXX , journal of Neuroscience by XXXXXXX Grace Professor of psychiatry.
Thanks,
XXXXXX
So If she reduces the clopixol depot and changes to a safer drug. Would you recomend seroquel ?
I think it suited her before.
Also do you know about the neurotransmitter Gaba. ( It can be taken as a supplement ) I have just read an article about it in the University of XXXXXXX , journal of Neuroscience by XXXXXXX Grace Professor of psychiatry.
Thanks,
XXXXXX
Brief Answer:
olanzapine or risperidone.
Detailed Answer:
Dear XXXXXXX
My first choice would be risperidone or olanzapine.
I do not prefer to use seroquel in psychosis because doses needed for treatment of psychosis are high. Most patients require 400mg or more. At this dose, there is high sedation and hypotension leading to dizziness and drowsiness.
Neurochemicals implicated in psychosis is mainly dopamine. Some recent studies suggest glutamate is also responsible for psychosis.
GABA is an inhibitory neurotransmitter which has negligible role in causation of psychosis, and thus is not indicated in treatment.
I do not advise its usage in your sister.
Hope this answers your query satisfactorily.
Do not hesitate to ask further, if you have more queries.
Take care.
Thanks.
olanzapine or risperidone.
Detailed Answer:
Dear XXXXXXX
My first choice would be risperidone or olanzapine.
I do not prefer to use seroquel in psychosis because doses needed for treatment of psychosis are high. Most patients require 400mg or more. At this dose, there is high sedation and hypotension leading to dizziness and drowsiness.
Neurochemicals implicated in psychosis is mainly dopamine. Some recent studies suggest glutamate is also responsible for psychosis.
GABA is an inhibitory neurotransmitter which has negligible role in causation of psychosis, and thus is not indicated in treatment.
I do not advise its usage in your sister.
Hope this answers your query satisfactorily.
Do not hesitate to ask further, if you have more queries.
Take care.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi,
Thank you. What dosage of Risperidone or Olanzapine would you reccomend ?
Also , are there any nutritional supplements that would be good to take ?
XXXXX
Thank you. What dosage of Risperidone or Olanzapine would you reccomend ?
Also , are there any nutritional supplements that would be good to take ?
XXXXX
Brief Answer:
upto 8mg of risperidone or 20mg of olanzapine.
Detailed Answer:
Hello again:)
She has been taking 500mg of clopixol every two weeks.
The equivalent dose is difficult to calculate but, In my opinion, she would require upto 8mg or risperidone or upto 20mg of olanzapine. (Under doctor's supervision).
Most patients of psychosis respond to these doses very well.
Supplements containing Co-enzyme Q10 and essential fatty acids are being shown to be useful in cases of psychosis in recent studies.
I think this should help.
Your are most welcome if you have more queries.
Kindly close the discussion if you are satisfied with my responses and give your valuable feedback.
Thanks.
upto 8mg of risperidone or 20mg of olanzapine.
Detailed Answer:
Hello again:)
She has been taking 500mg of clopixol every two weeks.
The equivalent dose is difficult to calculate but, In my opinion, she would require upto 8mg or risperidone or upto 20mg of olanzapine. (Under doctor's supervision).
Most patients of psychosis respond to these doses very well.
Supplements containing Co-enzyme Q10 and essential fatty acids are being shown to be useful in cases of psychosis in recent studies.
I think this should help.
Your are most welcome if you have more queries.
Kindly close the discussion if you are satisfied with my responses and give your valuable feedback.
Thanks.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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