tag:blogger.com,1999:blog-6886575137375451769.post7082551696672612787..comments2023-08-08T00:53:58.434-07:00Comments on Garth Kroeker: Low-dose atypical antipsychotics for treating non-psychotic anxiety or mood symptomsGKhttp://www.blogger.com/profile/14714377295981745087noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-6886575137375451769.post-18472498361265113952009-07-29T17:16:01.990-07:002009-07-29T17:16:01.990-07:00You're right.
I can think of examples, thou...You're right. <br /><br />I can think of examples, though, of cases of depression or anxiety where SSRI treatments (sometimes several different trials) don't help much. Or, the side-effects of the antidepressant are worse than the side-effects of a low-dose antipsychotic. Sometimes the combination of SSRI+antipsychotic helps reduce the side effects of both. <br /><br />Also, in many individual cases of mood or anxiety disorder, I have concerns about subtle "bipolarity": in some of these cases I have seen people develop agitated, psychotic, or manic states while on antidepressants alone. In these cases, I find that low-dose atypicals are much safer. <br /> <br />Conversely, the side-effects of non-treatment of various anxiety or depressive states could at times include dysphoria or diabetes (via behavioural withdrawal or unhealthy diet). I would not expect movement disorder as a side-effect of non-treatment of anxiety though. Mind you, the incidence of EPS or tardive movement disorders due to atypical antipsychotics is low, even with chronic, high doses in schizophrenia treatment. <br /><br />But given the lack of clear, specific long-term evidence, the standard of practice has to be reserved about using atypical antipsychotics for anxiety routinely, especially over the longer term.GKhttps://www.blogger.com/profile/14714377295981745087noreply@blogger.comtag:blogger.com,1999:blog-6886575137375451769.post-64172800201622820262009-07-29T15:19:43.698-07:002009-07-29T15:19:43.698-07:00Thank you very much for your helpful entry on low-...Thank you very much for your helpful entry on low-dose antipsychotics. It is clear from the studies you noted that these medications can be useful adjunctives to SSRIs for anxiety/mood problems, or useful as the sole medicine for treatment of serious illnesses such as schizophrenia.<br /><br />Thank you for citing relevant research.<br /><br />I have yet to find quality studies on side-effects of low-dose antipsychotics when taken long-term. In particular I like to know how frequent and pervasive are extrapyramidal symptoms, weight gain/diabetes, etc. <br /><br />Surely in most cases of schizophrenia the balance of benefits vs. side-effects leans in the direction of use. However, in anxiety/mood illnesses, a clear picture of drug's effects on the body must be evaluated. Hence switching to another SSRI instead may be more beneficial in the long term given the side-effects such as dysphoria, diabetes, extrapyramidal symptom, not to mention the rare but dangerious side effects associated with certain antipsychotics like Clozapine.<br /><br />My best.<br /><br />Long time reader.Anonymousnoreply@blogger.com