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Antipsychotic side effects/Dr. G
casa222 posted:
I was on an anti-psychotic medication for two years and I discontinued the medication in September 2013 because of the insane weight gain that it was causing. Since I have been off of the medication I have surprisingly been anxiety free and I don't feel as obsessed with my thoughts. Unfortunately, I have been having trouble sleeping and I have had moderate depression after discontinuing this medication. My psychiatrist just recently suggested a brand new anti-psychotic drug out on the market that we are giving a try. I have been on a very low dose of this medication for two weeks but, so far I am feeling very anxious to the point where I am having visible hand shaking and I feel nervous throughout the day. I am beginning to feel symptoms that I had when I was taking the other med. Have you ever heard of anyone express these kinds of side effects with anti-psychotic medication? I'm wondering if I am having a rare adverse reaction to these kind of class of medication.
Joseph F Goldberg, MD responded:
Dear casa222,
If the new medicine is Latuda, it is one of only three FDA-approved treatments for bipolar depression (the other two being Seroquel and Symbyax). Latuda appears to have minimal to no weight gain, which makes it an attractive option for treating depression. Studies found that the usual antidepressant dose range is 20-80 mg/day. Tremor, ar physical restlessness, can be dose-dependent but fairly uncommon in general with Latuda (about 10-15% of patients). Restlessness or tremor caused by antipsychotics is sometimes treated with beta-blocking medicines such as propranolol. You and your psychiatrist will want to determine if the nervousness and hand shaking you're having pre-dates the new medicine (in which case, it's not caused by the new medicine) or if it began only since starting it. You'll also want to figure out if this is anxiety per se (in which case sometimes an anti-anxiety medicine like lorazepam is sometimes used); or, if the shakiness you're noticing is from the absence of the previous antipsychotic medicine, if it was abruptly stopped (which can cause shakiness, called a withdrawal dyskinesia) or if it was just treating anxiety symptoms and now, without it, the anxiety symptoms may have returned.

Dr. G.

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Joseph F. Goldberg, MD, is a Clinical Professor of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. He also maintains a private prac...More

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