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[P]
Tremor

By MichaelCrawford in Science
Sun May 13, 2007 at 11:37:59 AM EST
Tags: Side Effects, Psychiatry, Medicine, Motion Disorders, Leavin on a jet plane, don't know when I'll be back again, Vancouver, British Columbia (all tags)

My hands shake, sometimes uncontrollably. It got so bad when I was working for Live Picture back in '97 that I was unable to type. Whenever I held my hands over my keyboard they would bang on it so loudly that my coworkers came to see what the noise was. I feared I would no longer be able to provide for myself as a computer programmer, so I demanded my psychiatrist find some way to make it stop.

Hand tremor is a side effect of many of the medicines used to treat mental illness; in my case it turned out to be caused by the valproic acid I take to prevent mania. Once we figured that out, my doctor prescribed propanolol, which is more commonly used to treat anxiety and high blood pressure. My hands still trembled, but at least I could type again. However, I still cannot reliably hold a drink in my left hand - the shaking makes me spill it.

Usually the shaking bothers other people more than it bothers me. One night a woman I met at a cafe asked me if I had Parkinson's Disease. When I told her it was because of my medicine, she demanded that I stop taking it and allow her to treat me with herbal medicine instead.


Quite a few people have urged me to stop taking my medicine just because of my tremor. I try to explain that it's a small price to pay compared to what I'd face without the medicine, but they claim that herbal remedies will work without the side-effects.

They have absolutely no idea what my symptoms are like - I am, at times, in a profoundly altered state of consciousness. There ain't no herbal tea on the planet that will help - powerful medicine is required.

A friend at Caltech once took a Thorazine tablet to see what it was like. It's a "classic antipsychotic", at one time the most-commonly used medicine for schizophrenia. He said "It wasn't like I lay on the ground and couldn't get up. It was like I lay on the ground and couldn't want to get up."

My hands seem to be shaking worse than normal the last couple weeks. I don't know why; the shaking does tend to come and go. But I have found a good way to make it stop, if only for a little while: by playing the piano.

I woke up quite late today. My piano lesson was at six, and I thought it would be bad form to go to work for just a couple hours only to leave for my lesson. So I emailed my coworkers to say I wouldn't be in, but would make up the time this weekend.

That meant I had time to practice before my lesson. I get more out of my lessons if I practice before going. But when I sat down to play this afternoon I thought I'd be lucky to play at all: my hands were shaking so bad that I couldn't play anything right. I was quite dismayed.

I played one of the songs I knew as a test, to see how many mistakes I made. Then I played all the scales I know; I had a real hard time with this and had to repeat some of them very slowly to get them right. Afterwards I played the same song again. It was a little better.

I repeated this for a half hour, when I was finally able to play correctly. Only then did I start to work on the new song I'm learning, J.S. Bach's Prelude in C from the Well-Tempered Clavier.

It took an hour to ride the train and the bus from my apartment to my teacher's. By the time I got there, my hands were shaking again; while playing scales does stop the shaking, it doesn't last very long.

"My hands shake because of a medicine I take," I explained.

"What do you take it for?"

"I have a mental illness called schizoaffective disorder."

"What is that?" It's not a very well-known illness.

"Do you know what schizophrenia is? It's like being schizophrenic and manic depressive at the same time."

She looked pretty surprised and said "You're doing really well!"

"It's one of the worst things that can happen to someone, but in the late eighties and early nineties they developed some new medicines that work a lot better than what they used to have."

They're called atypical antipsychotics; I started taking Risperdal in 1994, just a few months after it was approved by the FDA. Now I take Zyprexa. The first time I tried Risperdal I described it as "A breath of fresh air blowing through my mind." The hospital staff seemed to regard it as a miracle drug.

The Secret Handshake

Most people don't notice my tremor. But it's such a common side effect of psychiatric medicine that those who know about it are able to recognize the mentally ill when we aren't otherwise showing any symptoms:

Lori Schiller, the schizophrenic author of The Quiet Room, once got a job in a mental hospital. One of the nurses there noticed her hands shaking, and asked her if it was because she was mentally ill.

It Could Be Worse

Hand tremor is just one of several motion disorders that psychiatric drugs can cause. There is also Akathisia, a potentially debilitating inability to sit still. The worst of all is tardive dyskinesia. It causes involuntary, repetitive movements that, at their worst, can put you in a wheelchair.

I was starting to show what may have been a symptom of TD the last few years I was taking Risperdal. From time to time, my mouth would open and close repeatedly. You might have thought I was chewing gum with my mouth open. I could stop it if I thought about it, but if I didn't pay attention it would start again.

When I was in St. Paul's Hospital Mental Health Unit last September, for a few days I took Rispderdal and a very high dose of Zyprexa simultaneously. The movement of my mouth got so bad it caused painful cramps in my jaw. Happily, now that I'm no longer taking Risperdal it doesn't happen anymore.

To Stun A Horse

I was diagnosed at the Alhambra Community Psychiatric Center in the Summer of '85. I spent my first few days in their Intensive Care Unit as I was hallucinating and profoundly manic. They gave me heavy doses of Haldol, a classic antipsychotic, but it didn't slow me down a bit.

One morning I was in a group therapy session when I suddenly found it difficult to speak. I thought it was just that I was upset, but in less than a minute I found myself unable to talk at all. My arms and legs started to contort painfully, and after a couple minutes I found myself paralyzed.

"It's the Haldol," said my psychologist.

The hospital staff picked me up and carried me to my bed. A nurse came in and asked if it would be OK if she pulled off my pants so she could give me an injection of Cogentin in my butt. It's usually taken by mouth in tablet form, but my condition called for stronger measures.

"Gaahhh," I uttered incoherently.

I started to relax almost immediately after she injected me, so much so that I found myself unable to focus my eyes.

Before she left my room, the nurse said:

"You worry too much. You should go to Hawaii and get laid."

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Poll
Zyprexa seems to have cured my hypergraphia. What should I do?
o Stay Sane 36%
o Write Insanely 31%
o Learn To Write While Sane 31%

Votes: 19
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Related Links
o Live Picture
o computer programmer
o One night
o a profoundly altered state of consciousness
o Thorazine
o schizoaffective disorder
o Risperdal
o Zyprexa
o Lori Schiller
o The Quiet Room
o Akathisia
o tardive dyskinesia
o in St. Paul's Hospital Mental Health Unit
o Haldol
o Cogentin
o Also by MichaelCrawford


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Tremor | 84 comments (76 topical, 8 editorial, 6 hidden)
I read in our local paper recently (2.75 / 8) (#2)
by LilDebbie on Sat May 12, 2007 at 01:29:40 AM EST

that some idiot prescribed rispederal to a 12-year old girl for anorexia on the grounds that increased appetite was a side effect.

she now has crippling pain in her back from one of the other side effects.

i can't help but point out that she'd've been better off just getting stoned a lot.

My name is LilDebbie and I have a garden.
- hugin -

Even one dose can cause TD (3.00 / 4) (#3)
by MichaelCrawford on Sat May 12, 2007 at 01:32:39 AM EST

I heard about some woman who was brought to the emergency room in an apparently psychotic state, so they injected her with some kind of antipsychotic. She had a bad reaction to it, and is now in a wheelchair.


Looking for some free songs?


[ Parent ]

lildebbie beat me to the punchline (3.00 / 7) (#4)
by circletimessquare on Sat May 12, 2007 at 01:37:07 AM EST

http://www.nytimes.com/2007/05/10/health/10psyche.html?ref=health

Psychiatrists, Children and Drug Industry's Role

 Fabrizio Costantini for The New York Times

Anya Bailey is among a growing number of children given antipsychotic drugs by doctors who are paid by the makers of those drugs.

By GARDINER HARRIS, BENEDICT CAREY and JANET ROBERTS

Published: May 10, 2007

When Anya Bailey developed an eating disorder after her 12th birthday, her mother took her to a psychiatrist at the University of Minnesota who prescribed a powerful antipsychotic drug called Risperdal.

Created for schizophrenia, Risperdal is not approved to treat eating disorders, but increased appetite is a common side effect and doctors may prescribe drugs as they see fit. Anya gained weight but within two years developed a crippling knot in her back. She now receives regular injections of Botox to unclench her back muscles. She often awakens crying in pain.

Isabella Bailey, Anya's mother, said she had no idea that children might be especially susceptible to Risperdal's side effects. Nor did she know that Risperdal and similar medicines were not approved at the time to treat children, or that medical trials often cited to justify the use of such drugs had as few as eight children taking the drug by the end.

Just as surprising, Ms. Bailey said, was learning that the university psychiatrist who supervised Anya's care received more than $7,000 from 2003 to 2004 from Johnson & Johnson, Risperdal's maker, in return for lectures about one of the company's drugs.

Doctors, including Anya Bailey's, maintain that payments from drug companies do not influence what they prescribe for patients.

But the intersection of money and medicine, and its effect on the well-being of patients, has become one of the most contentious issues in health care. Nowhere is that more true than in psychiatry, where increasing payments to doctors have coincided with the growing use in children of a relatively new class of drugs known as atypical antipsychotics.

...

read more if you want to vomit. the intersection of money and healthcare in the usa is sickening


The tigers of wrath are wiser than the horses of instruction.

Valproic acid, safe for adults, can kill kids (3.00 / 4) (#5)
by MichaelCrawford on Sat May 12, 2007 at 01:41:26 AM EST

My psychiatrist, when I first took it, told me that "tragically" it had been found to be toxic to "developing" livers.

It is potentially damaging to adults, so I have to have regular blood tests for liver function, but it is not considered at all safe for kids.

It's quite common for drugs to be prescribed to kids when the studies were only conducted on adults. It is also common for women to be excluded from studies, because of the possibility that they might get pregnant. The result is that drugs sometimes get approved without any testing on women at all.


Looking for some free songs?


[ Parent ]

ur one lucky man to live in manhattan, cts (3.00 / 2) (#8)
by Ruston Rustov on Sat May 12, 2007 at 02:19:43 AM EST

There's a Scientology reading room right down Broadway in the Bowery!

I had had incurable open sores all over my feet for sixteen years. The doctors were powerless to do anything about it. I told my psychiatrist that they were psychosomatic Stigmata - the Stigmata are the wounds Jesus suffered when he was nailed to the cross. Three days later all my sores were gone. -- Michael Crawford
Maybe tomorrow. -- Michael Crawford
As soon as she has her first period, fuck your daughter. -- localroger

[ Parent ]
the one on 46th between 8 and 9 ave is closer (3.00 / 3) (#12)
by circletimessquare on Sat May 12, 2007 at 11:36:19 AM EST

i walk by all the time

anyone know why they all dress up like airline pilots and chainsmoke?

didn't tom cruise go apeshit over brooke shields taking psychoactive drugs for postpartum depression? because they are against psychiatry and psychoactive drugs?

WELL WHAT THE FUCK IS NICOTINE YOU FUCKING CULT FUCKS?


The tigers of wrath are wiser than the horses of instruction.

[ Parent ]

they dress up like airline pilots (3.00 / 3) (#42)
by raduga on Sun May 13, 2007 at 09:33:33 PM EST

because they really are airline pilots. Only, the planes they fly don't have fans or propellers.

Nicotine is a natural substance found in the leaves of native american plants; which is totally different from something invented by doctors so they could throw you into a volcano.

[ Parent ]

you're shitting me (none / 0) (#58)
by circletimessquare on Mon May 14, 2007 at 01:23:31 PM EST

they dress up like airline pilots like they are on an intergalactic space trip?!

BWAHAHAHAHAHAHAHAHA


The tigers of wrath are wiser than the horses of instruction.

[ Parent ]

didn't read teh article (none / 1) (#22)
by nostalgiphile on Sun May 13, 2007 at 02:09:16 AM EST

but that Anya Bailey girl in the hirez is hot. She will go places in her orange clogs...mark my words.

"Depending on your perspective you are an optimist or a pessimist[,] and a hopeless one too." --trhurler
[ Parent ]
Good story, Michael: Straight from the heart. +FP (1.75 / 4) (#6)
by dakini on Sat May 12, 2007 at 01:59:38 AM EST



" May your vision be clear, your heart strong, and may you always follow your dreams."
Thank You For Your Kind Words. (none / 0) (#7)
by MichaelCrawford on Sat May 12, 2007 at 02:12:38 AM EST

I actually wasn't sure I'd submit it; it didn't feel to me as passionate as other essays I'd written.

On the other hand, it wouldn't kill as many forests if it were printed in hardcopy form. :-)


Looking for some free songs?


[ Parent ]

Gotta admit, I always enjoy your writing (none / 1) (#15)
by Kariik on Sat May 12, 2007 at 03:57:15 PM EST

It's interesting stuff, and your writing is actually pretty coherent compared to most queue write-ups. Well done.

Glad to hear you are off Risperdone (none / 1) (#18)
by Smiley K on Sat May 12, 2007 at 08:14:17 PM EST

I was briefly on 0.5mg for my TS.  That is one powerful tranquilizer.  After about 3 weeks I insisted on switching to something that didn't require narcolepsy meds to keep me awake and was not such an aggressive mood alterer.

A couple of weeks ago I had my neurologist take me off clonozepam as well.  The adjustment period was a little unpleasant but I find that over time going with the absolute minimum level of medication to maintain daily function is the best approach.  I may never be medication free but plan to fight the good fight.

Hope you are able to find a minimum pharmaceutical solution for yourself as well.  Rock on, brother.
-- Someone set up us the bomb.

You have a mental illness? [nt] (2.00 / 3) (#28)
by vera on Sun May 13, 2007 at 08:26:54 AM EST



Yes.. Alternately, one might say.... (none / 1) (#80)
by CindySueWho on Sun May 20, 2007 at 10:49:10 AM EST

"I am a person with"....

It's known as People First Language.. Expresses recognition of and respect for the person.. :)


Peace and best wishes from North Georgia..
[ Parent ]
Wow... (1.50 / 2) (#33)
by NoMoreNicksLeft on Sun May 13, 2007 at 11:57:24 AM EST

Tardive diskinesia!

--
Do not look directly into laser with remaining good eye.
awesome (2.00 / 2) (#43)
by raduga on Sun May 13, 2007 at 09:51:04 PM EST

you must find a way to harness this power for the betterment of Ogg Frog!

I was waiting for someone to point that out (none / 1) (#44)
by MichaelCrawford on Sun May 13, 2007 at 10:52:48 PM EST

I'm planning on using the Tremor decoder for 68k Macs that don't have a floating-point coprocessor.


Looking for some free songs?


[ Parent ]

jesus christ man (none / 0) (#46)
by rhiannon on Mon May 14, 2007 at 12:21:58 AM EST

You must be trolling, 68k macs, system 7 or what?

-----------------------------------------
I continued to rebuff the advances... so many advances... of so many attractive women. -MC
[ Parent ]
It's the Gospel Truth, here's why: (none / 1) (#47)
by MichaelCrawford on Mon May 14, 2007 at 12:52:55 AM EST

It happens that there are a lot of people who own old hardware, or can only afford what they get off freecycle or for just a few bucks from thrift stores.

I want these people to be able to enjoy digital music without having to upgrade.

It happens that ZooLib, the cross-platform framework that Ogg Frog is built on, still has robust support for System 7 - and it doesn't even require CarbonLib.

The reason is that ZooLib's main developers sell an educational product, and many schools can't afford to buy macs that can run OS X.


Looking for some free songs?


[ Parent ]

bullshit (none / 1) (#48)
by rhiannon on Mon May 14, 2007 at 01:01:39 AM EST

If someone has a 68k mac they probably have an extremely small hard drive, the last one I had was 40 megs! much too small to make use of much digital media.

An os x capable mac with monitor is about $75, maybe less.

You're doing it because you're crazy.

-----------------------------------------
I continued to rebuff the advances... so many advances... of so many attractive women. -MC
[ Parent ]

Also (none / 0) (#73)
by Chewbacca Uncircumsized on Tue May 15, 2007 at 10:54:19 PM EST

the homeless can get their hands on much more powerful hardware at the library

[ Parent ]
I have a friend... (3.00 / 3) (#45)
by Mystery on Mon May 14, 2007 at 12:15:02 AM EST

... that is exhibiting a lot of the characteristics common to DID at this time in life. He actually just came to me 2-3 days ago and admitted it solidly. Said that his whole life, every time it came up someone gave him a CAT scan, or told him it was all imagination. But it didn't stop the voices that would occasionally take him over in conversation (but the rest of the control is his), and that he'd only really started to have any hallucination recently... I'm concerned for him, he's like a brother.

I'm referring him to the writings on Geometric Visions. I think it will help him a lot to see things in this context.

Thank you for being so open with random folks... I'm of the mind that everyone has some faint mental problem, but only a few are willing to admit anything is there. Those that admit it, are much much closer to resolution for themselves.

Thanks again.
-------------------------
Failure is not an option -- It comes bundled with the software.

Buddha on a bike!!!!!!... (none / 0) (#50)
by mirleid on Mon May 14, 2007 at 07:05:03 AM EST

I look the other way for a couple of days and look what happens...

Chickens don't give milk
touching story :'-( (none / 1) (#54)
by kaiwai on Mon May 14, 2007 at 08:26:36 AM EST

The story bought a tear to my eye; I think I'm in the same boat, except bipolar - probably not as bad as my grandma, but still, I see myself doing things, then 3 days later, looking back and thinking, "what the?!"

Its difficult; going from low's of just not wanting to get out of bed, no wanting to see anyone, basically, wanting to curl up and die - to the other extreme of being up for 2-3 days straight like being hi on caffeine.

I probably should get it sorted out, but you could say I'm worried about the outcome.

you live in the best city for 'HERBal' remidies (none / 0) (#63)
by the77x42 on Mon May 14, 2007 at 07:30:06 PM EST

http://www.youtube.com/watch?v=mv2W-8BRBjQ


"We're not here to educate. We're here to point and laugh." - creature
"You have some pretty stupid ideas." - indubitable ‮

You will play at Carnegie Hall (none / 1) (#72)
by Chewbacca Uncircumsized on Tue May 15, 2007 at 10:46:43 PM EST

I'm your fairy manager

Haldol (none / 1) (#74)
by BadDoggie on Wed May 16, 2007 at 11:58:34 AM EST

I had to take it after suffering persistent hiccups for four days straight. It's absolute hell, hiccuping that long. The cure is just as bad. The first dose of halperidol took around an hour to stop the hiccups. I say "around an hour" because I don't know real well. That shit turned me into a complete zombie.

I had to take a second dose that night when they started again and after that, I was utterly useless for the next three days. Your friend was right: "It wasn't like I lay on the ground and couldn't get up. It was like I lay on the ground and couldn't want to get up."

I couldn't put a single coherent thought together, not for lack of trying, and this is a guy who's tried more drugs than most people can name. I've had K (hate the stuff) and managed to remain capable of not just thought but communication although that was a hell of a struggle. Not Haldol. I don't know how I managed to drink anything or go to the bathroom. I don't remember actually doing them but I must've done. It was three days before I actually ate something and a week before I was back to normal.

Who needs Rohypnol?

woof.

"Eppur si muove." -- Galileo Galilei
"Nevertheless, it moves."

I don't think Haldol is used as commonly now (none / 0) (#75)
by MichaelCrawford on Thu May 17, 2007 at 09:31:14 AM EST

I took it in 1985, before any of the atypical antipsychotics were on the market. I've had much better experiences with Risperdal and Zyprexa.

However, someone told me that Haldol is used in prisons, I think because its patent has expired and so it's available as a generic. The government is apparently trying to treat their mentally ill patients on the cheap, by not using the much more expensive brand-name atypicals.

I would bet that once the patents have expired on the atypicals, Haldol won't be used at all anymore. It's already expired on Clozapine, but it's a drug of last resort because of a potentially deadly side effect.


Looking for some free songs?


[ Parent ]

Mineral Intake (none / 1) (#76)
by Rahyl on Thu May 17, 2007 at 09:41:56 AM EST

"They have absolutely no idea what my symptoms are like - I am, at times, in a profoundly altered state of consciousness. There ain't no herbal tea on the planet that will help - powerful medicine is required."

This seems to be a common feeling among those that take medications for "mental illness."  An old girlfriend of mine went through a similar problem.  She took so many meds, she had a 31-day calendar container she'd pre-load with pills, LOTS of pills, so many that without this container, she'd easily forget which ones she was supposed to take each day.  She'd twice attempted suicide.  She once said to me that without the medications, she would kill herself.

She's now been med-free for almost two years and is doing just fine.

I'm going to go out on a limb here and suggest that maybe, just maybe, your dietary intake of minerals is almost non-existent.  Go ahead and do some research into what you're eating.  Are you getting enough magnesium, copper, manganese, phosphorus, and zinc?  Go to www.whfoods.com and look up the foods your eating.  Add it all up and see if I'm right.  I think I am.

Mineral content in the typical Western diet is woefully inadequate.  Mineral deficiency will affect each person differently but it usually results in nervous system anomalies.  Your genetics don't create a pre-disposition to mental illness but rather determine the affects mineral deficiencies will have on you.

It will take a few weeks for an adjusted diet to make a difference in most cases but it's not hard to do.  You can get all of those minerals and more if you start adding a variety of nuts and seeds into your diet.  I'd also recommend taking inventory of how much Omega-3 you're getting.  Assuming it's low, flax seed and salmon are great sources.

Don't take vitamin supplements; it's much better to get minerals from foods.  Who knows, you may discover a great new dish while you experiment
 :)

I'll look into it. (none / 0) (#77)
by MichaelCrawford on Thu May 17, 2007 at 12:35:13 PM EST

Omega-3 is known to help with bipolar depression - there have been some double-blind studies on it.

I've been taking the Methylcobalamin form of B12 in hopes that it will help my irregular sleeping patterns. There were some early studies that said it would help, but a large double-blind study said it wouldn't. It seemed to help me a little at first, but not now.


Looking for some free songs?


[ Parent ]

How much Depakote do you take? (none / 0) (#78)
by bighappyface on Thu May 17, 2007 at 07:01:22 PM EST

I'm on 1500mg and my shaking went away after the first few days.

750 mg (none / 0) (#79)
by MichaelCrawford on Thu May 17, 2007 at 08:14:27 PM EST

But I was on 1000 when the shaking was at its worst.  I don't think it causes tremor in most people - it took my doctor and I a long time to figure it out.

I've been on it for 13 years, and have had tremor the whole time.


Looking for some free songs?


[ Parent ]

For some people the side-effects ... (none / 1) (#82)
by joegee on Tue Jun 26, 2007 at 02:28:36 PM EST

... of the medication can be more traumatic than the symptoms of the disorder.  I am not one of those people.  I, like you, take psychotropics.  I have a few side-effects, but like you I am a fundamentally different, non-functioning lump of flesh without these meds.

I've had well-meaning people suggest prayer and anointing (God bless 'em, even), herbal remedies, and "good old-fashioned will-power."  I've given up trying to reason with these folks.  I nod in the appropriate places, smile, thank them for their suggestions, and continue to do what I know I need to do to be functional.  When I question my need for two antidepressants and a mood stabilizer I remind myself that my condition is a real physiological condition with real physiological components.

I know that sometimes the hardest fight can be continuing to take meds as prescribed when you're feeling well, but I am glad to read that you seem to be sticking with your regimen.

Thanks for the article,

Joe G.

<sig>I always learn something on K5, sometimes in spite of myself.</sig>

My grandfather had something similar to this (none / 0) (#84)
by SirPoolie on Wed Nov 28, 2007 at 07:49:18 AM EST

He took some medication and the issue went away to being barely noticeable. It seemed like it was pretty frustrating to him at the time. I sure wish he could have somehow gotten the medication earlier, as I believe it affected him for quite some time.

Tremor | 84 comments (76 topical, 8 editorial, 6 hidden)
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