tardive dyskenesia - bi polar - lamictal

I have bi polar disorder and have been treated for it for ten years or so.  I've been on a number of different meds with various side effects.  I've been taking Lamictal for about three years and was fairly stable until two weeks ago.  I'm very depressed in every way possible.  My doctor increased my Lamictal from it's normal 300 mg. to 200mg.  That didn't make a difference so he increased it two weeks later to 400 mg.  Now my tongue is twisting around my mouth and pushing against my teeth involuntarily.  I try to keep it still but I can't do this for even under a minute.  I've read up on tardive dyskenesia and realize that this is probably what I have.  I have a call in to my doctor, but I also wanted to post something here.  I'm new at this site.  I recently went off Abilify.  Going off that wouldn't cause TD would it?  If it is the Lamictal should I avoid this all together or be hesitant with my previous dose?  What would you do?  I also take a garbage bag of stuff to manage my serious for of Bi Polar.  I take Lithium, Levoxol (thyroid med), Cymbalta, Wellbutrin, cytomel (thyroid med), Tamazapan (for sleep), birth control pills to regulate hormone levels, Lamictal (and I just stopped the abilify).  I feel like a junkie - and I happen to be a recovering alcoholic and addict, so I have to be very careful about what meds I take.  Does tardive dyskenesia usually go away after a short period of time?  Does it mean that some part of my brain has been damaged?  This happened to me before with Seroquel but I stopped taking it and it went away.  I am really scared and concerned.  

[ILADVOCATE]

Clozaril is the only currently available antipsychotic that won't cause tardive dyskinesia. I acquired tardive dyskinesia from Lamictal but that is statistically rare. If you have tardive dyskinesia any medication that causes it will mask it will worsening it. Cymbalta and Wellbutrin can cause it on occassion. Don't make any changes on your own but obtain a referral to a neurologist who is a movement disorders specialist and they would be able to treat it but your psychiatrist needs to change you from any medications that can cause it if is diagnosed.

[ILADVOCATE]

Sorry I didn't put in your full screen name in my response as I physically have trouble typing. Thanks.

[okieannie65]

Thank you for responding. Did your td go away?  I'm waiting for my psychiatrist to call me back.   I've never heard of Clorzaril.  What kind of side effects does it have? Are neurologists familiar with all these meds?

[ILADVOCATE]

When tardive dyskinesia is as advanced as in me it is not reversible. If caught in its early stages it can reverse itself somewhat in time. Clozaril is an antipsychotic that is helpful for some people and would be used more if not for the side effect profile that requires weekly blood monitoring (which is changed over six months to every two weeks, then after a year to every month) for blood dyscreias. I myself could not tolerate Clozaril and that's why I am on an antipsychotic agent in Phase II FDA study (google "Dr. Javitt, glycine"). It is showing very promising results and cannot cause tardive but of course it is not FDA approved yet. It is a psychiatrist's decision as to whether a person is a candidate for Clozaril and a neurologist must diagnose tardive to begin with as it needs to be distinguished from temporary movement disorders such as akathesia and dystonia. If you are diagnosed with tardive I could provide you with information to take to your neurologist about what has helped me and you could post in the neurology forum as well but it must be diagnosed first as there are withdrawal dyskinesias that appear like tardive but go away. A neurologist who is a trained movement disorders specialist could make a conclusive diagnosis.

[okieannie65]

Very interesting.  
I had a brief phone conversation with my doctor who was in disbelief and a little baffled with my descriptions, which are basic tongue rolling, thrusting, and some chin movement. He was surprised about it coming from Lamicta.  It was a "first" for him.  Blah blah.  Although I wanted to go off it right away he wants to take me down from 400 mg. to my usual dose of 300.  I'm doing this for a month and after some blood  tests I'll ask to get off and mention Clozaril.  I really want to get off ALL this medication.  It seems like he just kept adding more and more.  This is it:  Cymbalta, Abilify, Wellbutrin, Lithobid, Lamictal, Tamazapan and thyroid meds Levoxyl and Cytomel. Oh, I forgot, we added Adderall (adderrall) XR for my ADD.  It is hard to manage refills with insurance coverage, etc.  You probably know the drill.  I'm fed up with it all.  My crying has stopped but I still want to stay in a bed in a corner all day long and not talk to anyone.  I ran out of my Abilify and just stopped it cold turkey four days ago.  I'm wondering if that will cause problems.  - sick and tired in NJ

[okieannie65]

How do you manage to keep up with your illness in life?  Any suggestions other than the obvious?

[ILADVOCATE]

You can read my journal entries as for my specific recovery but they are my perspective on what will be a case study my providers are writing, not advice of course. It is essential to have supports and services and accomodations. That much I can say. For myself I use a TTY since I can't speak due to dysphagia. I also use Access A Ride and am in application for a home attendant. That is due to the severity of the tardive dystonia I have. I'm sure you would not need that level of accomodations. But first have tardive diagnosed by a neurologist who is a movement disorders specialist. Please don't jump to conclusions. If it was caused it was probably by the Abilify. It is a known side effect of antipsychotics. I acquired tardive from "Lamictal worsening a pre-existing Parkinsonian condition". That is a statistical rarity and it worsened a pre-existing form of focal dystonia that was undiagnosed and the potential of Lamictal causing this was not known when I started it in 1998. Antipsychotics causing tardive is of course a known fact to psychiatrists. And for those two anti-depressents its a clinical possibility. You should not go off your medications because then all the symptoms they are treating will return. Follow your providers advice. When you have scheduled an appointment for a neurologist who is a movement disorders specialist to diagnose and treat the tardive I can explain to you some more information about what are known and experimental (but FDA approved for other uses) treatments for tardive but that would not take the place of what the neurologist would suggest. Also post in the neurology forum for an informed answer from the staff neurologist. I obtained helpful information there that I brought to my neurologist.

[mmjworks]

I have had TD symptoms for about 2 yrs. I am still taking Seroquel in very small doses at night. I also smoke (with a vaporizer) Medical MJ.
It temporarily ceases my TD and lets me relax. The down side is I am not very motivated and have gained about 10lbs. Since I have not found anything else that helps, I will continue to smoke it.

[ILADVOCATE]

Yes some people use that for tardive. I am aware of that. However, there are many other clinically approved options though for tardive that are far more effective. The standard ones being Aricept, Baclofen, Requip and Mirapex. I use the Clonidine patch application for tardive which is quite helpful. Tenex which is in the same class of medications is helpful as well. Botox shots are used for tardive dystonia that is specifc to one area (such as facial tics). Zofran is in experimental usage for tardive (and was helpful for me) but FDA approved for other purposes. Namenda is used for tardive experimentally as well and Depakoate, Keppra, lithium and Dilantin. Vimpat has been quite effective for me but that's a literal first use in people (before it was only in animal model studies) and it will be documented in a case study. The natural remedy rhodiola if authorized by a neurologist can be helpful as well. Only a neurologist would understand this in full but you should see a neurologist who is a trained movement disorders specialist and give them this information. As well if you are on Seroquel at any dose it will worsen tardive while masking it. That's a clinical fact. The only antipsychotic that won't is Clozaril. If you are using Seroquel as a sleep aid one FDA approved medication that is safe and non addictive is Rozerem that works like melatonin to adjust the sleep cycle. For more information google "Patient Education Tardive Dyskinesia" and for full clinically accurate medication google "emedicine tardive dyskinesia" and bring that to a neurologist who is a movement disorders specialist which I strongly reccomend you see for a consult. You could post a question in the neurology forum as well. I obtained helpful information there from one of the staff neurologists.  

[BP_TD]

Vitamin E 400 IU resolved this for me in 6 months. I still take Vitamin E to be safe.

[MicheleTort]

Stopping abilify cold turkey will definitely cause tardive dyskenesia.  My son took 2 mg of abilify for just over 2 years, we ran out so he stopped cold turkey (the dr said cold turkey was fine which it is not!!)  his TD was horrible, especially in the beginning - for a few weeks - forceful opening of his jaw and licking his upper lip till its chapped - its been 2 months and he still has it although it has been reduced somewhat.
I have read that stopping abilify suddenly can make the TD worse - in our case our dr never mentioned any signs of TD, we thought he had a tic.  I am praying it goes away and we are trying some natural treatments.
You need to decrease some of those meds - look up www.mensahmedical.com
It is a team of MD's who specialize in natural and targeted vitamins, aminos and minerals for those with mental health issues such as bipolar.  I will never again medicate my son and am furious at our doctor and the medical community as well as drug companies who deal these dangerous drugs like candy to innocent victims!
We work with Dr. Judith Bowman at Mensah Medical - she is briliant, kind and has helped us a great deal.  You can do testing where ever you live, they also have outreaches.  I wish you the best!
Michele