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Old 01-15-2009, 02:55 PM #1
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Trig Atypical Anti-psychotics CNN Story today about heart attack

http://www.cnn.com/2009/HEALTH/01/15....sudden.death/







This makes me want to get off Abilify and fast! I don't want to die...
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Old 01-15-2009, 04:48 PM #2
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Dear Pam,

Here is part of the article you link to:

Quote:
Overall, people taking typical antipsychotics were at 1.99-times greater risk of sudden cardiac death, while the risk for those on atypical antipsychotics was increased 2.26 times. The increased risk was greater for people on higher doses of the drugs. People who had used the drugs in the past but stopped weren't at greater risk of sudden cardiac death.

"The drugs are still very effective for conditions that there's proven evidence for," says Jeffrey A. Lieberman, M.D., a professor and chair of psychiatry at Columbia University, in New York City, and the director of the New York State Psychiatric Institute, who was not involved with Ray's research. "They clearly need to still be able to be used. I think this [study] really underscores the need to be very judicious about how these medications are used and whom they're given to."
So based on this alone it looks like the typical ADs are better than the atypical with regards to heart.

That's a darn shame.
I wish that our meds were safe.

Still we have to weigh the benefits.

It the med worked for me, I don't know what I would do.

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Old 01-16-2009, 07:46 AM #3
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Default Pam, How are you doing?

Dear Pam,
I hope that you are ok.
When will you see your pdoc again to be able to talk about your concerns?
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Old 01-16-2009, 10:24 AM #4
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I can't, my counselor who rx'd my meds left town and I am waiting to see the new P-Doc who "might" take over for me IF we click in March when my appt is set for. I have 3 refills on my meds so I am set, but I just worry about the cardiac concerns, I have been getting weird feelings, almost painful in my chest and I think it's anxiety but who really knows? One thing I am scared about is the new P-doc NOT wanting to RX me Lorezepam, this clinic doesn't like to rx benzos, and I definitely NEED it for anxiety attacks. Nothing else works for me. I talked to my regular dr and he might be able to help IF they try to stop me from taking benzos, he said there is a non controlled substance alt. but I can't remember the name...

I am having a real rough time this week, I can't write a pitch letter for the AMazon contest and I am feeling indequete as a writer because of it. Last night I was crying and so upset about it I wanted to give it all up. Because I just feel like I will never make it in this field, especially if I can't compose a decent query letter. I have read books and stuff on them but I still can't DO it to my satisfaction. So if I could I WOULD give up writing, it hurts too much to stick with it, I mean I couldn't stop crying last night and went to bed with a heckuva headache. All because I don't have faith in the writing of a stupid letter that you have to have for each and every book if you ever expect to have anyone get interested in them.

I really hate writing these letters and when I have posted them on the writing board I go to the feedback I get is not encouraging. It basically tells me I suck at writing these darn letters and without them I have no hope of ever selling a novel.
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Old 01-16-2009, 10:36 AM #5
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Lightbulb the cardiac concerns

heart rhythm and prolongation of the QT segment that controls the rate the heart beats.

Atypicals and many other drugs..including TCAs and valium, and SSRIs can prolong QT.

The best defense is understanding the risks and then you can still take the drugs with care.

1) genetic tendencies --this is usually hidden, and the best way to deal with it is to have a screening EKG to see what the QT time is. If delayed, then using drugs that prolong it further is
reconsidered.

2) developing low potassium and magnesium while taking QT risk drugs can bring on an event.
Examples are the drugs recently taken off the market, Seldane and Propulsid. Used in the wrong circumstances, or with other drugs that are additive, can lead to a cardiac QT event. You can develop low potassium and magnesium from the flu/dehydration.
From poor diet/intake, or from using other drugs that deplete them. (The drug Propulsid was taken off the market because many people were given diuretics by theirs doctors which depleted both electrolytes and were not monitored while using the Propulsid. This drug was commonly used along with acid blocking drugs to treat common GERD).

This website has grown considerably over the years. Please look at it. As new data comes in, drugs are added, or shifted around the 4 lists as needed.
http://www.azcert.org/

Basically it is up to doctors to screen you. And monitor you.
But they fail in this task. So it pays to understand the risks.
1) so you don't over-react and make yourself stressed out unnecessarily and
2) you don't get caught in a tragic situation.
You have to balance the two.

Not everyone gets a QT event. But when it happens it is terrible.

And also, there is evidence that a doctor who participated in the trials of Zyprexa, actually shredded the records of people who died under his care on that drug from cardiac events.

I post about this frequently... seems like I will be still doing that in the future!
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Last edited by mrsD; 01-17-2009 at 12:56 AM.
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Old 01-16-2009, 10:44 AM #6
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Default potassium and magnesium

Mrs.D,

Are you saying that potassium and magnseium will help? Do people need to get blood work first?


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Old 01-16-2009, 10:52 AM #7
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Thanks for posting MrsD. I had a EKG recently and I didn't ask about the QT thing, will my regular dr be able to tell if I have delayed QT?
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Old 01-16-2009, 10:59 AM #8
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Lightbulb blood work...

Blood work for potassium is pretty accurate.

It is the magnesium that becomes low. Serum tests only measure what is in the serum and not intracellular.

Typically most American's are somewhat low in magnesium.
Check what you eat, and look it up on that nutrition site I gave you.
http://www.nutritiondata.com/facts/v...roducts/2357/2

Recommended supplements for average people are 1/2 the RDA dose. For magnesium that would be about 200mg, elemental. Average RDA for magnesium is 350-400mg elemental for an adult.
See my magnesium thread for more details.

For potassium daily intake should be now around 4.5 grams or 4500 milligrams. (this was just raised from 3.5).

When a person is taking one or more drugs that affect QT and becomes dehydrated, that is a bad combination.
Mixing drugs is also dangerous.
Anna Nicole Smith's son Daniel died of this...and it was in the news for a long time. His was an accidental combination of methadone (not a high or toxic dose) with Lexapro SSRI.

When extreme even normal people with low magnesium can have an event. This most often happens with people on diuretics that are not supervised by doctors well...high dose diuretics for heart failure can kill people this way. The ER manages with IV magnesium sulfate. Doctors know how to monitor potassium, but they still remain rather clueless about magnesium.
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Old 01-16-2009, 11:56 AM #9
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Default Great Link.

Mrs. D
Here is what I found on your web site.

1 baked potato = 1600 mgs potassium.
That is one third of the daily intake you suggest.
Two more foods with similar amount of potassium
and a person would have enough.

Here is what I found for magnesium:
1 cup black beans = 120 mgs
1 cup of brown rice = 84 mg magnesium
1 cup of oatmeal = 112 mgs magnesium
22 grams spinach = 180 mgs magnesium
This would give someone 496 mgs magnesium for the day: a good amount

(according to my math)


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Old 01-16-2009, 12:12 PM #10
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Quote:
Originally Posted by Pamster View Post
Thanks for posting MrsD. I had a EKG recently and I didn't ask about the QT thing, will my regular dr be able to tell if I have delayed QT?
Pam,

Here is what I found about QT interval interval and EKGs on wikipedia:

http://en.wikipedia.org/wiki/QT_interval

http://en.wikipedia.org/wiki/Electrocardiogram

I too wonder what the EKG can do.

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