Hello
C.G.:
Haloperidol
is what is called a classic neuroleptic -- it is the oldest of the drugs
used to treat TS, and widely considered in the medical community as
no longer the best. A whole host of other classes of medications with
vastly fewer side effects and more specificity (where more specific
areas of the brain and more specific chemicals are targeted rather than
'blasting' the brain in what doctors call a 'shotgun' approach). Antihypertensives
(such as drugs called guanfacine or clonidine) are now most well-read
physicians' first drug of choice, followed by drugs called atypical
antipsychotics (such as drugs called risperidone or ziprasidone).
There
are a number of side effects of classic neuroleptics like haloperidol.
These can include weight gain, sedation or grogginess (called 'psychomotor
slowing'), heart rhythm changes (potentially very serious -- it is important
for doctors to monitor your heart by electrocardiogram when starting
this drug or altering its dosage), irritability, depression, difficulty
swallowing, lowered blood pressure (hypotension), dizziness, and lowered
sex drive or ability to sexually function. Particularly because you
are a woman, I should mention that one possible effect as well is a
false positive pregnancy test (all taken from the Clinical Handbook
of Psychotropic Drugs published by the Clarke Institute of Psychiatry
in Toronto ON).
Of greatest
concern long-term though is the development of a condition known as
tardive dyskinesia (TD) -- 56% of individuals on a classic neuroleptic
for longer than 10 years develop this side-effect (the risk is twice
as high for women). Ironically, TD is the development of involuntary
movements -- lip smacking, sucking or chewing movements, blinking, grimacing,
and jerking of body parts (fingers, toes, limbs, neck, etc.).
Regarding
the link between Parkinson's disease and TS, there really isn't one
except that the two disorders both involve dopamine (a brain chemical
involved in movement) and are opposites in a sense. In TS individuals
are hypersensitive to dopamine. Therefore TS medications REDUCE dopamine
in the system, or block it from working normally so that we don't have
EXTRA movements. In Parkinson's, an area of the brain (called the substantia
nigra) that manufactures dopamine is destroyed, meaning that there is
not enough dopamine. Therefore Parkinsonian medications try to INCREASE
dopamine in the system so that we are ABLE to move (one of the symptoms
of Parkinson's is to be 'frozen' in place like a statue, or to have
a completely unexpressive face).
I hope
this helps you C! I'm glad that even though your country has little
information available on TS you are still finding out all you can! Congratulations
on your courage and resourcefulness -- perhaps someday you will be a
pioneer, using everything you've learned to increase Singapore's awareness.
cheers,
Dr. Dunc.
