After 1500 mg of Seroquel failed to work this spring I went on an anti-psychotic called loxapine. Unfortunately from the beginning I had muscle pain that I kept blaming on poor posture while sewing, sleeping funny, walking too much, new sneakers, etc. Eventually I realized it was muscle rigidity from the loxapine. That was treated with valium and Cogentin but after a few weeks I began have uncontrolled oral motor movements and so needed the amount of dopamine in my brain to be reduced. We attempted lowering Seroquel to 800 mg from 1200 mg but it didn't help and so I was forced to taper off loxapine.
This put me in the hospital where the plan was to change from Emsam to Nardil. I can't afford Nardil, which is not covered by my insurance, so that change didn't happen. Instead I went back to the meds I was on when this episode began (9 mg/24 hours Emsam, 1200 mg of Seroquel, 25 mg topirimate, 400 mg gabapentin, 2 mg Klonopin HS, 1 mg klonopin PRN, 5 mg valium PRN) with the addition of Cogentin 1 mg.
After a month without EPS (the muscle problems and oral motor movements) I was off Cogentin and the Emsam was increased to 12 mg/24 hours. At this point I am maxed out on every med and a major change is going to be needed soon. If there is not adequate response to the Emsam at this dose I have been referred for consideration for ECT which I am very willing to do because it is not a drug and I am having a hard time believing meds can help sufficiently after 10 months of this episode and knowing there is nowhere else to go with what I'm on.