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I found this  about akathisia and had a Eureka moment! 

 

http://www.medicationsense.com/articles/2010/ciproakathisia0210.html

 

Types of Akathisia

 

Type 1. The first type of akathisia occurs most commonly with antidepressant medications.2 Acute anxiety, panic, restlessness, physical agitation create a state that is intense and difficult for people to bear. In severe cases, thinking may become disorganized, and judgment is often impaired. Behavior can become impulsive. Suicidal thinking may occur. Severe akathisia is a medical emergency. Because of the seriousness of this reaction, all antidepressant medications carry black?box warnings in their package inserts. In addition, antidepressants such as Prozac specifically include akathisia among their lists of adverse reactions.3

Type 2. Another form of akathisia is seen with medications known as neuroleptics. These medications are also known as antipsychotics and frequently administered to people with mania or schizophrenia. These drugs can trigger an akathisia that resembles some aspects of Parkinson's disease. This akathisia produces symptoms that are mainly physical, such as a constant need to move around, to pace or be in motion. It may also cause heightened anxiety, but not the panic, emotional or mental turmoil, that is seen with type 1 akathisia.

 

 

I get type one from antipsychotics, and that is probably why treatments such as cogentin are not effective for me.  I am going to try Ativan tonight with Latuda to see if there is any effect.  I just hope the Ativan lasts long enough to be able to just take 1mg at night with the Latuda.

 

This is the first time I have seen someone acknowledge that there is one type with extreme anxiety/panic.  Increased dosages of APs and/or treatment with cogentin makes it APPEAR better, due to less involuntary movement, but for me, does NOTHING for the inner panic/anxiety/restlessness that is still there.

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hmmm... i'm not on latuda currently. however

 

so, ok, i have eps. which i hate to admit.

 

but it is what it is

 

and just wanted to say that THE key for me for the "type 2", which, for me turns into the "type 1" because 

 

i can't sleep with my body desperate to turn itself inside out

 

it plays out in every way in my life until i get medication together and i narrowly (but still fucking DID avoid so YES on goal) 

 

avoided hospitlaization this last time

 

inderal/propranolol and ativan, those are what iv'e found when titrated up and complieed with 100% will sort me

 

cogentin i've found is more for the rigidity

 

the masklike stiffening of every muscle

which the tongue is a muscle

and then you think

so is the heart 

holy fuck

 

anyway...cogentin is better for that ive found

you get it on injection if you develop the parkonsinism

fuck i can't believe it's called that

dystonia as well... it can be stiffening of muscles and then 

 

 

anyway...you were asking about what you posted and said you planned to take ativan

you MUST get sleep if you have schizophrenia or you're fucked

so or..well...i think the same is prolly likely with whatever you're taking latuda to treat

so, if your 2 is turning into 1 like mine does

and it's not due to antidepressants for me at all because i can'ttake them at all or i'll be really quickly florid

i would say that you might want to ask you doctor etc but yes to the ativan and cogentin, when you have eps (not saying you do) but every antipsychotic can have a different presentation of it and for the rigidity for me cogentin/ativan and for the akathisia propranolol/ativan and which it is can be different even on the ame medication at a different dosage of it...which eps thing comes to dominate and when.

 

best to you

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Thanks!  Mine is for bipolar mixed, depression lately but also impulsive and reckless behavior.  I don't get the stiffness much but mostly the type 1 anxiety/panic.  Took 1mg of Ativan last night with 10mg Latuda after dinner, and slept well.  I admit I also drank a beer.

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  • 3 weeks later...

I can't believe it's October 10 already.  Been on Latuda that long!  Skipped a day or 2 here and there, now down to 10mg at night with 10mg propranolol.  New pdoc agreed to go very very slowly on any increase in Latuda so I can keep functional at work and keep akathisia to a minimum.

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  • 8 months later...

Old thread, but I've been off of Latuda for a while.  The Inderal had weight gain, the entire reason I was taking Latuda in the first place.  (Avoiding weight gain.)

 

I'm wondering if I should try it again, this time with Ativan instead of Inderal  (I don't think Ativan causes weight gain)

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hmm. i take ativan without weight gain. but it doesn't fix akathisia for me (that's not its main function and it doesn't suffice to fix it alone).

have you taken artane or cogentin? both have been effective at times for me (and yes ativan with all). i'm back on cogentin now because i switched one of my antipsychotics and have had zero akathisia for at least a month or two. i have heard benedryl is also good, but cannot speak to using it myself for that. hope you're feeling better soon.

one other thought: there are other antipsychotics, too, and maybe that's an option if latuda gives you akathisia and the thing that resolve causes weight gain?

best to you

Edited by mellifluous
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I get type 1 with Latuda and Geodon, but for me its all in the timing. If I take the Latuda before 9pm i'll get it and get it bad. If I eat a meal within 3 hrs after taking my Geodon, I get it and I get it bad. All other scenarios i'm fine. I too didn't get much relief from Congentin. I don't know if i'm just a weird case or what but man when it happens it really hurts!

 

Ativan is pretty useless for akathisia for me too - no weight gain either.

 

best of luck

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hmm. i take ativan without weight gain. but it doesn't fix akathisia for me (that's not its main function and it doesn't suffice to fix it alone).

have you taken artane or cogentin? both have been effective at times for me (and yes ativan with all). i'm back on cogentin now because i switched one of my antipsychotics and have had zero akathisia for at least a month or two. i have heard benedryl is also good, but cannot speak to using it myself for that. hope you're feeling better soon.

one other thought: there are other antipsychotics, too, and maybe that's an option if latuda gives you akathisia and the thing that resolve causes weight gain?

best to you

Thanks -- I have taken those, but they are really more for "type 2" and did nothing for my "type one."   Also, they made my vision blurry and caused weight gain.  I guess I'm extra susceptible to side effects.  I've tried pretty much all of the APs, and they all either caused massive weight gain, or too much akithisia.  I think I give up.

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I got something similar to the second type when I was on Latuda (and it was one of the big reasons why I quit).

My muscles became extremely tense and rigid. It felt like it was going down to the bone. I wanted to just crawl out of my skin or tear my legs off (where most of the feeling was located). I nearly started crying one day because it was so uncomfortable.

It wasn't painful by any means. Just a weird feeling I still can't describe fully.

I no longer have that issue, thankfully.

I'm glad you aren't having that anymore!  Right now I'm sticking to Ativan once in a while and that's it.  I'm kind of miserable, but the cure is worse.  Ugh.

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hmm. i take ativan without weight gain. but it doesn't fix akathisia for me (that's not its main function and it doesn't suffice to fix it alone).

have you taken artane or cogentin? both have been effective at times for me (and yes ativan with all). i'm back on cogentin now because i switched one of my antipsychotics and have had zero akathisia for at least a month or two. i have heard benedryl is also good, but cannot speak to using it myself for that. hope you're feeling better soon.

one other thought: there are other antipsychotics, too, and maybe that's an option if latuda gives you akathisia and the thing that resolve causes weight gain?

best to you

Thanks -- I have taken those, but they are really more for "type 2" and did nothing for my "type one."   Also, they made my vision blurry and caused weight gain.  I guess I'm extra susceptible to side effects.  I've tried pretty much all of the APs, and they all either caused massive weight gain, or too much akithisia.  I think I give up.

how about typicals? i do far better on them. though they are worse for me for akathisia oftentimes--prolixin depot was fucking hell until i titrated up on propranolol--but they might not be for you. i take haldol and zyprexa now and cogentin works for me. good luck!

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hmm. i take ativan without weight gain. but it doesn't fix akathisia for me (that's not its main function and it doesn't suffice to fix it alone).

have you taken artane or cogentin? both have been effective at times for me (and yes ativan with all). i'm back on cogentin now because i switched one of my antipsychotics and have had zero akathisia for at least a month or two. i have heard benedryl is also good, but cannot speak to using it myself for that. hope you're feeling better soon.

one other thought: there are other antipsychotics, too, and maybe that's an option if latuda gives you akathisia and the thing that resolve causes weight gain?

best to you

Thanks -- I have taken those, but they are really more for "type 2" and did nothing for my "type one."   Also, they made my vision blurry and caused weight gain.  I guess I'm extra susceptible to side effects.  I've tried pretty much all of the APs, and they all either caused massive weight gain, or too much akithisia.  I think I give up.

how about typicals? i do far better on them. though they are worse for me for akathisia oftentimes--prolixin depot was fucking hell until i titrated up on propranolol--but they might not be for you. i take haldol and zyprexa now and cogentin works for me. good luck!

 

Hmmm.. Well maybe because my bipolar 2 is not super severe, that I'm not as tolerant of SEs?  I dunno.  Haldol gives me the worst akithisia of anything.  I still remember the nightmare of being restrained and injected with Haldol in a hospital in the 90s.  Try having severe akithisia while in 5 point restraints!  :o)

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I'm sorry Haldol was such a disaster. But that doesn't mean you should give up on typicals, there are lots of them. There is a good chance you will find one that works for you.

 

Also, did you try Geodon (sorry if I? It is supposed to be weight neutral. I didn't tolerate it well; in fact I asked to be taken off of it in 4 days, and I am usually willing to ride out side effects for the regular 4-6 weeks. But I am just one person, and many CBs members like it. I also became manic on Abilify

 

On the other hand, Risperdal works well for me.  So those are three meds that are actually in the same class, but my body responded to each one differently.

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Thank you.  Yes, I think I have tried all of them.  Geodon was unpredictable for me -- the type and amount of food eaten made the effect vary greatly. 

 

Even my latest pdoc was surprised at the number of meds I've tried.  I don't think I'm very patient though -- when side effects make it hard to go to work and be highly functional, I get afraid of losing my job or what have you, before I can get used to the med.

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typicals are often, but not always, associated with less weight gain than atypicals. of the typicals that had the least akathisia or any eps for me: stelazine and loxapine

the one with the most: prolixin/fluphenazine injections

all others i've tried, including my current haldol depot, are in between those two "extremes", for me.

 

i have developed persistent eps and always must take a something additional now, however, so that might simply be a difference that renders my comments less useful to you. in the event they are useful:

 

on some level what you said in your last post is what i think is most likely the case: you're not very patient. sadly, a lot of these medications require some amount of patience to get to the therapeutic dosage and actually fixing things level.

 

i totally get ...i mean, fuck, if i had a job i wouldn't want to lose it either and i'd do what i could to protect it! i also get not wanting to go to the hospital for medication adjustments, though that's what's always recommended for me. in your case, doing something like that might enable you the time and space to get your meds sorted, though. and taking a bit of time off work could save your employment long term.

 

and, yes, i have been in restraints multiple times and i can empathize with the suck of it. sorry you've faced that before. take care x

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The thing I struggle with the most is, how severe do my symptoms have to be before medication is worthwhile?  I hate to use vacation hours and such to spend it in a hospital.  I don't think my insurance would go for that anyway.  (I have Kaiser) 

 

I've been depressed and anxious, with some impulsive behaviour.  Is that worth taking meds for?  I guess the danger would be if I'm not on anything, and it gets worse suddenly.

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hmm. i don't know really if anyone but you can answer that question. if it's worth it, i mean. if you're not on court order, i guess it depends. most of the time i wouldn't take jack shit if it were entirely my call. since you do get impulsive, i guess consider what consequences there have been and conceivably could be. you have a job now, what if shit gets worse? i don't know. and i don't share your diagnosis. but you're posting on this forum so i am assuming you struggle in life. how much struggle does it take? only you can say. I wish you well in navigating the conundrum.

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something else that occurred to me upon re reading your post: i have kaiser and they hospitalize the fuck outta me. i don't know if there's a reason for or against that or if your experience would necessarily be the same or different, but thought to note. my partner's insurance (which is what i'm on) used to be kaiser only and so i found my current psychiatrist there about nine ish years ago. then when, a few years in, my partner had an either/or insurance option, we stayed with kaiser specifically so as to keep my psychiatrist. one caveat of sorts though: the kaiser here in my city doesn't have an inpatient psych ward, so once i'm identified i get place at one of three hospitals in the city (usually the same one though, which i'm reluctant to identify for obvious reasons) that kaiser has some agreement with.

 

anyway, just noting because it might not be a problem with your insurance to do it. my doctor has hospital privileges and can definitely get me a bed for medication adjustments. whether i take him up on it voluntarily is another matter, but the point is that it's possible. it might be possible for you, too, if you opt to pursue it.

 

hope that helps and best to you.

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