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What do you take for antipsychotic-induced akathisia?


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i'm currently on cogentin for EPS generally, and it keeps it at bay.

 

i've taken propranolol and artane as well---some do better in some combinations or depending on which...eps thing. for akathisia specifically, the time that was the worst for me (prolixin depot) propranolol was what got it under control and maintained. 

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I was prescribed Cogentin. But I had to stop today because it gave me horrible blurry vision. Anyone else get this side effect? He should be calling me soon to discuss it. I hope the other options don't cause the vision problems. Anyone taking anything other than Cogentin, have you had blurry vision from what you take? I

Edited by Evey
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I take Propranolol 20 mgs, 2x a day. 10 mgs wasn't cutting it, and only worked a week. Akathisia = worst thing ever! Cogentin gave me HORRIBLE dry mouth! 

 

 

 

DX - Bipolar with psychotic features, anxiety, PTSD

 

RX - Latuda 40 mgs, Paxil 10 mgs, Buspar 5 mgs

Edited by kittnclaw
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I am so glad you brought this up.  Many people, including doctors, do not know the difference between Akathisia and Dystonia.  Drugs like Cogentin I suppose COULD help with Akathisia, but from what I can tell, not for many.     Akathisia is when you can't sit still, yes, but it is accompanied by what in my opinion is the worst feeling on earth.  Anxiety and sense of doom do not even begin to describe it.  When I get it, I would do almost ANYTHING to make it stop.   The emotional/psychic part is far worse than any involuntary movements.  And this cannot be stopped except with a beta blocker and/or benzodiazapine.  (In my case)

 

I'm on Wellbutrin SR and low dose Trilafon right now, (2 mg twice a day)  and I get akithisia after eating, and at bedtime.  So far is it relatively mild, so I'm trying not to take other meds to control it.

 

In my opinion, Cogentin and the like are worthless for this kind of Akathisia, but Inderal and Ativan have worked very well for me in the past, with Latuda akathisia.

 

What I have said here is backed up by recent research done on Akathisia.

 

Cheers.

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I take Propranolol 20 mgs, 2x a day. 10 mgs wasn't cutting it, and only worked a week. Akathisia = worst thing ever! Cogentin gave me HORRIBLE dry mouth! 

 

 

 

DX - Bipolar with psychotic features, anxiety, PTSD

 

RX - Latuda 40 mgs, Paxil 10 mgs, Buspar 5 mgs

 

How long has the 20mg been working for you?

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I took Cogentin. It was so frustrating...in the hospital I was on Invega and it made me SO restless that I literally couldn't stand still, ever. Even sitting and smoking a cigarette (they let us smoke there) was impossible. And all they had on file for me was vistaril or zydis. It's like no...I need something else. Cogentin worked for me for other meds, but it made me have bad close up vision and I couldn't put sentences together very well.

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Many people, including doctors, do not know the difference between Akathisia and Dystonia. 

 

What I have said here is backed up by recent research done on Akathisia.

 

please supply link(s) to peer reviewed research that supports that claim, because having had both acute akathisia and acute dystonia...and just less severe akathisia flares during some adjustments... i have a hard time believing that trained psychiatrists...or really...any well trained mental health professional familiar with EPS...at all...would mistake the two.  and, as someone with persistent eps and a history of both...they're pretty damned distinct in most every way.  

 

for me

akathisia at worst: the desire to turn body inside out was absolutely desperation inducing. and the need to move and inability to contemplate sitting, let along lying down...and no sleep...the only other experience i've had like it...it's like psychotic agitation without the psychosis...but....go a few days unslept and how sleep deprivation is like a welcome mat for breakthrough symptoms and i could see how if you didn't do thorough assessment or know your patient's history well... maybe. though that'd be horrible given the resolution for psychotic agitation is pretty much the opposite of the resolution for akathisia and i'd be so furioius if my doctor increase the thing that causes akathisia rather than alleviating it. but, he's thankfully not incompetent.

 

dystonia at worst: all of my muscles started to cramp and then stiffen. when i had it... it feels like the opposite of akathisia, actually. instead of move, move, move..i mean...akathisia, for me....is "must keep moving" and i'm constantly stretching and flailing about on some level....my muscles are very "loose" is my point. dystonia is the opposite. the time i had it horribly, i woke up and i was like wooden. and my muscles were hard sorta. and painful and..it took me a really long time to get out of bed. it's like tin man without oil or something. and it occurs to you that ...muscles are all hard and stiff....and swallowing is ...it's hard to explain (actually though...another key difference. akathisia...when i've had it for multiple days really strongly...the tongue is a muscle, and you can't control it well. you can end up biting down really hard on it and rubbing against your lower side teeth, you end up with it all ripped up; sores all along the sides and..you get the point: it's unattractive. if it's not dealt with, it becomes excuciating to swallow your own saliva. i've only had it that bad once though, because a mouth guard can make it not THAT bad and that's lesson i didn't need twice) but the heart is a muscle. and that's a freaky thought in the moment. i had to go to the hospital for it and get an cogentin injection, if memory serves. and they kept me to monitor. i guess my muscles were...the cramping was kinda jerky looking. but...totally not like the movement of akathisia for me. not at all.

 

dystonia didn't inspire the desperation akathisia does. like an animal trapped in flesh cage that made me want to rip my flesh off and inside out...just remembering it..OY. dystonia was just like...freaky. it was more frightening and like...like turning to stone but...painful and ...you jerk around some and that also fucking KILLS.

 

i'm not a trained psychopharmacologist and i lack the education (which, presumably, for those in psychiatry who treat patients with psychotic disorders would include some amount of information on the difference between akathisia and dystonia) and expertise of being a clinician. i also know there not all disorders present in all persons identically, but unless i'm some statistical anomaly... the elements in each make distinguishing between the two something that i find it shocking a significant percentage of doctors have been found incapable of of having great difficulty in differentiating.  even patients...i mean...if you've had the two...i can't imagine someone with persistent eps, for example, mistaking one for the other. to me, of the all types of eps or types of medication induced movement disorders you can present...those are, in my experience, the two most diametrically opposed.

 

one other thing, and this is just my personal opinion, but since i'm among those who take cogentin currently for my eps because, my psychiatrist finds it better in combination with haldol, in contrast to when i was on prolixin and that he says goes better with propranolol, i don't appreciate what it looks like you're suggesting. the weak disclaimer that maybe for some small number, cogentin would treat akathisia, but not for many, that many people can't tell the difference between akathisia and dystonia, and "explaining" what akathisia is... i mean, that's pretty insulting. it's great that you keep up with current research and i'm definitely looking forward to see what you have, but, come on, man, get a grip. physicians have a person's history and current medications and interactions and the actual person presenting with the symptoms to talk to and any number of other things to take into consideration when diagnosing and treating. saying cogentin could help, but not for many...etc..in light of all the posts preceeding yours... it reads like you're trying to invalidate/discredit others' reporting THEIR (our) experiences/medications. i don't understand the rationale on that, but i think it's a divisive and overall bullshit move. reading some studies and your personal experience of having akathisia...doesn't make your answer to the thead's question any more or less legitimate than others' answers.

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I'm sorry if you thought I was trying to invalidate anything, that was not my intention.  It was just a kind of rambling that I do sometimes based on recent experiences of mine, and an article I read.  I'm not that great on making things clear.  I'm sorry.

 

When I said "backed up"  I wasn't referring to doctors not knowing the difference -- I was referring to beta blockers and such being more effecitve for my type of Akathisia than cogentin type meds.  The thing about the doctors, is mostly from my personal experience and that of others I personally know.

 

Again, I'm sorry about the things you pointed out.

 

Here is a link to the article I had read that I got all worked up about:

 

http://bjp.rcpsych.org/content/196/2/89.full

 

I should have just posted that, instead of my interpretation --- I apologize.

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I'm sorry if you thought I was trying to invalidate anything, that was not my intention.  It was just a kind of rambling that I do sometimes based on recent experiences of mine, and an article I read.  I'm not that great on making things clear.  I'm sorry.

 

When I said "backed up"  I wasn't referring to doctors not knowing the difference -- I was referring to beta blockers and such being more effecitve for my type of Akathisia than cogentin type meds.  The thing about the doctors, is mostly from my personal experience and that of others I personally know.

 

Again, I'm sorry about the things you pointed out.

 

Here is a link to the article I had read that I got all worked up about:

 

http://bjp.rcpsych.org/content/196/2/89.full

 

I should have just posted that, instead of my interpretation --- I apologize.

 

ah, i see. that makes sense. and, no worries; i appreciate the apology and the clarification :) (i've certainly been unclear or confusing and have defo come off totally other than as intendedf...so...i get it ;) )

 

thanks for the link, i'll take a look.

 

best wishes

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  • 2 months later...

Please listen to what I have to say about akathisia. It could change your life. Most of it is my opinion based on my experience but some of it is backed up by research. I'll give links at the bottom of the comment for more info.

 

I was diagnosed with schizophrenia 35 years ago. I have tons of experience with psychiatrists, therapists, self-help groups and medications.  I'm not totally against taking medication but it's my opinion that many psychiatric medications do more harm than good. I'm presently not taking any medication and I'm coping quite well. I will not take any medication that causes akathisia. 

 

Psychiatrists are well-meaning people but they can't fully understand side effects of medications they have never taken themselves. They only know what the drug sales rep tells them. The sales reps learn about the side effects because the drugs were tested on real people. These people reported how they felt and told the researchers about it. By the time the information reaches the doctor it's fifth-hand information but akathisia is much more than just restlessness.  If a person is experiencing severe akathisia an experienced doctor can detect it by observing the patient's outward behavior but the doctor can't possibly know what it FEELS like. What akathisia looks like on the outside is totally different than what it feels like on the inside.

 

Mild akathisia is insidious. I had mild akathisia for months and didn't realize it until after I stopped taking the medication. After stopping the medication, I felt like I had been let out of prison.

 

When doctors know the patient is experiencing severe akathisia the doctor can reduce the dosage. Which begs the question: What's the difference between severe akathisia and mild akathisia? With mild akathisia it takes longer before I get to the point where I can't stand it any longer and I start thinking about suicide.

 

I want to emphasize that I'm not totally against taking medication but healthcare has become way too reductionist when it needs to be more holistic. When doctors believe a "chemical imbalance" can be fixed with a man-made chemical or combination of man-made chemicals it's way too reductionist.

 

How do I cope with my mental illness without taking medications? Firstly, let me admit that my condition might just be a mild case of schizophrenia but I have experienced four full-blown episodes of psychosis in my life. Having said that, I treat my illness holistically by getting enough sleep, reading self-help books, attending support groups, eating a healthy diet, having lots of friends that I go out with on a regular basis, etc, etc. IT TAKES A COMBINATION OF ALL THESE THINGS for me to maintain my mental health. My life is far from perfect and sometimes I have really bad days but I'm happy most of the time.

 

http://www.newsweek.com/why-antidepressants-are-no-better-placebos-71111

 

http://www.lawyersandsettlements.com/features/drugs-medical/ssri-suicide-akathisia.html#.VCrJUvldVpI

Edited by Jim1961
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I am so glad you brought this up.  Many people, including doctors, do not know the difference between Akathisia and Dystonia.  Drugs like Cogentin I suppose COULD help with Akathisia, but from what I can tell, not for many.     Akathisia is when you can't sit still, yes, but it is accompanied by what in my opinion is the worst feeling on earth.  Anxiety and sense of doom do not even begin to describe it.  When I get it, I would do almost ANYTHING to make it stop.   The emotional/psychic part is far worse than any involuntary movements.  And this cannot be stopped except with a beta blocker and/or benzodiazapine.  (In my case)

 

I'm on Wellbutrin SR and low dose Trilafon right now, (2 mg twice a day)  and I get akithisia after eating, and at bedtime.  So far is it relatively mild, so I'm trying not to take other meds to control it.

 

In my opinion, Cogentin and the like are worthless for this kind of Akathisia, but Inderal and Ativan have worked very well for me in the past, with Latuda akathisia.

 

What I have said here is backed up by recent research done on Akathisia.

 

Cheers.

1 mg Cogentin works great for my Abilify-induced akathisia.
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