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Just bumped up to 40mg from 20mg yesterday and I believe I experienced akathisia for the first time last night.  It felt awful and I'm not sure I can do it justice with words, but I'll try.  It was like a gnawing, driving compulsion to move, and it hit while I was laying in bed trying to go to sleep.  Should I report this to pdoc?  I find it worrying that this side effect is coming on after one dose--I'm concerned that if I try to stay on 40mg the akathisia will intensify and persist.  Thoughts?

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Update: called answering service for pdoc and she called me.  Said to continue with 20mg because I didn't experience any symptoms at that dose, and to not attempt a 40mg dose.  Said we could consider cogentin to counter the akathisia if we really wanted to try upping the dose.  I probably won't go that route though.  Already about to start a small dose of oxybutynin for excessive sweating--I think that's enough "meds to counteract the side effects of other meds" for my cocktail, imo.

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