treating EPS symptoms

[dancesintherain]

Hi all,

I'm having some movement stuff that may be EPS-related.  IIt might not be, but it's familiar enough to me to think that it might be.  What are all the drug options out there?  I can't go off the AAPs that I'm on. 

I've tried cogentin and it gave me blurry vision, which doesn't work.

I think propanalol is on the list....I'd have to go off prazosin, but I might be willing to try that and see how it goes.

I can't remember what's left and the pros/cons of them.

Thanks,

dances

[jarn]

I'm never sure if akathisia is part of EPS or not, but I've been having issues since on Zyprexa.  I took some old CBD capsules we had that Toby was trying to see if it helped him sleep, and it helped me.  I've had an appointment with a medical marijuana doctor and am now titrating up on my own oil.  It's not perfect - I still take the occasional ativan - but is a great help and mostly I can avoid ativan which I didn't want to take long-term every day.

[dancesintherain]

Hi all,

sorry for not replying jarn.  I unfortunately can’t do cbd - my employer has a bright line rule.

any other ideas out there?

[Banana Smurf]

I've taken klonopin, valium, propranolol, and benadryl, but I've mostly only had akathisia.  I have had this weird thing where my knees jerked, but it wasn't medicated, so I don't know what's effective for other movements.  

[dancesintherain]

Thanks!  It’s some sort of intermittent leg tremor.  I haven’t tried propranolol.  Klonopin and Valium don’t seem to make it go away.

[dancesintherain]

It also seems to get worse with anxiety.  I’m not sure about that though. It might just be when I notice it more.

Edited May 6, 2020 by dancesintherain

[dancesintherain]

So for now my pdoc is not convinced that it's EPS.  She thinks that it may be anxiety medication withdrawal since the dose of XanaxXR I take in the morning is less than the Valium dose at night....and because so far I most often notice it in the afternoon or evening.  That's a guess, though. 

We're going to add 0.25mg xanaxIR to the afternoon to see if that prevents them.  She didn't want to disturb anything else because things are going okay otherwise.

[dancesintherain]

I think her anxiety medication withdrawal theory is wrong.  It was based on when I noticed it most, but now that I'm aware of it, I'm noticing it whenever--regardless of where I am on the anxiety spectrum or medication timeline. 

[dancesintherain]

So for now we're adding propanolol at a small (I think) dosage - 10 mg twice per day.  I'm supposed to check my pulse one hour after taking the first dose and see if it's 60 or above.  I increase it to 20 mg, twice per day, after three days.

Then I also have a blood pressure monitor coming to me in the mail thanks to amazon.  Because I'm not thrilled at the idea of two anti-hypertensives when I don't have hypertension.  Hopefully they're both low enough dose to be effective without bottoming out my BP. 

[Banana Smurf]

I don't blame you for being cautious about the hypertensives.  I took a higher dose of propranolol than that without trouble, so I hope the combination works for you without causing significant cardiovascular effects.  

[dancesintherain]

thanks @Banana Smurf.  Last night's dose went over just fine.  I've taken it before briefly but not with prazosin.

[notloki]

I have pseudo parkinson hand tremor due to Ability. I take Inderal 60 mg time release capsules, one a day, so I avoid side effects from the Inderal which knocks out the rapid/fine tremor in both hands. 

Edited May 15, 2020 by notloki

[dancesintherain]

thanks @notloki, I'm glad it works for you.  I think that pseudo-parkinsonianism is what I'm dealing with also.  It at least feels like the last time I had it.  Fortunately this pdoc doesn't automatically take me off the drug like the last one did (and I was in the hospital, psychotic and mania, within a few months). 

[dancesintherain]

it may be placebo effect becuse it was only 3 days at 20mg and one day at 40mg.  But it seems to be helping.  So I'll take it.

[jarn]

Placebo or not, it's working, which is great!!!!!

 

[dancesintherain]

thanks @jarn. Something's happening.  It's definitely not gone, but I'll take improvement as good nough for day four. 

[jarn]

It's very positive.  I take CBD for similar issues and it works so well I wonder if it's just me, but even if it is placebo, it's working for me.  Probably it's not placebo for either of us, but I'm glad you've found something that works for you.  

[dancesintherain]

thanks jarn--it's not gone, yet, but progress

[echolocation]

i'll bring this same question to my pdoc when i see her next, but i was wondering at what point should you be concerned about tremors. my hands have been shaking since i started taking clomipramine. i notice it most when i'm drawing as my lines have been coming out much more wiggly than they used to. it doesn't bother me much. is this the sort of thing where meds are an option if it becomes bothersome?

[Banana Smurf]

My hands have a tremor from lithium and I used to take propranolol for work because I kept dropping pills when I was passing them.  It can be a prn thing, too, if it is mild and only bothersome for some activities.  

[dancesintherain]

echo, I believe it's a situation where meds can help if needed, but I'm not 100% sure about whether propranolol helps with clomipriimine.  I'm just not sure enough about the mechanism.  But worth asking if it's having an impact.

thanks Banana Smurf.  It's bothersome and annoying, so I think it' for something daily rather than prn. 

[notloki]

On 5/6/2020 at 3:43 PM, Banana Smurf said:

I've taken klonopin, valium, propranolol, and benadryl, but I've mostly only had akathisia.  I have had this weird thing where my knees jerked, but it wasn't medicated, so I don't know what's effective for other movements.  

The benzos are not very effective treatments for EPS compared to the anticholinergics like propranolol, and benadryl. I prefer propranolol, for me it does not have the cognitive effects benadryl does.