Posted by Ritch on June 27, 2003, at 23:20:51
In reply to Re: Why dopaminergic for RLS but not for akathisia? » Ritch, posted by MB on June 27, 2003, at 13:35:32
> > I've had "for real" (indisputable) akathisia from antipsychotics (Haldol, esp.) before (that involves the extrapyramidal involuntary muscle stuff), and it is DIFFERENT from the "foot-wiggler" type of RLS that you mention (which I also experience to various degrees along with other family members with and WITHOUT meds being a *cause*). I think RLS and akathisia are two different *symptoms*. They may be connected by some common pathways, but they are different.
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> Can you describe the subjective feeling of the neuroleptic induced akathisia? What was the restlessness *like*? Is it true that there is no dysesthesia with it? Have you ever felt "restless" from an SSRI...if so was it different than the antipsychotic restlessness?
The akathisia I got from Haldol happened within an hour of taking it. I couldn't sit still-it wasn't a restlessness while you are sitting kind of thing-it was have to get up and move around constantly with no RELIEF-no matter where I moved to. I remember climbing on top of stuff-cabinets, a stove, all sorts of things trying to alleviate that feeling and it didn't work. UGH, I've never felt anything like it since. I have gotten "shuffles" from SSRI's, but the difference was that moving around constantly made me feel better. I DIDN'T FEEL BETTER with AP-induced akathisia, but HAD TO continue to move regardless-it was torturous. I didn't feel tortured with the SSRI stuff-just felt a need to boogie about and felt good doing it.
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> Back in my partying days, I remember doing some cocaine and being unable to sit still. I had to keep moving. I had to be doing *something*. If I sat, I'd get horribly anxious so I'd pace, and straighten the books on the shelf, and wipe off the counter top, and walk down the block, etc. *However*, there was no *physical* unpleasantness that kept me moving, it was psychological. I wonder if this is what "for real" akathisia is like.Sounds similar to AP-akathisia in the sense of "horribly anxious".
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> In the past, you mentioned that Mirapex might not be helping my RLS/(akathisia?) because of it's preference for D3 receptors, and that a dopaminergic with a different ratio of receptor affinity might help. I briefly tried Pergolide years ago, and don't remember it helping much. I started abusing opiates soon after that, and found no use for something as yucky as Pergolide when the lovely (so I thought) opiates did such a better job alleviating the RLS (along with the OCD and the anxiety and the depression). It didn't help me much in the department of setting and achieving life goals, however. I was quite a sloth. But a *content* sloth.
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> Well, I'm back on the wagon and must fall back on remedies that don't involve breaking the law.
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> MB
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I think clonazepam and *avoidance* of meds that *trigger* akathisia would be the first things I could suggest.
poster:Ritch
thread:237227
URL: http://www.dr-bob.org/babble/20030624/msgs/237614.html