Posted by SLS on July 22, 2005, at 8:59:36
In reply to Re: EXACTLY, posted by Mistermindmasta on July 22, 2005, at 0:12:17
> Just want to point out that myself and several others agree that akasthisia is EXTREMELY underreported in the literature.This is surely true. I don't think many doctors would recognize an inner tension as akathisia if it weren't accompanied by the patient rocking in a chair or pacing or shifting weight from one foot to the other while standing. However, I am *sure* that the appearance of akathisia is not necessary for the provokation by an antidepressant suicidal ideation. I have had several antidepressants make me feel worse. It is as simple as that. Depending on where I am at psychologically at the time, this might be all that is needed to push me over the edge. It does seem that an increase in anxiety does contribute to suicidality. Prozac in particular, but other drugs too, produce anxiety early in treatment.
> However, I think another part to this suicide thing is that some people can become more impulsive / agressive while on SSRI's, if they happen to have a certain brain circuitry predisposition.
Your description of an increase in impulsivity and agression evolving with antidepressant treatment figures very prominently in the evolution of suicidality. JJ Mann, MD has done quite a bit of work in this area. These are things that can occur in the absence of akathisia. So, we have more than one route by which SSRIs can provoke suicidality. It is paramount that psychiatry recognize this and develop a strategy to identify it and treat it when it happens.
- Scott
poster:SLS
thread:530027
URL: http://www.dr-bob.org/babble/20050718/msgs/531473.html