Posted by yxibow on December 1, 2007, at 2:08:18
In reply to Re: Tardive Akathisia and Opiates, posted by fenix on November 30, 2007, at 14:29:44
> > > > > The biggest problem with Tardive Akathisia is the sheer physical pain. It only makes sense to me that opiates are considered.
> > > > >
> > > >
> > > > First of all you have to get a diagnosis from a neurologist, that's rather important. Then you need a psychiatrist who has a sub-"degree" in addiction specialization. They're far more likely to consider your case as they have taken the training. Malpractice insurance has shied a fair amount of psychopharmacologists away from opiates and barbiturates because of the risk of death, allergic reaction and extreme habituation.
> > >
> > > I got a diagnosis from a neurologist stating that it is probably tardive akathisia over a year and a half ago.
> >
> >
> > I'm sorry it was confirmed, then get that doctor's files if he is still around and have him route you to an appropriate doctor or your GP do so, if you have an HMO system, or however it works.
> >
> > Addiction specialist psychiatrists are much more likely to prescribe bupenorphine because they do so in their regular practice. Have a consultation with one.
> >
> > Two, if you're not happy with one, but don't start first into the office and say "I want drug X" -- no competent MD unfortunately is going to do that, they have to assess your current medications and make sure you're not drug seeking.
>
> I have a copy of the paper my neurologist wrote to my GP that mentions the akathisia. I don't know if this matters or not but the paper (which I don't have with me right now so I can't recall precisely) also mentions stuff about iron and the possibility of restless-leg syndrome, however, it stated basically that it is most likely akathisia given the symptoms I mentioned and the fact that I was taking APs when it happened. Unfortunately, what I have is very subjective.
>
> At the moment my GP is prescribing me diazepam for this, I've been taking it now for over a year and a half and I know it isn't the best treatment for it, however, it does help somewhat and the side-effects aren't bad. Also, it is actually the only drug I have been on for along time as, again, what I have is tardive and it has lasted for almost 4 years now even though I stopped taking the psychiatric medication which seemed to cause it.
>
> Thanks for the advice but I'm not familiar with addiction specialist psychiatrists. I also really don't know if I should just see my GP first and get referred somewhere which would probably take a while or if I should just make an appointment my self with a psychiatrist of some kind, which would also probably take a while.Probably get referred with your GP if you're not satisfied with the palleative results from diazepam. You will eventually habituate to either, that's just unfortunately how it works. When, is anybody's guess, it could be months or hopefully many years.
Addiction medicine specialists are just one type of psychiatrist, e.g. psychopharmacologist -- they have taken the equivalent of a full residency or CE credits to both diagnose people who have true addiction problems and also have mental illness and also have a special license to prescribe things like bupenorphine so they don't lose their ability to practice medicine. Otherwise, they're psychiatrists like any other.
poster:yxibow
thread:797126
URL: http://www.dr-bob.org/babble/20071125/msgs/798033.html