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akathisia or anxiety? (seroquel XR)

Posted by order and chaos on March 26, 2011, at 13:52:50

I've gotten akathisia from other atypical antipsychotics - including abilify, geodon, and risperdal. Within a few days of starting them (in hospital setting), I felt like I was going to jump out of my skin, and I couldn't stop pacing back and forth through the hallways. Cogentin didn't help at all. I thought seroquel caused less EPS than the other meds in that class, and that was my experience in the past.

Now, I've been on seroquel for a few years - at first 400-600mg of the immediate release kind, and there was no akathisia. I switched to the XR form so I would have a more even amount in my system, and it helped w/that and daytime sleepiness. So I have been on 400mg for 6 months or so (again, no akathisia), but recently my mood crashed, along w/increased anxiety/agitation, and some delusional thinking (but I caught it early so I had some insight and sought help).

Over a period of a month or so, 200mg of immediate release was added to the 400, and then I switched to 600mg XR to smooth it out again. Anyway, ever since a relative mentioned akathisia, I've been obsessing over it (I have OCD and bipolar disorder) - going back and forth between whether or not I'm anxious/activated (I tend to have more agitated/mixed depression, w/racing thoughts,etc), or if it's medication induced, since I haven't been on 600mg in 2 years. I feel like I want to jump out of my skin, and have internal tension, but I don't have to pace at all, and can sit through 2 hour lectures, though I do bite my cheeks more than usual. So now it's a self-fulling prophecy - the more I obsess over whether or not this is anxiety or akathisia, the worse the symptoms get. Is the only way to tell would be to go back down to 400mg (although even if I didn't have akathisia in the 1st place, placebo effect could make it seem better upon changing...)

Thanks! (and sorry for rambling...)


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poster:order and chaos thread:981197
URL: http://www.dr-bob.org/babble/20110321/msgs/981197.html