Posted by psychobot5000 on November 21, 2013, at 9:38:47
In reply to Re: Akathisia remedies -microupdate, posted by sigismund on November 14, 2013, at 21:59:23
> Anticholinergics and benzos?
Definitely good, solid ideas, IMO. For whatever reason, though (and I've checked, and my profile seems to fit acute akathisia rather than tardive, aside from this detail), anticholinergics (mostly Benadryl, so far, which, so far as I know, is a pretty standard anticholinergic when taken in slightly excessive doses.) seem to provide very limited relief.
The dirty secret about all this, of course, is that Benzos DO work (clonazepam and alprazolam both, in my case), but I'm not sure they're a permanent solution. The body readjusts to benzos so effectively...in my experience you definitely need dose-escalation to maintain its effect. And that's just a path into hell, let's face it--i.e. when you eventually have to come down off those benzos. But in the short term, I believe they're an excellent fudge...you just can't get dependent on large doses of them. Maybe some patients will be able to take relatively modest doses and continue to get some benefit, who knows.
Right now, I'm looking into cyproheptadine, as it seems to me a much less hardcore med than lyrics/pregabalin (those are the same, right?). Cypro is an antihistamine, true, which isn't great, but it seems to me that it's at least worth giving it's 5HT-2 modulating properties a chance to do their thing. Might even have some other ancilliary benefit...who knows. But it seems a damn sight less risky (and better understood) than something like Lyrica, which I sort of expect, as an antispasmodic, to cause various nasty side-effects in brain function, once your body gets used to it. I have an appointment with my doctor next Tuesday. We'll just see how that goes, then, I guess.
poster:psychobot5000
thread:1054385
URL: http://www.dr-bob.org/babble/20131115/msgs/1054718.html