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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by MB on January 25, 2002, at 17:32:12
I've had bouts of Restless Leg Syndrome since birth. I remember sitting in my crib completely beside myself with this itching, agitating feeling in my muscles that not only compelled me, but *forced* me to wiggle and writhe. Certain things make it worse. Antihistamines make it unbearable. Neuroleptics also make it worse. SSRIs don't seem to hurt at first, but later cause the akathisia (which I guess is the name for drug induced/exacerbated restless leg syndrome).
Right now I take fluoxetine, Neurontin, Klonopin, and Adderall. From past experience, I know that the fluoxetine is the culprit. My queston is this: would SERZONE be a better choice of antidepressant? I heard that because it blocks a certain seratonin receptor it prevents dopamine depletion in the brain region responsible for akathisia. I need help. The old "jimmy-leg" is driving me absolutely bonkers.
MB
HELP
Posted by Ritch on January 26, 2002, at 0:26:00
In reply to ADs, RLS, and akathisia--Help (Elizabeth,Cam,TSA)?, posted by MB on January 25, 2002, at 17:32:12
> I've had bouts of Restless Leg Syndrome since birth. I remember sitting in my crib completely beside myself with this itching, agitating feeling in my muscles that not only compelled me, but *forced* me to wiggle and writhe. Certain things make it worse. Antihistamines make it unbearable. Neuroleptics also make it worse. SSRIs don't seem to hurt at first, but later cause the akathisia (which I guess is the name for drug induced/exacerbated restless leg syndrome).
>
> Right now I take fluoxetine, Neurontin, Klonopin, and Adderall. From past experience, I know that the fluoxetine is the culprit. My queston is this: would SERZONE be a better choice of antidepressant? I heard that because it blocks a certain seratonin receptor it prevents dopamine depletion in the brain region responsible for akathisia. I need help. The old "jimmy-leg" is driving me absolutely bonkers.
>
> MB
>
> HELPHi MB,
Wow, you are on two of the four meds I am now on. Also, you are taking some Adderall which helped the most for my ADHD and didn't cause any cycling. I am on low-dose Celexa instead of Prozac and I can't handle much of any SSri without akathisia as well. What about just reducing your Prozac dose? Anything above 5mg/day made me very agitated. But lower doses helped my sociability.
Mitch
Posted by Noa on January 28, 2002, at 17:37:26
In reply to ADs, RLS, and akathisia--Help (Elizabeth,Cam,TSA)?, posted by MB on January 25, 2002, at 17:32:12
I am interested in this line of questions too. Not just for the akithisia effects but other effects of serotonin, like tight jaw muscles, bladder problems, etc. Do you know if this serotonergic-dopamine antagonism process affects any of these issues?
Should I be looking at dopamine agonists?
What about wellbutrin--how does it rate in this regard?
Thanks.
Posted by Ritch on January 28, 2002, at 23:27:32
In reply to Re: ADs, RLS, and akathisia--Help (Elizabeth,Cam,TSA)?, posted by Noa on January 28, 2002, at 17:37:26
> I am interested in this line of questions too. Not just for the akithisia effects but other effects of serotonin, like tight jaw muscles, bladder problems, etc. Do you know if this serotonergic-dopamine antagonism process affects any of these issues?
>
> Should I be looking at dopamine agonists?
>
> What about wellbutrin--how does it rate in this regard?
>
> Thanks.
Hi Noa,All I have found out (with BP and ADHD, etc.) is that receptor *specific* meds don't help me very much. DA agonists (pergolide and pramipexole) both just made me nauseous, sleepy, and weird. DA antagonists (thioridazine, atypical AP's) caused dystonia, depression, and EPS, NE antagonists (Remeron, Buspar) caused hostility. 5-HT2x antagonists (Serzone, Remeron) just made me confused-although my IBS was better and I had no heartburn. It has just has been easier for me to use monoamine reuptake inhibitors and carefully adjust the dosage. I liked Zoloft (because of the dual 5-HT and DA reuptake inhibition), but it is too lopsided and blocks the serotonin transporters too excessively. Also, Zoloft "gets into your motor circuits" a lot and does cause a lot of jaw-clenching and teeth grinding and more. I would like to get away from SSri's (for GI upset reasons, esp.), but just can't seem to. Maybe there will be some new stuff soon that won't cause all of these problems-"a tolerable SSRI??".
Mitch
Posted by MB on January 29, 2002, at 10:56:17
In reply to ADs, RLS, and akathisia--Help (Elizabeth,Cam,TSA)?, posted by MB on January 25, 2002, at 17:32:12
I ran my Serzone theory by my pdoc last night. He said (in regards to RLS and akathisia), "Well, its not quite as simple as that, but we can give it a try." He is more convinced than ever that I'm bipolar. He says I am a tough case. I feel like I am in good hands because he really seems to know his stuff. He's the first pdoc I've run accross who knows all the different receptors and what they do and what active metabolites do what and how they inhibit this enzyme or that. He's a smart guy. If *he* can't fix me, I'm screwed.
Anyway, start serzone tonight. Sometimes I wonder if I was just better off drinking Yukon Jack and smoking weed. Sheesh... (partially tongue in cheek, partially not).
MB
Posted by therese desqueroux on January 30, 2002, at 18:28:26
In reply to ADs, RLS, and akathisia--Help (Elizabeth,Cam,TSA)?, posted by MB on January 25, 2002, at 17:32:12
I've taken combinations not unlike yours. In the past, the fluoxetine was the culprit. This time, the stimulant, in your case, Adderall, was the guilty party. I stopped taking it for a couple of weeks and then restarted it because I was feeling too groggy in the a.m. My RLS has virtually disappeared.
Hope you find some relief soon.
> I've had bouts of Restless Leg Syndrome since birth. I remember sitting in my crib completely beside myself with this itching, agitating feeling in my muscles that not only compelled me, but *forced* me to wiggle and writhe. Certain things make it worse. Antihistamines make it unbearable. Neuroleptics also make it worse. SSRIs don't seem to hurt at first, but later cause the akathisia (which I guess is the name for drug induced/exacerbated restless leg syndrome).
>
> Right now I take fluoxetine, Neurontin, Klonopin, and Adderall. From past experience, I know that the fluoxetine is the culprit. My queston is this: would SERZONE be a better choice of antidepressant? I heard that because it blocks a certain seratonin receptor it prevents dopamine depletion in the brain region responsible for akathisia. I need help. The old "jimmy-leg" is driving me absolutely bonkers.
>
> MB
>
> HELP
Posted by MB on January 31, 2002, at 1:34:33
In reply to Re: ADs, RLS, and akathisia--Help (Elizabeth,Cam,TSA)?, posted by therese desqueroux on January 30, 2002, at 18:28:26
> I've taken combinations not unlike yours. In the past, the fluoxetine was the culprit. This time, the stimulant, in your case, Adderall, was the guilty party. I stopped taking it for a couple of weeks and then restarted it because I was feeling too groggy in the a.m. My RLS has virtually disappeared.
>
> Hope you find some relief soon.So are you saying that Adderall worsens restless leg syndrome or makes it better? It seems that since it increases dopamine, it might help RLS. This is all confusing. Would a different stimulant (Desoxyn, Dextroamphetamine, etc.) cause less restless leg syndrome? I've quit the Prozac (fluoxetine) and feel better already. Also: NO CAFFEINE WHATSOEVER!!!
MB
MB
This is the end of the thread.
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