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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by TrishP on November 22, 2006, at 10:58:24
Ok - this akathisia that the docs call it is driving me nuts! I love the AD effects of Abilify (only on 2mg!), but I feel jittery, hyper and inable to concentrate sometimes. I've been taking Benedryl and it first it helped. The Xanax doesn't help it.
If I try to go down to 1mg of abilify I get depressed again. I hate to change drugs after only 16 days! But I feel like I am going to rattle of my chair!
Posted by emme on November 22, 2006, at 11:58:19
In reply to Akathisia driving me nuts!, posted by TrishP on November 22, 2006, at 10:58:24
> The Xanax doesn't help it.
> If I try to go down to 1mg of abilify I get depressed again. I hate to change drugs after only 16 days!I agree that is awfully soon. This might fade. I wonder if a speck of Seroquel would take the edge off it while you're waiting to see if it passes. What else are you taking with it?
Posted by Phillipa on November 22, 2006, at 12:28:42
In reply to Re: Akathisia driving me nuts!, posted by emme on November 22, 2006, at 11:58:19
Does your Doc think it will go away or should you try something else? Love Phillipa
Posted by TrishP on November 22, 2006, at 13:04:11
In reply to Re: Akathisia driving me nuts!, posted by Phillipa on November 22, 2006, at 12:28:42
Doc thinks it will go away. She says to take more benedryl if needed. I took 2 of them today and it actually does work.
I am also taking Xanax 2x a day. I tried switching to Klonopin to see if that made a difference, but it didn't.
I'm sticking with it becuase it seems to be the only med in a long while that is working without really terrible side effects.
This side effect is making me nuts, but I'll deal with it and see if it goes away in the long run.
Posted by fenix on November 22, 2006, at 13:27:50
In reply to Re: Akathisia driving me nuts!, posted by TrishP on November 22, 2006, at 13:04:11
> Doc thinks it will go away. She says to take more benedryl if needed. I took 2 of them today and it actually does work.
>
> I am also taking Xanax 2x a day. I tried switching to Klonopin to see if that made a difference, but it didn't.
>
> I'm sticking with it becuase it seems to be the only med in a long while that is working without really terrible side effects.
>
> This side effect is making me nuts, but I'll deal with it and see if it goes away in the long run.From my experiences, it will probably not go away as long as you are taking it. Taking benadryl or a benzodiazepine for a while to help can actually make things more confusing simply because they will minimize the akathisia side-effects to the extent that you might think it has disappeared, when it actually still remains and can develop into a more severe form of it.
You think your akathisia is scary? Imagine having it 24/7 for 3 years. That is what I have had to go through so far. Heed my advice, you don't want to go down to that kind of a hell, get off of that drug slowly with your doctor and try something else.
Posted by TrishP on November 22, 2006, at 13:47:40
In reply to Re: Akathisia driving me nuts!, posted by fenix on November 22, 2006, at 13:27:50
> > Doc thinks it will go away. She says to take more benedryl if needed. I took 2 of them today and it actually does work.
> >
> > I am also taking Xanax 2x a day. I tried switching to Klonopin to see if that made a difference, but it didn't.
> >
> > I'm sticking with it becuase it seems to be the only med in a long while that is working without really terrible side effects.
> >
> > This side effect is making me nuts, but I'll deal with it and see if it goes away in the long run.
>
> From my experiences, it will probably not go away as long as you are taking it. Taking benadryl or a benzodiazepine for a while to help can actually make things more confusing simply because they will minimize the akathisia side-effects to the extent that you might think it has disappeared, when it actually still remains and can develop into a more severe form of it.
>
> You think your akathisia is scary? Imagine having it 24/7 for 3 years. That is what I have had to go through so far. Heed my advice, you don't want to go down to that kind of a hell, get off of that drug slowly with your doctor and try something else.
Do you think that Lamectil would do the same think? I really need a mood stabilizer that won't cause weight gain and doesn't have awful side effects. I don't do well on SSRIs either.
Posted by Quintal on November 22, 2006, at 14:55:52
In reply to Re: Akathisia driving me nuts!, posted by TrishP on November 22, 2006, at 13:47:40
Lamictal may work very well for you, especially since you have access to benzos if you need them for insomnia. I had akathisia with Abilify that did not respond to benzos, and Lamictal did not cause this problem for me. Lamictal does not cause akathisia but is sometimes 'activating', and many people find it a positive effect.
Q
Posted by blueberry on November 22, 2006, at 17:05:18
In reply to Akathisia driving me nuts!, posted by TrishP on November 22, 2006, at 10:58:24
You may want to study how abilify works and try to closely duplicate it with other meds. For example, a touch of zyprexa and a touch of a dopamine agonist and a touch of remeron.
Actually, you might want to try a touch of remeron first while still on abilify. I can't go into all the complexities here of why it could be helpful, just to say that there are clinical studies backing it up for akathisia.
I've been on zyprexa for 6 years. It did not cause akathisia in the first 3 years, but in the last 3 years it made itself known and was getting worse. I am on a long journey of slowing reducing dosage while adding in other things.
You doctor would probably not go along with it, but one thing I experimented with in 2005 that got rid of all the akathisia was 600mg Kira St Johns Wort.
Posted by Phillipa on November 22, 2006, at 19:42:21
In reply to Re: Akathisia driving me nuts!, posted by blueberry on November 22, 2006, at 17:05:18
Lamictal will be fine just get the starter pack and don't rush things. Love Phillipa
Posted by yxibow on November 23, 2006, at 1:53:08
In reply to Akathisia driving me nuts!, posted by TrishP on November 22, 2006, at 10:58:24
> Ok - this akathisia that the docs call it is driving me nuts! I love the AD effects of Abilify (only on 2mg!), but I feel jittery, hyper and inable to concentrate sometimes. I've been taking Benedryl and it first it helped. The Xanax doesn't help it.
>
> If I try to go down to 1mg of abilify I get depressed again. I hate to change drugs after only 16 days! But I feel like I am going to rattle of my chair!
Benzodiazepines are one choice for akathisia but probably require enough of a dose -- I don't know how much Xanax you take, but agents that tend to be more geared towards anti-spasmotic and anti-epileptic might help, such as Klonopin, Valium, and possibly Ativan.Benadryl is a rather harsh solution and not a refined drug generally used for long term anticholinergic therapy. Generally the most common anticholinergic used is Cogentin (benztropine), although it can be as groggy as Benadryl. I happen to prefer Akineton (biperiden), your pharmacy depending on their stock may have to special order it although it is still in definite use. Otherwise there is Artane (trihexiphenidyl).
Another possible solution is propranolol or any of the non-cardioselective beta blockers, but again, a dose more than just a 10 mg "stage fright" dose may be necessary -- thats up to your doctor.
I sympathize with your struggle on Abilify -- it was an agent I thought would be better in terms of akathisia because of its partial agonism but it has proven to be as strong as Geodon for some of those who experience akathisia badly (I assume you've tried Geodon.)-- Jay
Posted by ace on November 24, 2006, at 21:11:36
In reply to Akathisia driving me nuts!, posted by TrishP on November 22, 2006, at 10:58:24
> Ok - this akathisia that the docs call it is driving me nuts! I love the AD effects of Abilify (only on 2mg!), but I feel jittery, hyper and inable to concentrate sometimes. I've been taking Benedryl and it first it helped. The Xanax doesn't help it.
>
> If I try to go down to 1mg of abilify I get depressed again. I hate to change drugs after only 16 days! But I feel like I am going to rattle of my chair!I'm so sorry to here this. I personally have suffered akathisia and it is indeed tormenting.
I stongly suggest the administration of Cogentin.
I had akathisa on Abilify and Benzo's, even the great muscle relaxant, Valium, did not ameliorate my symptoms.Stick with the Abilify a bit longer if it is helping and see how it pans out.
I'm sorry I can't offer more advice at the moment.
Ace
Posted by mindevolution on November 28, 2006, at 22:05:42
In reply to Re: Akathisia driving me nuts! » TrishP, posted by ace on November 24, 2006, at 21:11:36
> > Ok - this akathisia that the docs call it is driving me nuts! I love the AD effects of Abilify (only on 2mg!), but I feel jittery, hyper and inable to concentrate sometimes. I've been taking Benedryl and it first it helped. The Xanax doesn't help it.
> >
> > If I try to go down to 1mg of abilify I get depressed again. I hate to change drugs after only 16 days! But I feel like I am going to rattle of my chair!
>
> I'm so sorry to here this. I personally have suffered akathisia and it is indeed tormenting.
>
> I stongly suggest the administration of Cogentin.
> I had akathisa on Abilify and Benzo's, even the great muscle relaxant, Valium, did not ameliorate my symptoms.
>
> Stick with the Abilify a bit longer if it is helping and see how it pans out.
>
> I'm sorry I can't offer more advice at the moment.
> Ace
>
> be carefull about congentin, it can cause major mental problems such as severe confusion, toxic psychosis, coordination problems and worsening of mental state.
http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20(General%20Monographs-%20C)/COGENTIN.htmlI know I still suffer the side effects from only 2 tablets 4 months ago. Anticholinergics are the least enjoyable drugs available.
I would recommend a really low dose of the sedating antidepressant mirtazapine. I mean a dose of say 7.5mg so you can avoid the side effect of weight gain. only up the dose it if you get no relief.
so try the nicer drugs first like the antidepressants such as mirtazapine, beta blockers, Clonidine, valium and opiates. then try the harsher drugs like cyproheptadine, adamantadine, and anticholinergics last like benztropine or biperiden.
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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