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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by ed nieg on March 9, 2019, at 20:35:53
Can someone with a background in psychiatry explain the clinical presentation of this disorder? I took olanzapine for a total of 6 months more than 5 years ago and it gave me anhedonia, which has continued until now. There is no 'mood' component, just an inability to feel pleasure. I've recently begun wondering if I may have tardive akathisia in addition to the permanent emotional effects I suffered from taking these meds. It seems like I can never truly relax or wind down, like it's uncomfortable/unpleasant just to sit.
However, I'm curious if with tardive akathisia there must be a motor component along with the subjective to necessitate a diagnosis. I don't really feel a compulsion to move other than the general discomfort I experience all the time and there's definitely no myoclonus or fidgeting or anything like that. I'm also very confused about the treatment recommendations for this disorder, which state to reintroduce the offending agent (!), I haven't seen research substantiate this and if it's entirely based on clinical experience and empirical observation it's frankly b*llsh*t. I'd rather die before taking another antipsychotic, and I'm sure many people feel the same. Anyways... sorry for that tangent.
Posted by LarsHoney1 on March 10, 2019, at 9:54:34
In reply to Tardive Akathisia from Antipsychotics, posted by ed nieg on March 9, 2019, at 20:35:53
Ive experienced that restlessness you refer to. When I too Halsol at 5mg I felt horrible. Couldnt figure out if I wanted to lay down, sit or stand. Felt so bothered inside. This is indeed Akithisia. It seems certain parts of psychiatry only recognize the movement aspect of it. Their education seems to ignore the enotionak part, as well. But Akithisia has been connected to the Suicidal and Homicidal thoughts/actions these meds induce, in some cases. So maybe they down mpkaybthe severe emotional aspect of Akithisia to keep burriedvtge fact these meds can induce Homicidal thoughts.
My Akithisia subsided after the dose wore off. So I never tried any medication for it. But I expect youve Googled treatments for it already. If not, this article mentions some:
https://www.healthline.com/health/akathisia#causes-and-risk-factors
Im sorry youre having to deal with this
Posted by Christ_empowered on March 10, 2019, at 10:15:06
In reply to Tardive Akathisia from Antipsychotics, posted by ed nieg on March 9, 2019, at 20:35:53
hi. im not an expert by any stretch of the imagination, but I've done some research into the "other" tardive syndromes, including tardive akathisia.
opioids apparently can help. benzodiazepines. as with so much in psychiatry, its all about palliatives and behavioral control. a couple case studies i read over mentioned Remeron, but that was for aripiprazole-induced tardive akathisia. gabapentin, lyrica. switch to a different agent, with the goal of suppressing the symptoms.
sometimes...this was more with TD, but I seem to recall reading about it in a patient with akathisia upon discontinuing clozapine (which, btw, is actually a big deal, it seems...surprisingly common, really freakishly intense, too...) was to switch to quetiapine, then gradually taper the quetiapine. something about "normalizing" messed up brain receptors (?). I don't know.
from reading over your posts, my thought was more along the lines of 'tardive dypshoria.' just as the neuroleptics can -induce- psychosis in the previously unafflicted (from being tranquilized for personality disorder, off label for sleep and agitation, non-psychotic depression and/or mania, etc.), so too can the "antidepressants" cause depression, make depression more severe, and create brain changes that make a person who once did a-OK on, say, 20mgs of Prozac turn "treatment resistant" and require a mini-cocktail to feel ok.
I wish I could offer something in terms of fixing it. Personally, since I'm stuck on aripiprazole, I've been doing a DIY Orthomolecular protocol with "standard treatment." So far, this seems to have protected against both EPS and TD (0 tics, 0 tremor, etc....10 years into daily treatment @ 15-30mgs/day) and I also find that I have far less impaired concentration, dysphoria, the general "antipsychotic suck" -type reactions.since you don't seem to require a neuroleptic, maybe you could try an Orthomolecular protocol or other potentially helpful supplements, without the psych drugs on board?
taurine has been studied with ongoing 'atypical antipsychotic' treatment. at 4 grams/daily, it seems to hasten response, improve scores in all the tests the shrinks use...
and some evidence suggests a reduction in the risk of TD. Taurine has other uses in "alternative health," too...
helping stabilize mood, lowering anxiety levels, helping cardio-issues, etc. like most (all?) amino acid supplements, one would be well advised to take it on an empty stomach.
amino acids are not part of traditional Orthomolecular protocols...the more old school OM literature, especially dealing with psych issues, is geared more towards B3, antioxidant vitamins (C, E, beta carotene, etc.), minerals. I've personally gotten better results from going above 10 grams/daily with time release vitamin C and pushing the B3 dosage (I personally prefer niacinamide) above 3 grams/daily, but...
4 grams/taurine daily might be a relatively easy, fairly inexpensive way to "test the waters." just a thought.
Posted by ed nieg on March 10, 2019, at 18:35:15
In reply to Re: Tardive Akathisia from Antipsychotics, posted by Christ_empowered on March 10, 2019, at 10:15:06
> hi. im not an expert by any stretch of the imagination, but I've done some research into the "other" tardive syndromes, including tardive akathisia.
>
> opioids apparently can help. benzodiazepines. as with so much in psychiatry, its all about palliatives and behavioral control. a couple case studies i read over mentioned Remeron, but that was for aripiprazole-induced tardive akathisia. gabapentin, lyrica. switch to a different agent, with the goal of suppressing the symptoms.
>
> sometimes...this was more with TD, but I seem to recall reading about it in a patient with akathisia upon discontinuing clozapine (which, btw, is actually a big deal, it seems...surprisingly common, really freakishly intense, too...) was to switch to quetiapine, then gradually taper the quetiapine. something about "normalizing" messed up brain receptors (?). I don't know.
>
>
> from reading over your posts, my thought was more along the lines of 'tardive dypshoria.' just as the neuroleptics can -induce- psychosis in the previously unafflicted (from being tranquilized for personality disorder, off label for sleep and agitation, non-psychotic depression and/or mania, etc.), so too can the "antidepressants" cause depression, make depression more severe, and create brain changes that make a person who once did a-OK on, say, 20mgs of Prozac turn "treatment resistant" and require a mini-cocktail to feel ok.
>
>
>
>
> I wish I could offer something in terms of fixing it. Personally, since I'm stuck on aripiprazole, I've been doing a DIY Orthomolecular protocol with "standard treatment." So far, this seems to have protected against both EPS and TD (0 tics, 0 tremor, etc....10 years into daily treatment @ 15-30mgs/day) and I also find that I have far less impaired concentration, dysphoria, the general "antipsychotic suck" -type reactions.
>
> since you don't seem to require a neuroleptic, maybe you could try an Orthomolecular protocol or other potentially helpful supplements, without the psych drugs on board?
>
> taurine has been studied with ongoing 'atypical antipsychotic' treatment. at 4 grams/daily, it seems to hasten response, improve scores in all the tests the shrinks use...
>
> and some evidence suggests a reduction in the risk of TD. Taurine has other uses in "alternative health," too...
>
> helping stabilize mood, lowering anxiety levels, helping cardio-issues, etc. like most (all?) amino acid supplements, one would be well advised to take it on an empty stomach.
>
> amino acids are not part of traditional Orthomolecular protocols...the more old school OM literature, especially dealing with psych issues, is geared more towards B3, antioxidant vitamins (C, E, beta carotene, etc.), minerals. I've personally gotten better results from going above 10 grams/daily with time release vitamin C and pushing the B3 dosage (I personally prefer niacinamide) above 3 grams/daily, but...
>
> 4 grams/taurine daily might be a relatively easy, fairly inexpensive way to "test the waters." just a thought.
>
>The only "orthomolecular" thing I've been doing is taking a fish oil/vitamin d supplement. I agree my symptoms are maybe more adequately explained by tardive dysphoria because, well, I'm always dysphoric and anhedonic. I've had acute akathisia from neuroleptics before and that form of inner restlessness was maybe a 9 or 10 on the pain/suffering scale while the type of restlessness I currently experience is more a 2 or 3. It's so subtle that I'm not sure if I hadn't already jumped down the research rabbit hole on the interwebs that I would even give it much thought. Now that I've read about it I notice it more, haha. I think it's worse when I'm trying to sleep.
Posted by Christ_empowered on March 10, 2019, at 19:22:25
In reply to Re: Tardive Akathisia from Antipsychotics, posted by ed nieg on March 10, 2019, at 18:35:15
hi. im fond of orthomolecular because its helped me minimize the # of psych drugs, keep the dosage in line, and avoid TD, neuroleptic induced dysphoria, etc. and also...
using a psych drug to counter the ill effects of another psych drug is not a good idea, long term, because -all- psych drugs 'work' by disrupting the way your brain would function without chemicals. basically...
its adding a whole, additional level of drug-induced 'chemical imbalance' to the mix. that's what i like about the orthomolecular...the idea is that the human body can process these vitamins, even at massive doses, safely. one might even get 'side benefits,' instead of 'side effects' (adverse effects) from xenobiotics.
it isnt drugs vs OM. standard OM treatment often involves carefully selected drugs with an eye towards low to moderate dosages and possible discontinuation, when and if appropriate.
but...yeah...'tardive dysphoria.' its lame. could be worse. 'tardive dementia' involves loss of IQ and a decline in overall cognitive functioning, and it often goes hand in hand with tardive dyskinesia. :-(i hope you can get your mojo back.
This is the end of the thread.
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