Psycho-Babble Medication Thread 1112287

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Akathisia, meds , Pseudo-Parkinson and help pls.:(

Posted by jay2112 on October 17, 2020, at 5:34:10

(Warning SI and triggers.._

Well, I went to the neurologist today. (He is an awesome doctor and nice person.)

This was my second visit. We talked about my many years of psych meds. One revelation that I made is my current hyper-anxiety (which has resulted in psychois...I am bp2)...and even though that nice little book, DSM, doesn't make any connection between psychosis and *SEVERE* anxiety, there is. It is almost prodromal. (Precipitates). Especially for me. The odd thing is, after 25+ years of antipsychotic trial failures, I have now found one (and I hope this doesn't jinx me ), but Latuda, about a month in my being on it, has, for once in almost 20 years, has actually removed about 80 or so percent of my deep, primal psychotic fear. I used to be not even barely fathom leaving the apartment, never mind holding a job, and I would lay in bed, staring at everything...the wall for 10 munutes...the ceiling for another 10...or I would sleep...20 hour marathons. Everything was just decay, sad, terrifying. Traditional mood-stabalizers were almost a joke. They plunged me into horrifying despair. Besides Latuda, only one other drug has really helped me..Lyrica, which is used in bipolar, and is absolutely the most pleasant drug (for me anyways), because it MELTED most anxieties. But, I became tolerant to it :(

Lyrica was what the benzo's used to do...allow me to relax. But, I also too became tolerant to benzo's quite quickly.

So, my neuro said I was showing signs, that all seemed to start years ago, of pseudo-Parkinson's disease. My muscles are always so, so sore and very stiff...I have the 'mask' blank-face stare...I have no balance (I now can't even ride a bike), have the trembles constantly, the only think (olfactory) I can smell is what hovers like a foul smell of gasoline...everyday..every minute..every second..and barely blink my eyes..and, even in 100 degree heat, am freezing cold,,(He had done all the tests with me, too) Plus, my anxiety (besides being psychotic at times) is so intense, I have nearly killed...HAVE pushed strangers in lines (lucky I didn't get arrested).. often, just yell out obscenities in public...and like I said, leave the house maybe once a week for food, or an appointment...most other times, laying in bed, frozen.

Almost all antidepressants have, consistently, brought me right back to psychotic fear. So..like I said though...only two meds have worked...Lyrica
and now, Latuda. (L words..lol.) BUT, Lyrica as I said, I am pooped out with.

So, I want to try some alternatives. I don't know who else has the same dx, but with Latuda, and I won't drop that med as it is the on;y one to significantly help. Taurine has helped like Lyrica...but Taurine also pooped out. Sacrosine?? Help...

So, of I stay on those two meds (Like I said, the Lyrica pooped out..)

 

Re: Akathisia, meds , Pseudo-Parkinson and help pls.:(

Posted by linkadge on October 17, 2020, at 15:38:10

In reply to Akathisia, meds , Pseudo-Parkinson and help pls.:(, posted by jay2112 on October 17, 2020, at 5:34:10

Sounds a bit complicated...

Parkinson's and psychosis are treated with very different meds (dopamine enhancers vs. blockers). I'm assuming you've tried the partial agonist antipsychotics (like abilify)? For natural treatments for anxiety, I like niacin, magnesium and omega 3. I also use cannabis (more so CBD in particular) which agrees with me. Pure CBD has antianxiety, anticonvulsant and antipsychotic effects. Regular weed (usually low in CBD) is no indication of how CDB works.

Have you tried mirtazapine?

 

Re: Akathisia, meds , Pseudo-Parkinson and help pls.:( linkadge

Posted by jay2112 on October 17, 2020, at 17:21:47

In reply to Re: Akathisia, meds , Pseudo-Parkinson and help pls.:(, posted by linkadge on October 17, 2020, at 15:38:10

Thanks Linkadge. Yep, I have tried most antipsychotics..typical and atypical. Abilify was the most wretched experience...it's like the agonism and antagonism are playing tug-of-war in the brain.
And the akathisia was the absolute worst..like a form of human torture. (For me, anyways.) Latuda is definitely the best one I have been on. That prison of ice-cold fear, of even my own shadow, has for the first time in a few decades, brought me back to a kinder, gentler reality.

I just wanted to underscore that my neurologist felt my symptoms were pseudo parkinson's, quite possibly from a few of my meds, as he has had quite a few similar cases. So, it's not a Parkinson's diagnosis, just the possibility we might have to change up a med or two, and observe over the long term. My aunt and my great-grandmother both had Parkinson's. He said we won't touch the Latuda, as I said, it brought me back to reality. He was a bit concerned about the antidepressants, and my former use of stimulants, may have slightly altered both my serotogenic and dopamine pathways.(He did not make a co-relation, directly, though, as he said psych meds, at therapeutic doses used, are actually neuro-protective.) I have had a few MRI's and CAT scans, and he said previously that "..all seems fine under the hood." LOL. I have tried almost every psych med out there.

I am on Latuda, Effexor, clonazepam, Lamictal, 25 mg of Remeron at bed, and .5mg of risperidone as a PRN. Interesting thing about Effexor...he said there is a bit of a controversy on it's effects on norepinephrine, that it is a fair bit weaker on norepinephrine than thought...even with the dose escalation.(I'd have to look up the references.)

So, we may try an anti-cholinergic (but no additional antidepressants, till we figure this out.) and a small dose of a dopamine agonist..but we will decide when we meet next week. He is just afraid of the psychosis.

And, I tried CBD, a few times, and it was just like a placebo. Surprisingly, cannabis is hit and miss, but I don't want to chance psychosis. One med that works *really* well is Lyrica..even way better than benzo's for for anxiety, and help's with depression too. But, I developed tolerance, and maxed it right out. Same with gabapentin.

So, that is where I am at. The Latuda was a huge game-changer for me. Seroquel, which also acts as a weak partial dopamine agonist, and Zyprexa (which I maxed out) really bring on heavy, heavy depression, me being BP2. Zyprexa almost made me OCD...I think because of antagonism at one of the serotonin receptors.

One thing I really don't understand in the research, is that they should try more specific-site serotonin receptors, combined with adrenal blockage...or more specific norepinephrine antagonists. It seems like clozapine does a lot of this, and about the agranulocytosis risk, it being only about 1 percent, and in some European countries, is only test for monthly, after being on the med for awhile.

 

Re: Akathisia, meds , Pseudo-Parkinson and help pls.:(

Posted by undopaminergic on October 18, 2020, at 3:04:31

In reply to Akathisia, meds , Pseudo-Parkinson and help pls.:(, posted by jay2112 on October 17, 2020, at 5:34:10

>
> So, I want to try some alternatives. I don't know who else has the same dx,

I would say I do have bipolar 2, but since some of my episodes resulted in hospitalisation, it is classified as bipolar I.

I'm a bit apathetic, but I have no anxiety.

> but with Latuda, ...

I'm interested in trying that.

-undopaminergic

 

Re: Akathisia, meds , Pseudo-Parkinson and help pls.:(

Posted by undopaminergic on October 18, 2020, at 3:25:25

In reply to Re: Akathisia, meds , Pseudo-Parkinson and help pls.:( linkadge, posted by jay2112 on October 17, 2020, at 17:21:47

>
> And, I tried CBD, a few times, and it was just like a placebo. Surprisingly, cannabis is hit and miss, but I don't want to chance psychosis. One med that works *really* well is Lyrica..even way better than benzo's for for anxiety, and help's with depression too. But, I developed tolerance, and maxed it right out. Same with gabapentin.
>

I suggest you try a few opioids. First, you just make an experiment, to see if it helps at all. Then, if the experiment was successful, you take it on an occasional basis, suitably when the anxiety is particularly bad. Then, if necessary, you can take it on a more regular basis, but you need to be careful about the tolerance. Because the clinically available opioids are subtly (and sometimes notably) different, it is important to try several different ones. As I mentioned, they differ, and therefore, cross-tolerance is incomplete; this means you may be able to use opioid rotation in order to deal with the tolerance. Another option to keep doses low, is to add memantine, since this has proven to (in many cases) lower or inhibit opioid tolerance. Memantine may also be useful in its own right.

> It seems like clozapine does a lot of this, and about the agranulocytosis risk, it being only about 1 percent, and in some European countries, is only test for monthly, after being on the med for awhile.
>

I'm on clozapine. I thought it was worth trying, but I found it quite useless, and I want to quit but the doctors insist on continuing it. It disrupts the swallowing reflex, so there will be saliva on your pillow when you wake up in the morning. For the same reason, food gets stuck in your throat. Many people experience weight gain on clozapine, but I have escaped this problem.

-undopaminergic

 

Re: Akathisia, meds , Pseudo-Parkinson and help pls.:( jay2112

Posted by PCB on October 18, 2020, at 14:27:49

In reply to Re: Akathisia, meds , Pseudo-Parkinson and help pls.:( linkadge, posted by jay2112 on October 17, 2020, at 17:21:47

>Interesting thing about Effexor...he said there is a bit of a >controversy on it's effects on norepinephrine, that it is a fair >bit weaker on norepinephrine than thought...even with the >dose escalation.(I'd have to look up the references.)

There is no controversy. Effexor and most of the SNRIs are very weak norepinephrine reuptake inhibitors. Here are the ratios of serotonin to norepinephrine reuptake inhibition:

Effexor/Venlafaxine 30:1 (serotonin:norepinephrine, higher number means more inhibition/stronger)
Duloxetine 10:1
Desvenlafaxine 10:1
Levomilnacipran 1:1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008300/#!po=1.61290
https://en.m.wikipedia.org/wiki/Clomipramine#Serotonergic_activity (under pharmacodynamics)

So really most of the SNRIs are just SSRIs with the exception of Levomilnacipran. Although some people do get blood pressure increases on a SNRIs due to the norepinephrine effect, so maybe in vitro the norepinephrine effect is significant. You could add Wellbutrin to a SSRI if you wanted more balanced reuptake of serotonin to norepinephrine.

But linkage would know better than I. He is the master! Sorry if you know all this already.

PCB

 

Re: Akathisia, meds , Pseudo-Parkinson and help pls.:(

Posted by linkadge on October 18, 2020, at 14:30:22

In reply to Re: Akathisia, meds , Pseudo-Parkinson and help pls.:( linkadge, posted by jay2112 on October 17, 2020, at 17:21:47

Interesting.

For a anticholinergic, benztropine might be worth trying (it is an anticholinergic and a dopamine reuptake inhibitor).

I found that with CBD, there is a tremendous variance from product to product. I found that the non-medical CBD products were a waste of time.

Linkadge


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