Posted by g_g_g_unit on December 3, 2013, at 7:25:42
In reply to Re: how did I induce akathisia? » g_g_g_unit, posted by ed_uk2010 on December 3, 2013, at 6:56:03
> Sorry to hear it didn't work out for you.
>
> I know you said propranolol drops your blood sugar, have you tried any other beta blockers? You'd (presumably) need one of the lipid soluble beta blockers that enter the brain, but perhaps one of the more selective drugs such as metoprolol could alleviate your restlessness with fewer adverse effects? (Although you are not a rat (!), only lipid soluble beta blockers reduce drug-induced movement disorders in rats. Fortunately, beta-1 selective drugs such as metoprolol still appear to be effective. Atenolol is not lipid soluble, I suspect it wouldn't help. None of this is very evidence-based, I'm just thinking out loud really. Personally, I would dump the propranolol and give metoprolol a shot. It's often used for other 'brain related' disorders such as migraine, so I expect your doctor won't be too averse to trying it.Thanks ed! I did indeed drop the propranolol yesterday -- since reinstating Mirtazapine for a night fixed things, I presumed the propranolol wasn't the culprit.
I'll ask my doctor if I could try another beta-blocker .. 20mg of propranolol took the edge off of things, but never hit the core restlessness. Hopefully something else might do the job, though I don't want to end up stuck on another drug. Do other beta blockers tend to mess up sleep like propranolol? I think I read it reduces melatonin production; either way, it made falling asleep difficult.
>
> As far the jaw clenching, perhaps your doctor could prescribe a low dose of a muscle relaxant? I'm unsure what's sold in Australia. I'll look on the Pharmaceutical Benefits Scheme website. Hmm, seems to be even fewer choices than over here. The Americans have millions of muscle relaxants, most of dubious value but at least the choice is there. Diazepam tends to be useful for jaw clenching, do you react paradoxically to all benzos? I believe the differences between the various drugs are greater than is often appreciated. Diazepam is particularly muscle relaxant.
>Good old 'stralia. I have reacted paradoxically to Xanax, Lorazepam and Clonazepam. I tried Valium while I was on Parnate (in an attempt to treat the anxiety) and just recall feeling a little sedated, though still uncomfortable.. it was hard to tell if it was making things better or worse.
Out of desperation, I almost bought a codeine-based painkiller today, since I figured that might help the restlessness and tension, though am I just asking for more trouble?
> >Should I just ask my doctor for a Cogentin script or something?
>
> You could, but I'm unsure how you'd respond. It may be a little like doxylamine with more dry mouth. It would be ideal if your doctor could give you a prescription for small quantities of a few different meds to try (not all at once!). Eg. Metoprolol, diazepam, Cogentin. What do you think?Yeah, after reading up on Cogentin, it doesn't sound ideal.
I'll see what my doctor has to say! You've given me some good ideas, so thank you for all your help.
poster:g_g_g_unit
thread:1055049
URL: http://www.dr-bob.org/babble/20131115/msgs/1055327.html