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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by crazyrage on February 15, 2006, at 22:24:14
Feeling worse now...
Taking 5 mg of abilify and 50 mg of lamictal...
however; all the others have been too sedating for me in the past and/or made me FAT!
Getting very fed up with this crap
Wondering if the anger and feeling of extreme agitation is the akathisia i have read in prior posts?
Posted by yxibow on February 16, 2006, at 4:10:50
In reply to akathisia?, posted by crazyrage on February 15, 2006, at 22:24:14
> Feeling worse now...
> Taking 5 mg of abilify and 50 mg of lamictal...
> however; all the others have been too sedating for me in the past and/or made me FAT!
> Getting very fed up with this crap
> Wondering if the anger and feeling of extreme agitation is the akathisia i have read in prior posts?
Yes... likely.... Abilify is known to produce akathisia. Akathisia is the feeling of wanting to move and punch a hole through the wall or writhe on the sofa. The best drug I've found to overcome it is the anticholinergic Akineton (biperiden) or Artane (trihexiphenidyl). Benzodiazepines and to a limited degree beta blockers can also be used.
Posted by Phillipa on February 16, 2006, at 21:15:29
In reply to Re: akathisia? » crazyrage, posted by yxibow on February 16, 2006, at 4:10:50
Can you lower the dose? Fondly, Phillipa
Posted by James K on February 16, 2006, at 22:52:57
In reply to akathisia?, posted by crazyrage on February 15, 2006, at 22:24:14
> Feeling worse now...
> Taking 5 mg of abilify and 50 mg of lamictal...
> however; all the others have been too sedating for me in the past and/or made me FAT!
> Getting very fed up with this crap
> Wondering if the anger and feeling of extreme agitation is the akathisia i have read in prior posts?===I don't want to step into a hornet's nest of a sensitive and important topic, but I think that it is very possible that you are just agitated and miserable. I only say this to hold off over worry about a serious side effect before you have a chance to be diagnosed. But please see you doc, and listen to others, because I'm just going on personal experience and instinct, not expertise.
James K
Posted by yxibow on February 17, 2006, at 2:48:37
In reply to Re: akathisia? » crazyrage, posted by James K on February 16, 2006, at 22:52:57
> > Feeling worse now...
> > Taking 5 mg of abilify and 50 mg of lamictal...
> > however; all the others have been too sedating for me in the past and/or made me FAT!
> > Getting very fed up with this crap
> > Wondering if the anger and feeling of extreme agitation is the akathisia i have read in prior posts?
>
> ===I don't want to step into a hornet's nest of a sensitive and important topic, but I think that it is very possible that you are just agitated and miserable. I only say this to hold off over worry about a serious side effect before you have a chance to be diagnosed. But please see you doc, and listen to others, because I'm just going on personal experience and instinct, not expertise.
>
> James K
>
The escalation of things over time does suggest a possible EPS. Akathisia is definately an uncomfortable EPS, but there are worse EPS than akathisia. Its very common with all neuroleptics other than Zyprexa and Seroquel. But you're right, see your doctor about it.
Posted by SLS on February 17, 2006, at 9:12:58
In reply to Re: akathisia? » James K, posted by yxibow on February 17, 2006, at 2:48:37
I found that Abilify produced a "restlessness" that was uncomfortable, but not debilitating. This phenomenon pretty much disappeared within the first 1-2 weeks. It did not escalate once it appeared, but rather, showed signs of abatement. The only thing I can attribute this experience to is a mild akathisia-like syndrome that Abilify seems to be particularly apt to produce.
Recently, it seems to me that people are too quick to conclude that whatever agitation or anxiety they feel with a new drug is akathisia. Akathisia with drugs other than neuroleptic antipsychotics is very infrequent, if not rare. Prozac might be the worst offender of the SSRIs. However, Abilify has been all but determined to precipitate akathisia on a regular basis. I forget the theory as to why it carries this liability, but the early predictions of this EPS seem to be born out in real world experiences. That abnormal movements are not seen often with Abilify is the result of its not penetrating or accumulating in the striatum.
- Scott
Posted by yxibow on February 18, 2006, at 1:59:30
In reply to Re: akathisia?, posted by SLS on February 17, 2006, at 9:12:58
> I found that Abilify produced a "restlessness" that was uncomfortable, but not debilitating. This phenomenon pretty much disappeared within the first 1-2 weeks. It did not escalate once it appeared, but rather, showed signs of abatement. The only thing I can attribute this experience to is a mild akathisia-like syndrome that Abilify seems to be particularly apt to produce.
>
> Recently, it seems to me that people are too quick to conclude that whatever agitation or anxiety they feel with a new drug is akathisia. Akathisia with drugs other than neuroleptic antipsychotics is very infrequent, if not rare. Prozac might be the worst offender of the SSRIs. However, Abilify has been all but determined to precipitate akathisia on a regular basis. I forget the theory as to why it carries this liability, but the early predictions of this EPS seem to be born out in real world experiences. That abnormal movements are not seen often with Abilify is the result of its not penetrating or accumulating in the striatum.
>Oh I can tell you every atypical except for Zyprexa and Seroquel gave me akathisia day 1 in trial. And I know first hand what excruciating akathisia is. Don't go into a hospital if you're vomiting and have a high fever because chances are they'll use a cheap drug like Compazine, put you in a room and forget about you and only after you are ready to punch a hole in the plaster will they come back with Benadryl, which will wear off on the taxi ride home.
Posted by SLS on February 18, 2006, at 7:08:10
In reply to Re: akathisia? » SLS, posted by yxibow on February 18, 2006, at 1:59:30
> Oh I can tell you every atypical except for Zyprexa and Seroquel gave me akathisia day 1 in trial. And I know first hand what excruciating akathisia is. Don't go into a hospital if you're vomiting and have a high fever because chances are they'll use a cheap drug like Compazine, put you in a room and forget about you and only after you are ready to punch a hole in the plaster will they come back with Benadryl, which will wear off on the taxi ride home.
Do you think it was the anticholinergic properties of Benadryl that helped? Which drugs do you feel are the best to treat akathisia?
Thanks.
- Scott
Posted by redscarlet on February 18, 2006, at 12:12:53
In reply to akathisia?, posted by crazyrage on February 15, 2006, at 22:24:14
I'm on 2.5 mgs of Abilify daily and I'm having akathisia from it.
I can't keep my legs still to save my life and it's driving me CRAZY !
The only time I have any relief is when I'm sleeping but once my sleeping meds wear off it starts right back up.
In fact today I just wanted a break so I didn't take my Abilify but I'm still having the akathisia.
I just took a Benadryl and I hope it will help some.
I just feel restless and I can't focus to get anything done.
I had akathisia bad once when I was on Geodon so I know what it is and how it feels and how hard it is to live with.... UGH !!!!!!!!
I don't wish this on anyone.
I just don't know if it will get better / go away on the Abilify or not so I'm sure if I want to keep taking it.
I may try cutting the 2.5mg in half and I know they just came out with the 2mg pill. Maybe I could cut that in half, maybe I only need 1 mg a day !!! But would that do any good for bipolar ? I do seem to be med sensitive. I've had a MILLION bad reactions to stuff.Crazyrage I hope you feel better soon.
Posted by crazyrage on February 18, 2006, at 12:28:38
In reply to Re: akathisia?, posted by redscarlet on February 18, 2006, at 12:12:53
Hi everyone,
I did talk to the doctor and was switched to geodon. It seems to be working for about 12-18 hours a day; however makes very tired until it wears off. now trying to stay awake without rage... confusing huh?
but feeling better when I am doped up...
Posted by yxibow on February 18, 2006, at 16:40:30
In reply to Re: akathisia? » yxibow, posted by SLS on February 18, 2006, at 7:08:10
> > Oh I can tell you every atypical except for Zyprexa and Seroquel gave me akathisia day 1 in trial. And I know first hand what excruciating akathisia is. Don't go into a hospital if you're vomiting and have a high fever because chances are they'll use a cheap drug like Compazine, put you in a room and forget about you and only after you are ready to punch a hole in the plaster will they come back with Benadryl, which will wear off on the taxi ride home.
>
> Do you think it was the anticholinergic properties of Benadryl that helped? Which drugs do you feel are the best to treat akathisia?
>Most definately, it was IV Benadryl and it cut it instantly -- that is until about half an hour or more when I finally signed out and could barely tell the cab driver where to go because the Compazine half life was still sitting right there. Fortunately I got some Klonopin from a doctor I was seeing because it was still there hours later. I am very sensitive to akathisia. Of course they gave me Compazine suppositories to stick up my *** which I promptly disposed of, at home -- what were they thinking ??
Personally I prefer Akineton (biperiden) and Artane (trihexiphenidyl) for akathisia as far as anticholinergics -- they're more activating and not nearly as atropine toxic with dosage as Cogentin. Otherwise, I would say some low dose of clonazepam could be used, or propranolol (maybe the others, pindolol or nadolol although I dont know if they're extensively used).
-- Jay
Posted by ed_uk on February 18, 2006, at 17:33:48
In reply to Re: akathisia? » SLS, posted by yxibow on February 18, 2006, at 16:40:30
Hi Yxi
I believe Cogentin injection lasts longer. I imagine it would have been a better choice than Benadryl.
Ed
Posted by redscarlet on February 18, 2006, at 18:43:44
In reply to Re: akathisia? » yxibow, posted by ed_uk on February 18, 2006, at 17:33:48
I took the pill form of Cogentin for akathisia and it dilated my eyes to the point I could not see for days !
I will NEVER take Cogentin again !
Posted by yxibow on February 19, 2006, at 2:07:40
In reply to Re: akathisia?, posted by redscarlet on February 18, 2006, at 18:43:44
> I took the pill form of Cogentin for akathisia and it dilated my eyes to the point I could not see for days !
> I will NEVER take Cogentin again !
>That's why I earlier suggested Akineton or Artane, they have a lower atropine toxicity profile. The dilation you experienced was the typical beladonna reaction of where an effective dose of a drug exceeds the toxicity range. More than a few mgs/day of even either Akineton or Artane and you'll get into the blurry eye territory.
Sorry you had that experience
-- Jay
Posted by redscarlet on February 19, 2006, at 12:33:38
In reply to Re: akathisia? » redscarlet, posted by yxibow on February 19, 2006, at 2:07:40
Posted by Tony P on February 19, 2006, at 14:36:35
In reply to akathisia?, posted by crazyrage on February 15, 2006, at 22:24:14
> Taking 5 mg of abilify and 50 mg of lamictal...
> however; all the others have been too sedating for me in the past and/or made me FAT!
> Wondering if the anger and feeling of extreme agitation is the akathisia i have read in prior posts?I wonder if Lamictal may make akathisia worse in combination with other meds. I had taken trazadone to sleep with no problems in the past, but when I took it while on 300 mg/day Lamictal I got nasty akathisia - no sleep possible!
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