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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Girlnterrupted on February 19, 2006, at 20:11:42
I posted a few days ago about my ordeal with Abilify after being on it for only 5 days.
From my post: "I was agitated and anxious the whole day, to the point that I couldn't do anything. I stayed in the computer for 7 minutes, and then ran to bed, but then I had to get up and do something else, because nothing would sort of "calm me down." So I quit, and after 3 days I still feel my heart pounding in my chest. I started to drink a little alcohol to calm myself down, and I was surprised to realize I no longer get "drunk." I just get more calm, but not drunk.
I hope this is not permanent, but it's scary. I hope Abilify didn't mess me up for good. I feel my heart pounding in my chest and can see it if I stand in front of a mirror. It's like a little bump every second. Abilify was a nightmare."Then somebody mentioned it could be akathisia:
Posted by fenix on February 15, 2006, at 10:12:01
"Sounds like akathisia to me. Oh, but your doctor probably never mentioned to you about akathisia, why would I not be suprised. I wouldn't blame the psychiatrists though, they are rather smart. Better to be the priest than to be the "inquired"."I emailed my doctor and told him about my symptoms, and mentioned that I had read something about antipsychotics having the "akathisia" side-effect, and told him I wondered whether this might be happening to me.
This was his response:
" I believe it has now been nearly a week since our last dose of study medication. At this point, I would expect the study medication to have been metabolized and removed from your body. While akathisia is a side-effect of medications like Abilify, it is not permanent. Further, it is characterized by a feeling of restlessness and the need to keep moving one's muscles(particularly in the legs) and is classified under the movement disorders you may remember reading about in the study consent. However, akathisia does not typically involve palpitations or feelings of anxiety as you have described. Further, akathisia does not ordinarily cause insomnia. Based on the information you have written and as I mentionned in my phone message yesterday, it sounds like you have had a worsening of anxiety. This has possibly manifest in palpitations, agitation and insomnia. I know that insomnia has been a chronic problem and you have reported it several times during the study already. It also may be possible that your symptoms of anxiety and insomnia may have increased partly due to the decrease in PaxilCR from 37.5mg to 25mg that I recommended when you briefly attended the clinic on Monday."
The problem is, I do find myself moving my legs often, and I have been grinding my teeth lately. My doctor seems to have "dismissed" akathisia, and he simply assumed I wasn't having muscle movement, without asking me first. I wonder why didn't he ask me that question before assuming I wasn't having that symptom?
I'm so messed up. I have been drinking so much lately just to restore myself. But this medication seems to have done some permanent damage to me. I'm not sure my doctor will believe me, but I'm serious. He'll probably keep saying it's all about the Paxil, but it isn't. These problems started specifically when I started the Abilify, not when I began weaning myself off the Paxil. Oh well. If it's not the "usual response" there must be something wrong with me. I must be lying!!!
Posted by Phillipa on February 19, 2006, at 20:37:46
In reply to Ruined after Abilify (Continued), posted by Girlnterrupted on February 19, 2006, at 20:11:42
You cold turkeyed paxil at the same time you started a stimulating antipsychotic. Sounds like you need to call the doc again, start the paxil again too. Sounds like withdrawal on top of the other. Just my opinion. Fondly, Phillipa
Posted by Girlnterrupted on February 19, 2006, at 20:52:46
In reply to Re: Ruined after Abilify (Continued) » Girlnterrupted, posted by Phillipa on February 19, 2006, at 20:37:46
"It also may be possible that your symptoms of anxiety and insomnia may have increased partly due to the decrease in PaxilCR from 37.5mg to 25mg that I recommended when you briefly attended the clinic on Monday.""
I'm sorry, I'm not sure where you got the idea I "cold-turkeyed" the Paxil. I am weaning myself off the Paxil still. There's only been a 'decrese' in the dosage, it hasn't been discontinued yet.
Posted by Phillipa on February 19, 2006, at 21:58:14
In reply to Re: Ruined after Abilify (Continued), posted by Girlnterrupted on February 19, 2006, at 20:52:46
I think I read your post wrong sorry about that. Fondly, Phillipa
Posted by fenix on February 20, 2006, at 5:56:20
In reply to Ruined after Abilify (Continued), posted by Girlnterrupted on February 19, 2006, at 20:11:42
> I posted a few days ago about my ordeal with Abilify after being on it for only 5 days.
>
> From my post: "I was agitated and anxious the whole day, to the point that I couldn't do anything. I stayed in the computer for 7 minutes, and then ran to bed, but then I had to get up and do something else, because nothing would sort of "calm me down." So I quit, and after 3 days I still feel my heart pounding in my chest. I started to drink a little alcohol to calm myself down, and I was surprised to realize I no longer get "drunk." I just get more calm, but not drunk.
> I hope this is not permanent, but it's scary. I hope Abilify didn't mess me up for good. I feel my heart pounding in my chest and can see it if I stand in front of a mirror. It's like a little bump every second. Abilify was a nightmare."
>
> Then somebody mentioned it could be akathisia:
>
> Posted by fenix on February 15, 2006, at 10:12:01
> "Sounds like akathisia to me. Oh, but your doctor probably never mentioned to you about akathisia, why would I not be suprised. I wouldn't blame the psychiatrists though, they are rather smart. Better to be the priest than to be the "inquired"."
>
> I emailed my doctor and told him about my symptoms, and mentioned that I had read something about antipsychotics having the "akathisia" side-effect, and told him I wondered whether this might be happening to me.
>
> This was his response:
>
> " I believe it has now been nearly a week since our last dose of study medication. At this point, I would expect the study medication to have been metabolized and removed from your body. While akathisia is a side-effect of medications like Abilify, it is not permanent. Further, it is characterized by a feeling of restlessness and the need to keep moving one's muscles(particularly in the legs) and is classified under the movement disorders you may remember reading about in the study consent. However, akathisia does not typically involve palpitations or feelings of anxiety as you have described. Further, akathisia does not ordinarily cause insomnia. Based on the information you have written and as I mentionned in my phone message yesterday, it sounds like you have had a worsening of anxiety. This has possibly manifest in palpitations, agitation and insomnia. I know that insomnia has been a chronic problem and you have reported it several times during the study already. It also may be possible that your symptoms of anxiety and insomnia may have increased partly due to the decrease in PaxilCR from 37.5mg to 25mg that I recommended when you briefly attended the clinic on Monday."
>
> The problem is, I do find myself moving my legs often, and I have been grinding my teeth lately. My doctor seems to have "dismissed" akathisia, and he simply assumed I wasn't having muscle movement, without asking me first. I wonder why didn't he ask me that question before assuming I wasn't having that symptom?
>
> I'm so messed up. I have been drinking so much lately just to restore myself. But this medication seems to have done some permanent damage to me. I'm not sure my doctor will believe me, but I'm serious. He'll probably keep saying it's all about the Paxil, but it isn't. These problems started specifically when I started the Abilify, not when I began weaning myself off the Paxil. Oh well. If it's not the "usual response" there must be something wrong with me. I must be lying!!!
Is your doctor very young (hope I don't get another 'be civil' thing... :o)? I have a difficult time believing that he said akathisia is not permanent. Well I will give him the benefit of the doubt because in a way he is right, akathisia isn't permanent. However, tardive akathisia (a form of akathisia)can be permanent.Again, benzodiazepines should enter the picture. Mainly because whether what you are experiencing is withdrawals/anxiety/akathisia, or a combination of those, benzos will be helpful in each case. And it would be a thing to be cosidered if this "anxiety" you describe is as bothersome as you say.
You must remember that doctors are not perfect and that they make mistakes too. Unfortunately, when dealing with drugs that are risky, this doesn't help the situation.
Posted by ace on February 20, 2006, at 8:22:37
In reply to Ruined after Abilify (Continued), posted by Girlnterrupted on February 19, 2006, at 20:11:42
What that doctor wrote was nonsense....to me it was a clear case of akathisia...
Posted by linkadge on February 20, 2006, at 8:25:22
In reply to Ruined after Abilify (Continued), posted by Girlnterrupted on February 19, 2006, at 20:11:42
It could be a combination of akathesia and other side effects from the drug. Oh, and Abilify has a really long half life, so it is concievable that it would be affecting you this way up till now.
Akathesia can very easily cause insomnia.
Don't you see how he tries to shift your attention away from their drug, and back on to you ??
Linkadge
Posted by linkadge on February 20, 2006, at 8:26:53
In reply to Ruined after Abilify (Continued), posted by Girlnterrupted on February 19, 2006, at 20:11:42
Akathesia can cause a severe inner restlessness that is indestinguishable from anxiety.
Linkadge
Posted by fenix on February 20, 2006, at 8:57:18
In reply to Re: Ruined after Abilify (Continued), posted by linkadge on February 20, 2006, at 8:26:53
> Akathesia can cause a severe inner restlessness that is indestinguishable from anxiety.
>
> LinkadgeAkathisia also can cause an agonizing kind of pain. It is a very unique form of inner torment and not just "psychic pain"; for it is an actual subjective yet physically tangible pain. Akathisia is easier to identify when these kinds of pains are presented to the doctor; what akathisia does to the self is far different than what anxiety does.
The trouble is that akathisia is frequently misdiagnosed. Often this is because it is sometimes difficult for the patient to describe the feelings they are having, for instance, they may feel that the pain they are having is too esoteric and foreign and thus never bring up the issues of feeling "pain" to their doctor (the unbearable pain really helps differentiate between mere anxiety, akathisia and restless legs syndrome). It can also rest on the doctor's shoulders in that he doesn't have enough experience with akathisia.
Again, it doesn't help that akathisia can be hard to actually physically see, you know. It's easier to spot that someone has broken their leg for instance.
Posted by Girlnterrupted on February 20, 2006, at 10:37:36
In reply to Re: Ruined after Abilify (Continued), posted by fenix on February 20, 2006, at 8:57:18
Thank you all for the comments.
From my experience with doctors, I know for a fact that no doctor would ever accept that I have akathisia. They would brainwash me and make me believe it just can't be happening.
I remember one time a doctor said to me, when I mentioned I had a particular side-effect for a med "That never happens. I don't know what you're talking about.." and gave me a dirty look.
Why doctors do that? Now this doctor, of course I can see he's trying to shift my attention. The part that angered me is that he didn't ask me if I was having any problems with my legs before ASSUMING I wasn't. Why did he assume so without asking? Why did he blame it on the Paxil? I remember telling him this: "I am quitting Abilify. I'm sorry, but I haven't had a MINUTE of peace since I started this med."
Clearly, the symptoms ARE Abilify related, not related to Paxil AT ALL. But now he has asked me to go back to a full dose of Paxil, which I don't want to because Paxil hasn't worked for me the way my old medication (Celexa) did, so I can't wait to go back on it, but now I have to go back on Paxil!! This doesn't make sense to me.
Anyway, I'm seeing my doctor today at 2pm, in 2.5 hours, so I will make it VERY clear that this is serious and not a joke. I'll have him feel my heart beating and that should be enough. It feels like a bomb about to blow.
Posted by fenix on February 20, 2006, at 11:31:11
In reply to Re: Ruined after Abilify (Continued), posted by Girlnterrupted on February 20, 2006, at 10:37:36
> Thank you all for the comments.
>
> From my experience with doctors, I know for a fact that no doctor would ever accept that I have akathisia. They would brainwash me and make me believe it just can't be happening.
>
> I remember one time a doctor said to me, when I mentioned I had a particular side-effect for a med "That never happens. I don't know what you're talking about.." and gave me a dirty look.
>
> Why doctors do that? Now this doctor, of course I can see he's trying to shift my attention. The part that angered me is that he didn't ask me if I was having any problems with my legs before ASSUMING I wasn't. Why did he assume so without asking? Why did he blame it on the Paxil? I remember telling him this: "I am quitting Abilify. I'm sorry, but I haven't had a MINUTE of peace since I started this med."
>
> Clearly, the symptoms ARE Abilify related, not related to Paxil AT ALL. But now he has asked me to go back to a full dose of Paxil, which I don't want to because Paxil hasn't worked for me the way my old medication (Celexa) did, so I can't wait to go back on it, but now I have to go back on Paxil!! This doesn't make sense to me.
>
> Anyway, I'm seeing my doctor today at 2pm, in 2.5 hours, so I will make it VERY clear that this is serious and not a joke. I'll have him feel my heart beating and that should be enough. It feels like a bomb about to blow.
Yeah, some doctors are that way, who knows why in his particular case. If you aren't agreeable to him then you should find another doctor. It sucks I guess because it might take a while. So it would be better to try and say that you don't want to be on the Abilify because it is really bothersome. If he doesn't want to come to an agreement that you like, then just get another doctor. But, if you do decide to seek another one, you have to be careful about the drugs you are on at the moment, because you could run out of whatever it is you are left on before you see a new doctor, and this would cause withdrawals. In this case, you should stop taking the drugs (taper off of them) slowly, very slowly... very very slowly.And if these drugs bother you a lot, then you could also consider not being on them at all. However, one of your fears is that the Abilify did something to you that will last a long time. This is very rational because these things can happen sometimes.
If I was in your position I would try and get a benzodiazepine to be on for a couple of weeks; if your doctor is reasonable then he must see that this is a viable option because you seem to be in quite a bit of distress over the side-effects you are getting.
Posted by linkadge on February 20, 2006, at 13:34:50
In reply to Re: Ruined after Abilify (Continued), posted by fenix on February 20, 2006, at 8:57:18
Beautifully stated. Its like LSD. No it may not cause the cocaine type of anxiety (heart palps etc) but it can cause a unique kind of torture, that like you said, many patients don't bring up cause it may manifest itself as such a personal issue.
Its just like people who may experience what others consider hyper-religiosity. It could cause a unique type of anxiety that may never be uncovered in a 5 min docs appointment
Linkadge
Posted by ed_uk on February 20, 2006, at 14:01:14
In reply to Re: Ruined after Abilify (Continued), posted by Girlnterrupted on February 20, 2006, at 10:37:36
Hi
Abilify has a very long half life - it can take quite some time for it to be completely eliminated from your body.
Also, for some people, even small reduction in their Paxil dose can cause unpleasant withdrawal symptoms.
Ed
Posted by deniseuk on February 21, 2006, at 4:20:38
In reply to Ruined after Abilify (Continued), posted by Girlnterrupted on February 19, 2006, at 20:11:42
Hi Girl Interrupted,
I've never actually had akathisia before but have read about it.
I have however experienced high levels of anxiety and that sounds to me like what you're experiencing.
I definately agree with the other posters, Abilify is known to cause initial anxiety so taking that coupled with decreasing the Paxil would have made you worse.
I have a very tense jaw most of the time and that's tension and anxiety.
You say your legs are moving a lot, can you stop them from moving or is it more like it's beyond your control? I just think that the restless legs would be more like a compulsion.
I really don't think you should worry about the abilify screwing you up as it doesn't sound to me that it has. But then you know yourself better than anyone else.
Denise
Posted by blueberry on February 21, 2006, at 5:23:06
In reply to Ruined after Abilify (Continued), posted by Girlnterrupted on February 19, 2006, at 20:11:42
A trial of a new med can screw things up for a few days or even a couple weeks. It will pass. In my own experiences, when a problem med is stopped, there are difficulties almost right away that are intermingled with the rapidly changing levels and function of the neurotransmitters. And then, there are more problems as the neuros settle down into their new environment without the med and adjust. Since abilify has a long half life, it's just my guess that the entire process might take about 2 to 3 weeks to get back to where you were.
With the paxil, I have noticed that any problems from a dosage change don't really show up for maybe 3 to 5 days after changing the dose. So there could be some delayed stuff there going on. And until the receptors adjust to the lower levels of serotonin, which could take 1 to 3 weeks, things could be weirdish.
None of these things should last. After a good 3 weeks following the changes, you should know where you really stand without any confusing symptoms of receptor readjustments going on.
This is the end of the thread.
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