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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by fenix on November 26, 2007, at 9:37:12
I once read that opiates were given sometimes to treat various forms of akathisia.
What do you think the chances are that a doctor would prescribe an opiate if you have tardive akathisia?
Posted by Sigismund on November 26, 2007, at 12:57:42
In reply to Tardive Akathisia and Opiates, posted by fenix on November 26, 2007, at 9:37:12
Hello fenix
No chance.
Good luck.
Posted by pstrait on November 27, 2007, at 4:10:51
In reply to Tardive Akathisia and Opiates, posted by fenix on November 26, 2007, at 9:37:12
You could try mirtazapine though -- http://ajp.psychiatryonline.org/cgi/content/full/158/5/819
Posted by fenix on November 27, 2007, at 13:30:22
In reply to Tardive Akathisia and Opiates, posted by fenix on November 26, 2007, at 9:37:12
The biggest problem with Tardive Akathisia is the sheer physical pain. It only makes sense to me that opiates are considered.
Posted by yxibow on November 30, 2007, at 5:11:02
In reply to Re: Tardive Akathisia and Opiates, posted by fenix on November 27, 2007, at 13:30:22
> The biggest problem with Tardive Akathisia is the sheer physical pain. It only makes sense to me that opiates are considered.
>First of all you have to get a diagnosis from a neurologist, that's rather important. Then you need a psychiatrist who has a sub-"degree" in addiction specialization. They're far more likely to consider your case as they have taken the training. Malpractice insurance has shied a fair amount of psychopharmacologists away from opiates and barbiturates because of the risk of death, allergic reaction and extreme habituation.
Posted by fenix on November 30, 2007, at 10:39:09
In reply to Re: Tardive Akathisia and Opiates » fenix, posted by yxibow on November 30, 2007, at 5:11:02
> > The biggest problem with Tardive Akathisia is the sheer physical pain. It only makes sense to me that opiates are considered.
> >
>
> First of all you have to get a diagnosis from a neurologist, that's rather important. Then you need a psychiatrist who has a sub-"degree" in addiction specialization. They're far more likely to consider your case as they have taken the training. Malpractice insurance has shied a fair amount of psychopharmacologists away from opiates and barbiturates because of the risk of death, allergic reaction and extreme habituation.I got a diagnosis from a neurologist stating that it is probably tardive akathisia over a year and a half ago.
Posted by yxibow on November 30, 2007, at 12:47:09
In reply to Re: Tardive Akathisia and Opiates, posted by fenix on November 30, 2007, at 10:39:09
> > > The biggest problem with Tardive Akathisia is the sheer physical pain. It only makes sense to me that opiates are considered.
> > >
> >
> > First of all you have to get a diagnosis from a neurologist, that's rather important. Then you need a psychiatrist who has a sub-"degree" in addiction specialization. They're far more likely to consider your case as they have taken the training. Malpractice insurance has shied a fair amount of psychopharmacologists away from opiates and barbiturates because of the risk of death, allergic reaction and extreme habituation.
>
> I got a diagnosis from a neurologist stating that it is probably tardive akathisia over a year and a half ago.
I'm sorry it was confirmed, then get that doctor's files if he is still around and have him route you to an appropriate doctor or your GP do so, if you have an HMO system, or however it works.Addiction specialist psychiatrists are much more likely to prescribe bupenorphine because they do so in their regular practice. Have a consultation with one.
Two, if you're not happy with one, but don't start first into the office and say "I want drug X" -- no competent MD unfortunately is going to do that, they have to assess your current medications and make sure you're not drug seeking.
Posted by fenix on November 30, 2007, at 14:29:44
In reply to Re: Tardive Akathisia and Opiates » fenix, posted by yxibow on November 30, 2007, at 12:47:09
> > > > The biggest problem with Tardive Akathisia is the sheer physical pain. It only makes sense to me that opiates are considered.
> > > >
> > >
> > > First of all you have to get a diagnosis from a neurologist, that's rather important. Then you need a psychiatrist who has a sub-"degree" in addiction specialization. They're far more likely to consider your case as they have taken the training. Malpractice insurance has shied a fair amount of psychopharmacologists away from opiates and barbiturates because of the risk of death, allergic reaction and extreme habituation.
> >
> > I got a diagnosis from a neurologist stating that it is probably tardive akathisia over a year and a half ago.
>
>
> I'm sorry it was confirmed, then get that doctor's files if he is still around and have him route you to an appropriate doctor or your GP do so, if you have an HMO system, or however it works.
>
> Addiction specialist psychiatrists are much more likely to prescribe bupenorphine because they do so in their regular practice. Have a consultation with one.
>
> Two, if you're not happy with one, but don't start first into the office and say "I want drug X" -- no competent MD unfortunately is going to do that, they have to assess your current medications and make sure you're not drug seeking.I have a copy of the paper my neurologist wrote to my GP that mentions the akathisia. I don't know if this matters or not but the paper (which I don't have with me right now so I can't recall precisely) also mentions stuff about iron and the possibility of restless-leg syndrome, however, it stated basically that it is most likely akathisia given the symptoms I mentioned and the fact that I was taking APs when it happened. Unfortunately, what I have is very subjective.
At the moment my GP is prescribing me diazepam for this, I've been taking it now for over a year and a half and I know it isn't the best treatment for it, however, it does help somewhat and the side-effects aren't bad. Also, it is actually the only drug I have been on for along time as, again, what I have is tardive and it has lasted for almost 4 years now even though I stopped taking the psychiatric medication which seemed to cause it.
Thanks for the advice but I'm not familiar with addiction specialist psychiatrists. I also really don't know if I should just see my GP first and get referred somewhere which would probably take a while or if I should just make an appointment my self with a psychiatrist of some kind, which would also probably take a while.
Posted by BGB on November 30, 2007, at 23:04:02
In reply to Re: Tardive Akathisia and Opiates, posted by fenix on November 30, 2007, at 14:29:44
I take hydrocodone for my akathisia, but my neurologist prescribes it for me, not my psychiatrist. I should warn you that I spent over a year and a half trying all kinds of other medications before she tried the hydrocodone. I never mentioned it or recommended it, since I figured she would label me a drug-seeker.
I have to say that it works better than anything else I've tried, but not by much. It maybe alleviates 10-15% of symptoms. And unfortunately it has done absolutely nothing whatsoever for my depression. I take 15mg/day.
Good luck to you....I know how incredibly irritating and painful it can be.
Posted by yxibow on December 1, 2007, at 2:08:18
In reply to Re: Tardive Akathisia and Opiates, posted by fenix on November 30, 2007, at 14:29:44
> > > > > The biggest problem with Tardive Akathisia is the sheer physical pain. It only makes sense to me that opiates are considered.
> > > > >
> > > >
> > > > First of all you have to get a diagnosis from a neurologist, that's rather important. Then you need a psychiatrist who has a sub-"degree" in addiction specialization. They're far more likely to consider your case as they have taken the training. Malpractice insurance has shied a fair amount of psychopharmacologists away from opiates and barbiturates because of the risk of death, allergic reaction and extreme habituation.
> > >
> > > I got a diagnosis from a neurologist stating that it is probably tardive akathisia over a year and a half ago.
> >
> >
> > I'm sorry it was confirmed, then get that doctor's files if he is still around and have him route you to an appropriate doctor or your GP do so, if you have an HMO system, or however it works.
> >
> > Addiction specialist psychiatrists are much more likely to prescribe bupenorphine because they do so in their regular practice. Have a consultation with one.
> >
> > Two, if you're not happy with one, but don't start first into the office and say "I want drug X" -- no competent MD unfortunately is going to do that, they have to assess your current medications and make sure you're not drug seeking.
>
> I have a copy of the paper my neurologist wrote to my GP that mentions the akathisia. I don't know if this matters or not but the paper (which I don't have with me right now so I can't recall precisely) also mentions stuff about iron and the possibility of restless-leg syndrome, however, it stated basically that it is most likely akathisia given the symptoms I mentioned and the fact that I was taking APs when it happened. Unfortunately, what I have is very subjective.
>
> At the moment my GP is prescribing me diazepam for this, I've been taking it now for over a year and a half and I know it isn't the best treatment for it, however, it does help somewhat and the side-effects aren't bad. Also, it is actually the only drug I have been on for along time as, again, what I have is tardive and it has lasted for almost 4 years now even though I stopped taking the psychiatric medication which seemed to cause it.
>
> Thanks for the advice but I'm not familiar with addiction specialist psychiatrists. I also really don't know if I should just see my GP first and get referred somewhere which would probably take a while or if I should just make an appointment my self with a psychiatrist of some kind, which would also probably take a while.Probably get referred with your GP if you're not satisfied with the palleative results from diazepam. You will eventually habituate to either, that's just unfortunately how it works. When, is anybody's guess, it could be months or hopefully many years.
Addiction medicine specialists are just one type of psychiatrist, e.g. psychopharmacologist -- they have taken the equivalent of a full residency or CE credits to both diagnose people who have true addiction problems and also have mental illness and also have a special license to prescribe things like bupenorphine so they don't lose their ability to practice medicine. Otherwise, they're psychiatrists like any other.
Posted by fenix on December 1, 2007, at 5:10:09
In reply to Re: Tardive Akathisia and Opiates, posted by BGB on November 30, 2007, at 23:04:02
> I take hydrocodone for my akathisia, but my neurologist prescribes it for me, not my psychiatrist. I should warn you that I spent over a year and a half trying all kinds of other medications before she tried the hydrocodone. I never mentioned it or recommended it, since I figured she would label me a drug-seeker.
>
> I have to say that it works better than anything else I've tried, but not by much. It maybe alleviates 10-15% of symptoms. And unfortunately it has done absolutely nothing whatsoever for my depression. I take 15mg/day.
>
> Good luck to you....I know how incredibly irritating and painful it can be.My neurologist seemed to not want to treat me for it thus sending me elsewhere. Perhaps because of incompetency with the illness.
The diazepam I take seems to alleviate it by around 10%, and I think I am taking weak diazepam.
Posted by fenix on December 1, 2007, at 5:13:21
In reply to Re: Tardive Akathisia and Opiates » fenix, posted by yxibow on December 1, 2007, at 2:08:18
> > > > > > The biggest problem with Tardive Akathisia is the sheer physical pain. It only makes sense to me that opiates are considered.
> > > > > >
> > > > >
> > > > > First of all you have to get a diagnosis from a neurologist, that's rather important. Then you need a psychiatrist who has a sub-"degree" in addiction specialization. They're far more likely to consider your case as they have taken the training. Malpractice insurance has shied a fair amount of psychopharmacologists away from opiates and barbiturates because of the risk of death, allergic reaction and extreme habituation.
> > > >
> > > > I got a diagnosis from a neurologist stating that it is probably tardive akathisia over a year and a half ago.
> > >
> > >
> > > I'm sorry it was confirmed, then get that doctor's files if he is still around and have him route you to an appropriate doctor or your GP do so, if you have an HMO system, or however it works.
> > >
> > > Addiction specialist psychiatrists are much more likely to prescribe bupenorphine because they do so in their regular practice. Have a consultation with one.
> > >
> > > Two, if you're not happy with one, but don't start first into the office and say "I want drug X" -- no competent MD unfortunately is going to do that, they have to assess your current medications and make sure you're not drug seeking.
> >
> > I have a copy of the paper my neurologist wrote to my GP that mentions the akathisia. I don't know if this matters or not but the paper (which I don't have with me right now so I can't recall precisely) also mentions stuff about iron and the possibility of restless-leg syndrome, however, it stated basically that it is most likely akathisia given the symptoms I mentioned and the fact that I was taking APs when it happened. Unfortunately, what I have is very subjective.
> >
> > At the moment my GP is prescribing me diazepam for this, I've been taking it now for over a year and a half and I know it isn't the best treatment for it, however, it does help somewhat and the side-effects aren't bad. Also, it is actually the only drug I have been on for along time as, again, what I have is tardive and it has lasted for almost 4 years now even though I stopped taking the psychiatric medication which seemed to cause it.
> >
> > Thanks for the advice but I'm not familiar with addiction specialist psychiatrists. I also really don't know if I should just see my GP first and get referred somewhere which would probably take a while or if I should just make an appointment my self with a psychiatrist of some kind, which would also probably take a while.
>
> Probably get referred with your GP if you're not satisfied with the palleative results from diazepam. You will eventually habituate to either, that's just unfortunately how it works. When, is anybody's guess, it could be months or hopefully many years.
>
> Addiction medicine specialists are just one type of psychiatrist, e.g. psychopharmacologist -- they have taken the equivalent of a full residency or CE credits to both diagnose people who have true addiction problems and also have mental illness and also have a special license to prescribe things like bupenorphine so they don't lose their ability to practice medicine. Otherwise, they're psychiatrists like any other.The thing is whether I would be referred to the right person.
Posted by yxibow on December 1, 2007, at 13:54:05
In reply to Re: Tardive Akathisia and Opiates, posted by fenix on December 1, 2007, at 5:13:21
> > > > > > > The biggest problem with Tardive Akathisia is the sheer physical pain. It only makes sense to me that opiates are considered.
> > > > > > >
> > > > > >
> > > > > > First of all you have to get a diagnosis from a neurologist, that's rather important. Then you need a psychiatrist who has a sub-"degree" in addiction specialization. They're far more likely to consider your case as they have taken the training. Malpractice insurance has shied a fair amount of psychopharmacologists away from opiates and barbiturates because of the risk of death, allergic reaction and extreme habituation.
> > > > >
> > > > > I got a diagnosis from a neurologist stating that it is probably tardive akathisia over a year and a half ago.
> > > >
> > > >
> > > > I'm sorry it was confirmed, then get that doctor's files if he is still around and have him route you to an appropriate doctor or your GP do so, if you have an HMO system, or however it works.
> > > >
> > > > Addiction specialist psychiatrists are much more likely to prescribe bupenorphine because they do so in their regular practice. Have a consultation with one.
> > > >
> > > > Two, if you're not happy with one, but don't start first into the office and say "I want drug X" -- no competent MD unfortunately is going to do that, they have to assess your current medications and make sure you're not drug seeking.
> > >
> > > I have a copy of the paper my neurologist wrote to my GP that mentions the akathisia. I don't know if this matters or not but the paper (which I don't have with me right now so I can't recall precisely) also mentions stuff about iron and the possibility of restless-leg syndrome, however, it stated basically that it is most likely akathisia given the symptoms I mentioned and the fact that I was taking APs when it happened. Unfortunately, what I have is very subjective.
> > >
> > > At the moment my GP is prescribing me diazepam for this, I've been taking it now for over a year and a half and I know it isn't the best treatment for it, however, it does help somewhat and the side-effects aren't bad. Also, it is actually the only drug I have been on for along time as, again, what I have is tardive and it has lasted for almost 4 years now even though I stopped taking the psychiatric medication which seemed to cause it.
> > >
> > > Thanks for the advice but I'm not familiar with addiction specialist psychiatrists. I also really don't know if I should just see my GP first and get referred somewhere which would probably take a while or if I should just make an appointment my self with a psychiatrist of some kind, which would also probably take a while.
> >
> > Probably get referred with your GP if you're not satisfied with the palleative results from diazepam. You will eventually habituate to either, that's just unfortunately how it works. When, is anybody's guess, it could be months or hopefully many years.
> >
> > Addiction medicine specialists are just one type of psychiatrist, e.g. psychopharmacologist -- they have taken the equivalent of a full residency or CE credits to both diagnose people who have true addiction problems and also have mental illness and also have a special license to prescribe things like bupenorphine so they don't lose their ability to practice medicine. Otherwise, they're psychiatrists like any other.
>
> The thing is whether I would be referred to the right person.If your doctors network well, they should be. Also, don't say, oh by the way Dr. GP, I want some opiates. Have a rational explanation too.
One way of checking up (I'm assuming you're stateside) is to go to your state's medical board and look up the guy he's given you. It will often list a line of specialty. If it doesnt and its a doctor at a major hospital, they sometimes list their major interests in their careers too.
Hope that helps
This is the end of the thread.
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