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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 pretty_paints on February 8, 2005, at 8:05:40
Hi guys,
I am having moderate akathisia on Abilify.
I don't know enough about this side effect. At the moment I am pumped full of procyclidine, otherwise I would not be able to write this. It is HELL. The only other time I've felt like this was when I was on Risperidone, except with Risperidone it was about 10 times worse and I wanted to die.
What exactly is this symptom? Yes, restlessness, inner restlessness, trembling hands/feet/legs, anxiety, inability to sit still.
But for me, it also creates intense restlessness in my mind. Is this possible?
Even thinking about doing something "detailed" almost paralyses me and my mind.
Putting on make up, plucking eyebrows, putting on nail varnish, painting a picture, doing a mosaic with tiny bits of cut-out magasine, doing housework, reading a magasine...ANYTHING.
It feels so unbelivably overwhelming that I can't do it. This isn't like the normal depression type "oh everything is overwhelming". I am restless and unable to sit still, YET I can't actually DO anything. If I even think about say, reading a magasine, I just cannot do it. It's impossible. I don't really understand this.
It's not that I'm not painting my nails because my hands are shaking (although, they are), I just can't focus on it or stay doing it. It is HORRIBLE. I read some posts earlier on started by Ed, but I still cannot understand if this whole package of symptoms is akathisia. I think akathisia is much more than just restlessness.
I think today it is much worse BECAUSE I cut down my Seroquel dose last night. I think the Seroquel was sedating me still, so it was dampening down the akathisia somewhat. Now today, I am going through hell. I am so restless and also majorly anxious. A man came round to fix our boiler and I was absolutely terrfied, shaking etc.
Now that I've taken the procyclidine, I feel a million times better. I have tidied my room, had a shower, gotten dressed, and now I'm about to pop out to the shop. I feel great now. But am I going to have to keep taking the procyclidine to feel like this? I'm a wreck without it.
Any help would be appreciated!!
Posted by SLS on February 8, 2005, at 8:23:10
In reply to Akathisia - help!, posted by pretty_paints on February 8, 2005, at 8:05:40
The akathisia I experienced with Abilify was only mild to moderate - nothing like what you have described. However, it completely disappeared within a few weeks. I hope this is the case with you as well.
- Scott
Posted by ed_uk on February 8, 2005, at 8:34:07
In reply to Akathisia - help!, posted by pretty_paints on February 8, 2005, at 8:05:40
Hi!
>It is HELL. The only other time I've felt like this was when I was on Risperidone, except with Risperidone it was about 10 times worse and I wanted to die.
Yes, it is hell! I would rather be in severe pain- at least that way the doctors would have understood what I was talking about when I went to A&E. DON'T even bother reading the descriptions of akathisia in textbooks, they don't even come close. No wonder it's not taken seriously.
>Yes, restlessness, inner restlessness, anxiety, inability to sit still.Yes, these are all symptoms of akathisia. It causes a horrible feeling in the muscles. When I had akathisia I felt like my body was going to explode. Akathisia is very difficult to describe. It's like trying to describe what severe physical pain feels like to someone who's never experienced it.
>trembling hands/feet/legs
This could be Parkinsonism.
But for me, it also creates intense restlessness in my mind. Is this possible?
Definately!!
>Putting on make up, plucking eyebrows, putting on nail varnish, painting a picture, doing a mosaic with tiny bits of cut-out magasine, doing housework, reading a magasine...ANYTHING.
Yes, it makes you totally helpless. Even the simplest things are impossible.
I was worried that you might get akathisia on Abilify, that's why I said you'd need some procyclidine on hand.
>I still cannot understand if this whole package of symptoms is akathisia.
Your symptoms sound very similar to my symptoms when I got akathisia on chlorpromazine. The fact that your symptoms have been relieved by procyclidine is very strongly suggestive of akathisia- other types of agitation aren't generally helped by procyclidine.
>I think akathisia is much more than just restlessness.
It is! Calling it restlessness makes it sound so mild!!!!! Unfortunately, it's just about the best descriptive term we've got!
> But am I going to have to keep taking the procyclidine to feel like this?
Yes, you'll probably need to keep taking procyc if you stay on 15mg Abilify, it might be best to reduce the Abilify to 10mg. Akathisia is strongly dose-dependent, you may be able to find a dose of Abilify where you don't experience it at all. What dose of procyclidine have you taken so far? 5mg? 10mg? Procyclidine is usully taken 3 times a day. How much procyclidine do you have?
Ed xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Posted by pretty_paints on February 8, 2005, at 8:41:02
In reply to Re: Akathisia - help! » pretty_paints, posted by ed_uk on February 8, 2005, at 8:34:07
Hi Mr Ed,
Yay, you understand me! I'm on 10mg Abilify still at the moment.
I take procyclidine in 5mg tablets, and I can take up to 3 a day it says. I'm sure you can take more, but I never take more than that. It helps for a good four hours with one tablet, so 3 x 4 = 12, that's most of the day. I am in bliss right now! I just wish it would last! I told my social-worker Helen about it and she took it seriously (although I agree, it is waaay underestimated as a side effect). At least I know that if it gets BAAAD I can just stop taking it. In hospital it was hell, but I thought this was the only treatment available so I felt that I HAD to stick with it and suffer.
Anyway, we shall see. I shan't let myself get absolutely insane on it! If it gets too bad, I'll ring the doc.
Have you ever taken procyclidine or any of the drugs like that?
xxxxxx
Posted by ed_uk on February 8, 2005, at 9:22:16
In reply to Re: Akathisia - help!, posted by pretty_paints on February 8, 2005, at 8:41:02
Hi Katie!
>I take procyclidine in 5mg tablets, and I can take up to 3 a day it says. I'm sure you can take more, but I never take more than that. It helps for a good four hours with one tablet
Yes, the maximum dose (UK) is 60mg/24 hours but most people take 30mg/day or less. Taking it three times a day is not always sufficient, some people need to take it more often. It is common for people to take it four times a day- this is perfectly acceptable. If you need to take 5mg four times a day, then take it! :-)
>it is waaay underestimated as a side effect
You're not kidding! It can rapidly drive people to suicide if it's not diagnosed and treated, especially if the dose of the AP is raised. This can happen if the patient's agitation is attributed to a worsening of their 'underlying condition.' This is particularly likely to happen in people who cannot describe how they're feeling eg. people with dementia, delirium, the final stages of a terminal illness, people who can't speak English etc.
>At least I know that if it gets BAAAD I can just stop taking it.
You may need to reduce the dose of Abilify. Alternatively, there are other APs available.
>Have you ever taken procyclidine or any of the drugs like that?
No. My akathisia was treated with diazepam (Valium). I needed 60mg (twelve 5mg tablets) in the space of a few hours! In an emergency, if you don't have any procyclidine you can take diphenhydramine instead. You can buy it without a prescription from a pharmacy, the brand name is Nytol (NOT Nytol Herbal!) In some countries the brand name is Benadryl. DO NOT BUY Benadryl!!!!!!!! In the UK, the brand name Benadryl is used for a DIFFERENT drug!!!!!! Nytol is what you want, don't tell them it's for akathisia or else they won't sell it, you can only sell it for insomnia!
>I am in bliss right now!
Is the procyclidine making you euphoric? It can do. Perhaps you only need 2.5mg doses.
Ed.
Posted by pretty_paints on February 8, 2005, at 9:41:20
In reply to Re: Akathisia - help! » pretty_paints, posted by ed_uk on February 8, 2005, at 9:22:16
Yo Ed,
>It can rapidly drive people to suicide if it's not diagnosed and treated, especially if the dose of the AP is raised. This can happen if the patient's agitation is attributed to a worsening of their 'underlying condition.'How can I make sure that my pdoc realises how horrible this is? If it's underestimated like you say, she'll just think it's no problem and that I'm just being pedantic.
>Nytol (NOT Nytol Herbal!)
Cool, thanks. I have made a note of it for in an emergency.
>Is the procyclidine making you euphoric?
I dunno, possibly!! I certainly felt much more relaxed and good after taking it, but maybe I was just relieved the akathisia had gone? In any case, a little bit of euphoria is good methinks ;) hehe
xxxxxx
Posted by ed_uk on February 8, 2005, at 10:12:58
In reply to Re: Akathisia - help!, posted by pretty_paints on February 8, 2005, at 9:41:20
Hi!
>How can I make sure that my pdoc realises how horrible this is?
I don't know really, I'm not sure what to suggest. Perhaps an injection of high-dose Haldol (an old AP) would convince her!
Ed xxxxx
Posted by banga on February 8, 2005, at 10:48:18
In reply to Re: Akathisia - help!, posted by ed_uk on February 8, 2005, at 10:12:58
How long have you been on the Abilify? Fo rme, I had these symptoms start to rise when I started at 5mg, i went back down to 2.5 for a while, then was able to increase no problem.
Posted by Phillipa on February 8, 2005, at 17:17:15
In reply to Re: Akathisia - help!, posted by banga on February 8, 2005, at 10:48:18
Okay here I go again with my lack of knowledge questions. But Prettypaints your symptoms believe it or not, sound just like mine. Can you develop this from AD's? See the neurologist tomorrow, I don't know what to tell him that won't make him think I'm "crazy", and a "pain". Katie, I'm sure glad you found something that works! Fondly, Phillipa
Posted by med_empowered on February 8, 2005, at 21:55:40
In reply to Re: Akathisia - help!, posted by Phillipa on February 8, 2005, at 17:17:15
ugh, sorry my friend...akathisia sucks. I found out about it on zyprexa. my shrink at the time didn't warn me about side-effects like this (do they ever?) so I was shaking and nervous and restless and wanting to die while already taking Klonopin, ambien, etc....anyway, I say cut down on the abilify, maybe try something else. Some people add propranolol to the mix to stop the akathisia, but whatever...I think cutting the dose or stopping the offending AP is the best way to go. Do you ABSOLUTELY need an antipsychotic? If there's any doubt, do get a second opinion. As for akathisia with antidepressants...its decidedly less common than with Antipsychotics, but it still happens. Prozac has a bad rep for this.
Posted by alienatari on February 9, 2005, at 5:36:44
In reply to Akathisia - help!, posted by pretty_paints on February 8, 2005, at 8:05:40
When i have had akathisia i have found benztropine to be the best drug to stop it. Actually a combo of Depakote and Benztropine worked best for me. Oh and benzo's help somewhat too. I hope it goes away for you soon. I can really relate. When I had my worst bout of it, the only releif i had was when i slept. I couldnt even watch tv and so on, simple things are so hard when you have it. I have read that some people have actually committed suicide because of akathisia so I dont understand why a lot of pdocs dont take the matter seriously.
Take care
Posted by ravenstorm on February 9, 2005, at 10:00:39
In reply to Re: Akathisia - help!, posted by alienatari on February 9, 2005, at 5:36:44
I developed it from only 5mg celexa. It was the most horrible thing that I have ever experienced. Pdoc didn't believe me. I had to stop taking it after five days because I was seriously going to end it all if I had to continue going through it. There are no words to adequately describe it!
Posted by Spriggy on February 9, 2005, at 17:08:47
In reply to Re: Akathisia - help!, posted by ravenstorm on February 9, 2005, at 10:00:39
OOH MY WORD, those symptoms are what I felt like on Lexapro. Is that what THIS is called??
It is the most miserable feeling in all creation. I have had two children and would rather experience that type of physical pain ANY day.
So Lexapro likely thrust me into that??
Even on day 8 off of Lexapro I am still feeling this way.
What can I do?
Posted by pretty_paints on February 9, 2005, at 17:14:04
In reply to Re: Akathisia - help!, posted by Spriggy on February 9, 2005, at 17:08:47
Hi Spriggy,
Ed can probably give you some good information, but basically, try procyclidine! It's bliss! It TOTALLY calms you. You can take up to 60mg a day, and most days I only take 5-10mg and that totally sorts it.
Ed also said you can buy something over the counter - read his post.
Hope this helps. Yeh, it is hell isn't it. When I was in hospital they let me SUFFER for like a week, and then one of the NICER nurses said, "oh I can give you something for that". UH HELLO? Where have YOU been all week...??!
Ha ha
Posted by Phillipa on February 9, 2005, at 17:16:38
In reply to Re: Akathisia - help!, posted by pretty_paints on February 9, 2005, at 17:14:04
Hi Katie! Glad to hear you're feeling better! Fondly, Phillipa
This is the end of the thread.
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