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Risilox: Continuos muscle twitches after olanzapine and mirtazapine. Can it be tardive dyskinesia?


Risilox

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Hello everyone,

my name is Nicholas and I'm a 21 years old guy from Italy.

I suffered from chronic insomnia from the age of 15 and in mid-February 2017 was prescribed before bedtime the antidepressant mirtazapine at 15 mg and the antipsychotic olanzapine at 2,5 mg. I took them for 2 weeks without improvement. Therefore the psychiatrist increased mirtazapine at 30 mg and olanzapine at 10 mg. Now I believe that he thought I had bipolar disorder type 1 but I hadn’t any mental illnes.

I took olanzapine at 10 mg because I think was only a tranquilizer and because I trusted the doctor.

Olanzapine made me sleep for 13 hours but I was no longer myself. After 5 days I tried to split the tablet but it gave me a strange effect. So I continued for others 15 days at 10 mg because I really needed to sleep. Then in April 2017 I tapered olanzapine in 1 week because I could not live anymore like that. I took it for a total of 48 days.

After this I reduced mirtazapine to 15 mg and 1 week later I stop cold turkey. At that time I took the benzodiazepine brotizolam at 0,25 mg for 2 weeks to help me sleep.

The withdrawal symptoms were terrible for 4 months and I have not been the same anymore.

When I was on mirtazapine and olanzapine I had eyelids fasciculation 2 or 3 times per day. When I quitted olanzapine the eyelids fasciculation ceased.

2 weeks after withdrawal from olanzapine and 1 week from mirtazapine I started to have frequently intermittent muscle twitching in the left thigh and occasionaly pulsating muscles in other parts of the body. After less than a couple of months they have decreased in frequency and intensity but didn’t stop completely. During this period I was forced to take the antidepressant sertraline and the benzodiazepine diazepam because for the new psychiatrist I had obsessive compulsive disorder with an obsession for the damage of antipsychotics. I did not have anything like that and could taper and withdraw after 3 months in July 2017.

Now I think maybe that the muscles twitching have diminished because diazepam is also a muscle relaxant.

In August 2017 I started to have continuous fasciculations in the legs when I lie down and less frequently when I sit while I never had them when I move. Few times a day I had pulsating muscles also in the arms and the trunc but never in the face. I never had muscle twitches in multiple parts of the body at the same time.

In September the muscles twitching moved for 1 week in the lower abdominals.

In October 2017 for 2 weeks the muscles twitches suddenly stopped in the legs and continued in the rest of the body about 10 times per day.

When the muscles twitching returned they were milder. Sometimes the fasciculations are so mild that when I looked at my calf I saw them without feel them. In the legs they have become more single rapid muscular contractions than pulsating muscles.

Soon after I started to have continuos pulsating muscle in my upper lip. The muscle twitch was very mild and lasted 2 weeks but after it I have sometimes pulsating muscle also in my face.

Do you think it is a tardive dyskinesia caused by olanzapine despite I haven’t involuntary body movements?

Do you think it could be some other side effect caused by olanzapine or maybe mirtazapine? It’s 8 months that I’ve it.

I have been visited by several psychiatrists and neurologists and everyone said it was just stress.

Even if I do not have the symptoms of tardive dyskinesia I do not know what else it could be: I’m not stressed and I do not suffer from anxiety, I do not take stimulants, I can sleep, I have had blood tests and I haven’t electrolyte imbalances or hypoglycemia, I did electromyography and had normal results.

The thing that worries me most is that there is a very large amount of medical literature that associates tardive dyskinesia with cognitive impairments.

If it were to be tardive dyskinesia do you think that the fact that for almost 2 weeks the muscles twitches had almost disappeared means that I am healing?

Thank you and greetings from Italy.

Edited by baroquep

Drugs:                                                                                                                                                                                                                   

Amitriptyline 10 mg (11/02/2016 - 12/08/2016) Amitriptyline 20 mg (12/09/2016 - 12/28/2016)

Trazodone 25 mg (12/29/2016 - 02/27/2017)

Mirtazapine 15 mg (02/14/2017 - 02/27/2017) Olanzapine 2,5 mg (02/14/2017 - 02/27/2017)

Mirtazapine 30 mg (02/28/2017 - 04/09/2017) Olanzapine 10 mg (02/28/2017 - 03/20/2017)  Brotizolam 0,25 mg (03/31/2017 - 04/13/2017)
Sertraline 25 mg (04/23/2017 - 05/03/2017) Sertraline 50 mg (05/03/2017 - 06/31/2017) Diazepam 4 mg (04/23/2017 - 06/31/2017)

Supplements:

Fish oil, Magnesium and Vitamin E

Symptoms:

Continuous muscle twitching (tardive dyskinesia?), decreased libido and difficulty in sexual arousal (PSSD?), apathy, anhedonia and cognitive deficit

 

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  • Administrator

Welcome, Risilox.

 

Did you have any muscle twitching while you were taking olanzapine?

 

Olanzapine is notorious for causing movement disorders and tardive dyskinesia. It's impossible to determine if you have this, as you may be experiencing adverse effects from your drug cocktail or withdrawal syndrome.

 

Going on and off psychiatric drugs can make the nervous system hypersensitive to drugs and their side effects. It sounds like your nervous system is unhappy from all the drug experiments. This can exacerbate insomnia as well as cause muscle twitches and other odd symptoms. Psychiatrists rarely understand adverse effects of these drugs.

 

Benzodiazepines such as brotizolam and diazepam can indeed reduce these types of symptoms. However, if you take them more than a couple of weeks, they can cause other problems, including physiological dependency and rebound insomnia.

 

How often do you take each of your drugs, at what times of day, and at what dosages?

 

We also see people recovering, slowly, from all of these symptoms.

 

Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php
and copy and paste the results in this topic.

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hi Risilox

 

i take Respiridone an anti psychotic and I have had fasciculations in my right foot, right leg, right thigh and other places in my body. I would recommend talking to the doctor about it and get it checked out. When I went to my doctor last year there were no faciculations when I was with him but they definitely happen. I have videod them since. I probably do need to get it checked out again. Sometimes I notice it at night after I have taken my Respiridone dose so I have thought it could be connected.

I also have acute insomnia and I think that can also cause twitches.

Prescribed Respiridone 1.5 mg January 2014

Tapered to 1 mg May 2014

Switched to liquid Respiridone and tapered to 0.9 ml March 2015

Tapered to 0.8 ml 3 June 2015

Tapered to 0.7 ml 8 July 2015

Tapered to 0.6 ml 2 November 2015

Tapered to 0.55ml 30 November 2015

Tapered to 0.5ml 11 January 2016. Held at 0.5ml for the whole of 2016 until February 2017. Tapered to 0.45 ml 13 Feb 2017. Tapered to 0.4 ml 2 April 2017. Tapered to 0.35ml 24 July 2017. 0.33 ml end Jan 2018. 0.30ml 18 Feb 2018. 0.27ml 18 March 2018. 0.25ml 8 April 2018. 0.23 ml  1 July 2018. 0.20ml 5 August 2018. 0.17 ml 13 September 2018. 0.15ml 12 October 2018. Updosed to 0.20ml 21 November 2018 Tapered to 0.18ml 28 Jan 2019. 0.15ml 25 Feb 2019 0.13ml 29 April 2019. 0.10ml 1 June 2019. End of July 2019 relapsed now taking 3mg Respiridone daily

Supplements magnesium and fish oil and folic acid, vitamin D

started HRT transdermal patches 18 Sept 2018 Evorel Sequi (estradiol) and Evorel Conti (estradiol & .norethisterone) . 4 Dec 7.5mg mirtazapine stopped immediately due to side affects. Stopped HRT 13.12.18. Gluten free since 30.11.18

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Thank you very much Altostrata and Campervan41 for your answers.

 

On 10/12/2017 at 12:08 AM, Altostrata said:

Did you have any muscle twitching while you were taking olanzapine?

 

When I was on mirtazapine and olanzapine I had eyelids fasciculation like these in the picture 2 or 3 times per day.

 

Bfs_spasm.gif

 

Now I have continuous muscle twitching in the legs when I lie down while I never had them when I move. Sometimes I have muscle twitching also in the rest of the body.

The muscle twitching is like that of the link but less frequent (1 every minute).

 

On 10/12/2017 at 12:08 AM, Altostrata said:

Going on and off psychiatric drugs can make the nervous system hypersensitive to drugs and their side effects. It sounds like your nervous system is unhappy from all the drug experiments. This can exacerbate insomnia as well as cause muscle twitches and other odd symptoms. Psychiatrists rarely understand adverse effects of these drugs.

 

How often do you take each of your drugs, at what times of day, and at what dosages?

 

Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php
and copy and paste the results in this topic.

 

I've quitted mirtazapine and olanzapine 8 months ago and sertraline and diazepam 4 months ago.

 

Altostrata do you think that I have tardive dyskinesia? I think I have tardive dystonia. Here there are dystonia muscle twitching and they are same as mine.

 

 

9 hours ago, Campervan41 said:

 

i take Respiridone an anti psychotic and I have had fasciculations in my right foot, right leg, right thigh and other places in my body.

 

Campervan41 do you still have the fasciculations? What other symptoms do you have?

 

9 hours ago, Campervan41 said:

I would recommend talking to the doctor about it and get it checked out.

 

I spoke with several psychiatrists and neurologists and everyone said it was just stress but I don't believe them because there was a causal relationship between the withdrawal from olanzapine and mirtazapine and the muscle twictching and I’m not stressed or suffer from anxiety.

 

I'm desperate because tardive dystonia progresses in the years before reaching the maximum severity and is caused by a neurodegenerative action of neuroleptics in the basal ganglia and like other basal ganglia disease (Parkinson's disease, Huntington’s disease etc) have cognitive impairment and neuropsychiatric symptoms.

 

On 10/12/2017 at 12:08 AM, Altostrata said:

We also see people recovering, slowly, from all of these symptoms.

 

Sadly the spontaneus reversibility of the tardive syndromes is 2%. They are permanent brain damage. But Altostrata do you think that the fact that for almost 2 weeks the muscle twitching had almost disappeared means that I am healing?

 

Thank you.

Drugs:                                                                                                                                                                                                                   

Amitriptyline 10 mg (11/02/2016 - 12/08/2016) Amitriptyline 20 mg (12/09/2016 - 12/28/2016)

Trazodone 25 mg (12/29/2016 - 02/27/2017)

Mirtazapine 15 mg (02/14/2017 - 02/27/2017) Olanzapine 2,5 mg (02/14/2017 - 02/27/2017)

Mirtazapine 30 mg (02/28/2017 - 04/09/2017) Olanzapine 10 mg (02/28/2017 - 03/20/2017)  Brotizolam 0,25 mg (03/31/2017 - 04/13/2017)
Sertraline 25 mg (04/23/2017 - 05/03/2017) Sertraline 50 mg (05/03/2017 - 06/31/2017) Diazepam 4 mg (04/23/2017 - 06/31/2017)

Supplements:

Fish oil, Magnesium and Vitamin E

Symptoms:

Continuous muscle twitching (tardive dyskinesia?), decreased libido and difficulty in sexual arousal (PSSD?), apathy, anhedonia and cognitive deficit

 

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  • Administrator

You may not have tardive dyskinesia. We often see people have muscle twitches in their legs when they go off psychiatric drugs.

 

Many people do better with fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

 

A lot of people find them helpful. Try a little bit of one at a time to see how it affects you. Believe it or not, many people don't have enough magnesium in their diets, and this makes them prone to muscle twitches and "restless legs."

 

One way or the other, you might as well be optimistic that these symptoms will eventually go away, there's no reason to think they're permanent.

 

Do you have any other odd symptoms after going off all those drugs? How did you go off each drug?

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 2 weeks later...

Hello Altostrata, thank you for your support and for this site.

 

On 13/12/2017 at 9:01 PM, Altostrata said:

Many people do better with fish oil and magnesium supplements, see

 

http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

 

A lot of people find them helpful. Try a little bit of one at a time to see how it affects you.

 

I've been taking them for months but without improvement in my muscle twitches. I also take vitamin E because can stop the deterioration of tardive dyskinesia.

I was thinking of adding korean ginsengquercetin or ashwagandha because they significantly reverse cognitive dysfunction caused by tardive dyskinesia in rats.

 

On 13/12/2017 at 9:01 PM, Altostrata said:

Believe it or not, many people don't have enough magnesium in their diets, and this makes them prone to muscle twitches and "restless legs."

 

In September I did a blood test and my magnesium level was normal.

 

On 13/12/2017 at 9:01 PM, Altostrata said:

Do you have any other odd symptoms after going off all those drugs? How did you go off each drug?

 

In April 2017 I tapered olanzapine in 5 days because I want to be off of it as soon as possible and then I stop cold turkey mirtazapine 6 days after be gone from 30 mg to 15 mg.

After stopping olanzapine I became like under the effect of drugs and then I became depressed.
I suffered insomnia and helped myself with the benzodiazepine brotizolam for 2 weeks.
For 4 months I had continuos headaches, very bad concentration and memory problems. I remember I could not read the newspaper.

For a while I also almost stopped eating.
In withdrawal I started my research on the damage of antipsychotics and I was so scared of what I read that I threatened suicide. Then my mother called the psychiatrist who prescribed olanzapine and told him that I was suicidal and he told her that he would call her back after 5 minutes but then he did not call back… So I went to the hospital and was forced to choose between hospitalization or take diazepam and sertraline.
I took them from April to June and tapered in July. The taper was fine but after I went off the drugs my parents stopped talking to me because they wanted me to continue to take them. So I took again diazepam and sertraline for 2 weeks because I needed their support but this time when I withdrew I became very apathetic. Is this normal withdrawal or PSSD?
I have low libido and difficulty to become excited but I don’t know if it is caused by olanzapine or sertraline. When I was on olanzapine I hadn’t sexual thoughts (I had no thoughts of any kind...), then when I stopped it I went in withdrawal so I didn’t think much about sex and shortly after I was forced on sertraline and again hadn’t sexual thoughts.
Sometimes I need to masturbate for long time before I can achieve orgasm and occasionally can’t maintain erection because I have difficulty to become excited.
I also thought was due to my drug induced hyperprolactinaemia but last blood test was normal and I haven’t see much improvements.

I was a porn addict and I masturbated 7 times per day. Now there is not much enjoyment left in watch porn or read hentai and I can’t masturbate much.

I hope I haven't PSSD. If it were olanzapine withdrawal I would have some chance of recovery.

More than 8 months after olanzapine withdrawal I still have lack of feeling and loss of interest.

I'm also less intelligent.

Drugs:                                                                                                                                                                                                                   

Amitriptyline 10 mg (11/02/2016 - 12/08/2016) Amitriptyline 20 mg (12/09/2016 - 12/28/2016)

Trazodone 25 mg (12/29/2016 - 02/27/2017)

Mirtazapine 15 mg (02/14/2017 - 02/27/2017) Olanzapine 2,5 mg (02/14/2017 - 02/27/2017)

Mirtazapine 30 mg (02/28/2017 - 04/09/2017) Olanzapine 10 mg (02/28/2017 - 03/20/2017)  Brotizolam 0,25 mg (03/31/2017 - 04/13/2017)
Sertraline 25 mg (04/23/2017 - 05/03/2017) Sertraline 50 mg (05/03/2017 - 06/31/2017) Diazepam 4 mg (04/23/2017 - 06/31/2017)

Supplements:

Fish oil, Magnesium and Vitamin E

Symptoms:

Continuous muscle twitching (tardive dyskinesia?), decreased libido and difficulty in sexual arousal (PSSD?), apathy, anhedonia and cognitive deficit

 

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  • Administrator
17 hours ago, Risilox said:

For 4 months I had continuos headaches, very bad concentration and memory problems. I remember I could not read the newspaper.

For a while I also almost stopped eating.

 

You had withdrawal syndrome for at least 4 months after going off olanzapine and mirtazapine in March (?). (This doesn't match the timeline in your signature, I am confused.)

 

It's too bad you worked yourself up to threatening suicide and got hospitalized. Please try to remain calm and undramatic, if you go back to the hospital, you will get even more drugs.

 

You might try taking magnesium anyway. Magnesium oil rubbed on your legs might relax them, too.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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I took olanzapine too for 3 months and Now im a little over a year off. Twitches diminished greatly. My issue is that im still experiencing cognitive difficulties especially during waves. Sometimes i feel lack of emotions too. It is really hard to accept because im 14 months off and im desperate to have my self back. I also im obsessed about withdrawal and how sick ive become and i cant enjoy things i used to love. Will that pass ? Is it withdrawal or i will have to be like this all the time ? Thanks 

2004-2007 paxil

2015- zoloft 3 months zyprexa 3 months lexapro 3 months xanax

Med free since Feb 28th 2017

Mostly experiencing PSSD

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  • 4 months later...

How r u ?

Is it getting better for you ? You have not updated here for a long time.

 

Best wishes

Bhasski

08/13 - 01/14
Olanzapine, petril MD (Clonazepam ), Dicorate ER (divalproex). Soza 10 (Zolpidem)

02/14 - 05/14
Flunil ​20mg , Divaa OD 250 mg(divalproex), Amisulpride 50mg (1-0-2), zolfresh 5 mg , Quetiapine
05/14 - 08/14 Venlafaxine 75 xr ( 1-0-1), zapiz 0.25
10/14 Zaptra 12.5mg , Oxetol xr 150mg (0-0-1)
11/14 - 08/15
Paris CR 25 (paroxetine) , Oxetol xr 600 mg (0-0-1), nitrest 5mg , Quetiapine for a month.
09/15-11 Venlafaxine XR 75 ( 1-0-1), Mirtazipine 15, Respiredal 0.5, Lamitor 25, zillion 10.
12/15-02/16 Off Meds (C.T)

03/16-Mid April Sertraline, Aripropazole, Quetiapine, Etizolam.

After that : CT and on OTC supplements (Roadback), now on Ayurveda
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Hello friend,

 

muscle twitches have improved but haven't healed.

 

On March 19 I took a sleep supplement that had 5-HTP and got PSSD. I knew that 5-HTP could cause PSSD and I would never have taken it. In fact the package said that the supplement had Griffonia and I didn't know that Griffonia was 5-HTP.

 

After taking the sleep supplement I couldn't sleep and I read the supplement leaflet. I learned that Griffonia was 5-HTP. I thought about throwing up but I didn't because I thought was very unlikely that I would have gotten PSSD after a single microdose of 5-HTP. The day after has started the erectile dysfunction.

 

Best wishes,

Risilox

Drugs:                                                                                                                                                                                                                   

Amitriptyline 10 mg (11/02/2016 - 12/08/2016) Amitriptyline 20 mg (12/09/2016 - 12/28/2016)

Trazodone 25 mg (12/29/2016 - 02/27/2017)

Mirtazapine 15 mg (02/14/2017 - 02/27/2017) Olanzapine 2,5 mg (02/14/2017 - 02/27/2017)

Mirtazapine 30 mg (02/28/2017 - 04/09/2017) Olanzapine 10 mg (02/28/2017 - 03/20/2017)  Brotizolam 0,25 mg (03/31/2017 - 04/13/2017)
Sertraline 25 mg (04/23/2017 - 05/03/2017) Sertraline 50 mg (05/03/2017 - 06/31/2017) Diazepam 4 mg (04/23/2017 - 06/31/2017)

Supplements:

Fish oil, Magnesium and Vitamin E

Symptoms:

Continuous muscle twitching (tardive dyskinesia?), decreased libido and difficulty in sexual arousal (PSSD?), apathy, anhedonia and cognitive deficit

 

Link to post
  • Administrator
Altostrata

Risilox, your nervous system is still very, very sensitive from going on and off all those drugs. Anything, even an herb, that is neuroactive might upset it.

 

Have your symptoms changed at all since March 19? How is your sleep?

 

How have the muscle twitches changed?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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1 hour ago, Altostrata said:

Risilox, your nervous system is still very, very sensitive from going on and off all those drugs. Anything, even an herb, that is neuroactive might upset it. 

 

Altostrata, are many herbs neuroactive?  Is it possible that the people on the PSSD forums who are constantly trying new things (drugs, herbs, suuplements) to try and cure or speed up their recovery, are actually making things worse for themselves - even though they many not realise it?

Escitalopram for anxiety (dates below are approximate).

 

Oct 09 - Apr 10, 20mg (tapered off over about 6 weeks). 

Jun 10 - Feb 11, 20mg (tapered off over about 6 weeks). 

Jun 11 - Aug 12, 20mg (started to taper off but failed). 

Oct 12 - Dec 13, 20mg.  Dec 13 - Apr 14, 10mg.  Apr 14 - Nov 14, 5mg. 

Nov 14 - Jan 16, 20mg.  Jan 16 - Aug 16, 10mg.  Aug 16 - Dec 16, 10mg every other day.  Dec 16 - Jan 17 5mg every third day.  Jan 17 - took last tablet.

 

 

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  • Administrator
Altostrata

They are taking those substances specifically because they are neuroactive. As you have seen, the results are unpredictable.

 

Every time you upset a hypersensitive nervous system, be it via drugs, drink, or neuroactive herbs, it needs to settle down. If you keep it in an uproar with anxiety over symptoms and constantly try new things that upset it. you are making your own problems.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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28 minutes ago, Altostrata said:

Every time you upset a hypersensitive nervous system, be it via drugs, drink, or neuroactive herbs, it needs to settle down. If you keep it in an uproar with anxiety over symptoms and constantly try new things that upset it. you are making your own problems. 

Thanks Altostrata.  I am trying to live a healthy lifestyle in terms of diet, with no drugs or supplements etc. apart from the fish oil and magnesium recommended here.

1Day

Escitalopram for anxiety (dates below are approximate).

 

Oct 09 - Apr 10, 20mg (tapered off over about 6 weeks). 

Jun 10 - Feb 11, 20mg (tapered off over about 6 weeks). 

Jun 11 - Aug 12, 20mg (started to taper off but failed). 

Oct 12 - Dec 13, 20mg.  Dec 13 - Apr 14, 10mg.  Apr 14 - Nov 14, 5mg. 

Nov 14 - Jan 16, 20mg.  Jan 16 - Aug 16, 10mg.  Aug 16 - Dec 16, 10mg every other day.  Dec 16 - Jan 17 5mg every third day.  Jan 17 - took last tablet.

 

 

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  • 3 months later...
Wellbutrinsucks

I stopped Wellbutrin and Adderall after a bad interaction in mid-June 2017, but the twitches started in late October 2017, and have been going on and off for months since last year. I don’t know what to do and how to treat it but I’ve got to find something because just not treating it has not been helpful, at all.

March 2016: Strattera

June 2016: Nothing

October 2016-April 2017:Wellbutrin SR

Mid-March 2017-March 2017 Adderall (9 days)

April 2017: Wellbutrin and Ritalin (7 days)

Mid-April to mid-June: nothing 

early June 2017: Wellbutrin XL

mid-June 2017: Wellbutrin XL, Adderall, and Hydrochlorothiazide (blood pressure); took for two days

Late August: Allegra for two days, then Propranolol

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