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Akathisia vs restlessness, anxiety, agitation


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Anyone familiar with windows and waves from SSRI induced Akathisia? I'm just looking for affirmation I have akathisia as my primary doctor insist it's my anxiety returning.  I was able to get on a call with Dr. Shipko (very short only 30 minutes). He said I probably have SSRI induced Aka based on my symptoms. Since I didn't get much time with him though I'm still wondering if that's the right diagnosis. Basically though my waves start with a headache / itchy skin / I feel extremely tired. Sometimes this is started by an obvious stressor, but not always. This one bad day turns into not sleeping long enough and waking with heavy morning anxiety. This is when things get really bad and I feel the need to pace. I walk miles in my house, even bought new shoes to walk since my knees started hurting. I don't enjoy sitting still at all. This goes on for days / weeks until for some reason it'll just break randomly and I'll feel almost back to normal. It literally feels like a switch. I was in a wave for a month almost all of February and have been going in and out of waves the past month or so with about 7 days, somewhat ok, 5 days in a massive wave, 7 days ok. Just not sure what I'm up against, part of me wants to contact a neurologist to see if they can diagnose me but it seems like I go into a window every time I'm about to make an appointment so I'm not sure if they'll even be able to diagnose me if I'm in a window. I've been completely off Lexapro after a somewhat fast taper over 4 months or so but I've been dealing with this issue (although it's improved) since I started Lexapro and especially since I started tapering. I still think there is a small possibility it could be benzo related as well but I think benzo Aka needs to be higher dose and probably longer term than a few months. I was only on Lexapro 1 month @ 10mg before I started tapering. I've dealt with severe burning skin, insomnia, nausea, amongst other things. I'm better today than I was in October but now that I'm completely med free for last 45 days and still having issues, I'm starting to get a bit nervous there is a bigger problem. 

 

If anyone can relate it would be hugely appreciated!

5/24 - Started .5mg - 1 Klonopin as needed - 7/20 - Started Lexapro 5mg (still on Klonopin) - 7/27 - Lexapro 10mg - 8/5 - Started tapering Klonopin stabilizing on a daily dose of .25mg - 8/17 - Jumped at .065 (fast taper... but it seemed to work)

8/17 - Lexapro to 9mg (time to get rid of the next drug..) - 8/29 - Lexapro to 6.5mg from 9mg (probably too fast but I had only been on Lexapro for a month so I felt like I could get away with it), 9/8-9/13 - Had alcohol all week sporadically (1 to 2 drinks) because I was feeling so much better. I tested with 1 drink, got away with it, and just kind of got excited.. ugh 

9/13 - Lexapro was down to 2.78mg (so 8/29-9/13 6.5 to 2.78mg) way too fast I know. 9/14 - Had a dentist appointment, received probably Lidocaine - Had mild anxiety in the afternoon after Novocaine wore off - 9/15 - Feels like I'm starting back into acute benzo withdrawal, 9/16 - Definitely very back into acute something, feels like Benzo withdrawal with severe burning sensation on skin, doing laps around the house. 

9/17 - Updosed Lexapro to 3.9mg 

9/19 - Updosed Lexapro more to 4.46mg

9/21-9/22 - reinstated Klonopin for 2 days .03125 mg 

9/26-10/16 - reinstated Klonopin again .03125 mg-.046875mg 

9/29-12/1 - reinstated Klonopin again - 03215mg-.065mg Klonopin

12/1 - 0 Klonopin

3/2 - .67mg Lexapro - Having a terrible month

3/12 - 0 Lexapro - advised it may actually be causing adverse side effects

 

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  • 3 weeks later...

Hi 

 

My Akathisia would go in a similar pattern each time I tried to come off and finally when I did. 

 

It would start similar to how you describe as well. It would usually last 2 weeks then a week off then a bit shorter then a bit longer window and so on. At one point it went for 6months then came back, then went for a year and came back. So it would switch round and eventually went. It was a scary time but once you saw the windows improve I felt a bit better. Although it was always hard to convince myself when it started again.

 

I went through this process 3 times due to getting off then back on, failed attempt to come and when I finally got off it was over a 4-5 month instead of a year or so.

 

I hope this helps.

 

 

 

 

 

 

 

April 2007 -  Seroxat 20mg

August 2008 - Cold Turkey

August 2009 - Cold Turkey

November 2009 - Reinstatement adverse reaction akathesia/suicidal/anxiety

March 2011 - Start taper

November 2012 - Crash badly at 1.25mg akathesia/suicidal/extreme anxiety

January 2013 - 5mg Seroxat, 300mg  Lyrica

April 2017 - Successfully get off Seroxat with taper followed by 4 month of withdrawal 

January 2018 - Start with constant urinary urge/pain/burning/genital sensations 2 week after anxiety/akathesia ends

January 2019 - Started reducing Lyrica as I suspect it's causing frequent urination, tinnitus, fatigue, brain fog and mental decline.

December 2019 - Off all pysch meds

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Super useful, thank you Boris!

5/24 - Started .5mg - 1 Klonopin as needed - 7/20 - Started Lexapro 5mg (still on Klonopin) - 7/27 - Lexapro 10mg - 8/5 - Started tapering Klonopin stabilizing on a daily dose of .25mg - 8/17 - Jumped at .065 (fast taper... but it seemed to work)

8/17 - Lexapro to 9mg (time to get rid of the next drug..) - 8/29 - Lexapro to 6.5mg from 9mg (probably too fast but I had only been on Lexapro for a month so I felt like I could get away with it), 9/8-9/13 - Had alcohol all week sporadically (1 to 2 drinks) because I was feeling so much better. I tested with 1 drink, got away with it, and just kind of got excited.. ugh 

9/13 - Lexapro was down to 2.78mg (so 8/29-9/13 6.5 to 2.78mg) way too fast I know. 9/14 - Had a dentist appointment, received probably Lidocaine - Had mild anxiety in the afternoon after Novocaine wore off - 9/15 - Feels like I'm starting back into acute benzo withdrawal, 9/16 - Definitely very back into acute something, feels like Benzo withdrawal with severe burning sensation on skin, doing laps around the house. 

9/17 - Updosed Lexapro to 3.9mg 

9/19 - Updosed Lexapro more to 4.46mg

9/21-9/22 - reinstated Klonopin for 2 days .03125 mg 

9/26-10/16 - reinstated Klonopin again .03125 mg-.046875mg 

9/29-12/1 - reinstated Klonopin again - 03215mg-.065mg Klonopin

12/1 - 0 Klonopin

3/2 - .67mg Lexapro - Having a terrible month

3/12 - 0 Lexapro - advised it may actually be causing adverse side effects

 

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  • 5 months later...
  • Moderator Emeritus

A member posted this in their Introduction topic.  Please note that I am not suggesting that this is the answer.  Just something that one of SA's members experienced that I thought would get to have documented in this topic.

 

1 hour ago, Alice1 said:

When I recovered the first time from Aka I remember not doing anything in particular to help.  The first 3 years I walked and meditated everyday, I had a counselor, and did everything possible to try to get better.  I really didn’t start getting better until I just forgot about all that stuff and started focusing on normal things.  If you ask me, I think just time and drug abstinence are the only things required. Then once you start feeling better even just a little bit, it’s important to just start living your life, smart and carefully of course.  

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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46 minutes ago, Lloyd said:

 

I survived Akathisia!!!! Of all the horrible things this was by far the worst part of withdrawal - the experience was truly the worst thing that has ever happened to me. Words can't describe how horrible it is to live with it 24x7. It eased up suddenly early this year quite dramatically and then vanished. Occasionally I feel fidgety but that seems to be anxiety more than anything else. I have no idea why it suddenly stopped - nothing changed, diet, medications, environment etc. But either way I am thankful that it has.

 

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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I had restless legs a week ago in the evenings
About 5-7 hours after administration
The day before yesterday, 23 days after the last cut, a very severe wave began
There is a great deal of anxiety and nausea. The pulse is very fast and high blood pressure
Strange, like restless legs precede the wave

Xanax 0,5mg 1999-2019 a Xanax 0,5mg paar korda kuus, vajadusel

Cymbalta 30mg 2012-25.04.2018 kitsenev 2-3 kuud,rasked sümptomid 1 nädal pärast viimast annust

Amitriptüliin 25mg 25.05.18-20.01.19 ,kitsenev 2-3 kuuga, unetus, paanika-ärevus, segasusseisund, iiveldus

Valdoxan 25mg 10.02.19-10.03.19, ei stabiliseerinud olukorda, Lorasepaam 10.02.19-20.02.19 vajadusel üleöö

Brintellix 5mg 10.03.19-30.06.19 ,ei stabiliseerinud olukorda, hirme, segasust ja unetust, olin haiglas 1 nädal

Olansapiin 5mg 01.03.19-02.08.19,unetuse leevendamiseks suureneb segasus, suureneb depressioon, tekib raske akatiisia Cymbalta 30mg 30.06.19-01.08.19,ei tööta enam, olukord ei stabiliseeru, jälle haiglas 2 nädalat

Levomepromasiin 5mg 03.08.19-20.12.19 aitas magada, kuid suurendas segadust ja depressiooni

Anafraniil 75mg03.08.19-15.12.19  15.12.19 , 35mg  17.05.20  , 27mg 01.01.21 16.07.21 oli päevane A19 mg 01.04.22 11mg 01.11.22 8,6mg, 01.11.23 6,5mg 01.01.24 5mg

 

 

 

                 

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  • 2 months later...
On 2/16/2021 at 9:22 PM, shambambo said:

 All of a sudden  I started to feel inner vibrations in both my legs. I thought my legs had their blood supplies cut off, never thought of akathisia, never heard of it before. 2-3 days later it was all over with a feeling of immense and persisting fear I never experienced before. I felt it EVERYWHERE, even in my eyelids.

 

 

I've never related to a post more. It's an odd sensation to be overly aware of your eyelids. Question for other members who have more knowledge that I-when I get akathisia, it really throws my balance, like i have a bobble head or my body doesn't know where it is in space. 

 

Does that make sense or is that a separate symptom?

Luvox (2015, 100mg)

Xanax (2018, 1mg as needed)

Pristiq (2018 for 3 weeks then ended CT)

Gabapentin (2018)

Lyrica (2018)

**Weaned off all drugs except Luvox between 2019-2020**

Luvox (2020 increased to 300mg)

Luvox (2021 decreased to various levels between 200-125; 2021 100-150 around my period for PMDD; Late September 2021: Start weaning off 100mg;September ?-Oct 3 Various dosages between 100 and 75 recommended by doctor; October 3-8: 75mg (various doses through the day for w/d.; October 9-18: 50mg; October 20-29: 37.5mg; October 30-Nov 1: 25mg; November 2-November 19: Back to 37.5mg; November 20-December 4: 31.25mg; December 4-December 21: 25mg;December 21-December 23: up-dosed to 31.25mg doing 6.25 in the morning and 25mg at night; 12/23-present: 6.25mg Luvox AM/25 mg Luvox PM; 0.0625mg of Xanax at 8 AM, 2 PM and 8 PM.)

 

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13 hours ago, UnusualRoom said:

I've never related to a post more. It's an odd sensation to be overly aware of your eyelids. Question for other members who have more knowledge that I-when I get akathisia, it really throws my balance, like i have a bobble head or my body doesn't know where it is in space. 

 

Does that make sense or is that a separate symptom?

 

Hi again UR, as I just gave you a link here from your Introduction.

I definitely can relate to having had the "bobble head" symptom.

And no, I did not consider that to be akathisia at all.

Mine occurred shortly after taking magnesium citrate orally/by mouth when I was in acute WD.

 

That out of space feeling, could be WD symptom of DP/DR(depersonalization, derealization), or secondary to your benzo too.  I know with my own brief experience on benzo's I really did feel out of it, in that kind of way.

I also got the symptom of feeling out of space in early WD too and then off and on later.

 

Derealization or Depersonalization(DR and DP)

Here's that topic ^. 

Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks.

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021. Lapsed.  Redo of quit smoking 9/28/2022.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider.  My success story:  Blue skies ahead, clear sailing

 

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  • 3 months later...

Hi, since january i have had constant tightness and restlessness in my chest. It never goes away and makes it Impossible to relax properly.
 

Have tried meditation and breathing techniques, but they just dont work.

 

I am starting to get really tired because my chest never will relax. I can never just sink back in the couch or lay down in my bed.

 

My sleep is messed up because of this! 

 

I also have this diffuse anxious and scared feeling all the time, and i dont know why! Its constant, and i just want to relax. Feels like i am constantly on the verge of panick. 
 

Sometimes i get this burning pain in my chest and the restlessness gets way worse!

 

My breathing is also troubling me. 


I sometimes get the restlessness in my legs, but this constant in my chest is the worst, and the diffuse scared feeling.

 

Its been four months off this, is it even possible to recover?


I have waves that come roughly every three weeks like clockwork. The Windows always stay the same though. I never get any better.

June-July -21 Zyprexa 2.5-7.5 mg 

July -21 Mianserin 20 mg four days

July-Aug -21 Valium 30 mg a day, tapred, return of symptoms 

Aug-Oct -21 Oxazepam Tapred from 10 mg x 3 to zero

Dec-Jan -21/22 On and off mirtazapine 15 mg. Kindling reaction?

March 8.-19. - Zopiclone 7.5 mg to combat insomnia 

March 20 - 5 mg valium because of akathisia and panic 

April 3. - 5 mg x 2

 

 
 

 

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8 minutes ago, Sofa said:

Hi, since january i have had constant tightness and restlessness in my chest. It never goes away and makes it Impossible to relax properly.
 

Have tried meditation and breathing techniques, but they just dont work.

 

I am starting to get really tired because my chest never will relax. I can never just sink back in the couch or lay down in my bed.

 

My sleep is messed up because of this! 

 

I also have this diffuse anxious and scared feeling all the time, and i dont know why! Its constant, and i just want to relax. Feels like i am constantly on the verge of panick. 
 

Sometimes i get this burning pain in my chest and the restlessness gets way worse!

 

My breathing is also troubling me. 


I sometimes get the restlessness in my legs, but this constant in my chest is the worst, and the diffuse scared feeling.

 

Its been four months off this, is it even possible to recover?


I have waves that come roughly every three weeks like clockwork. The Windows always stay the same though. I never get any better.

I sometimes have akathisia and discover that a small dose of Betaloc (half a tablet of Metropolol) went to bed the next day took akathisia.
In case of akathisia, I have had very disturbing weakness in my legs and arms with great unrest

However, these symptoms will not go away, even if you have had them for a long time

Xanax 0,5mg 1999-2019 a Xanax 0,5mg paar korda kuus, vajadusel

Cymbalta 30mg 2012-25.04.2018 kitsenev 2-3 kuud,rasked sümptomid 1 nädal pärast viimast annust

Amitriptüliin 25mg 25.05.18-20.01.19 ,kitsenev 2-3 kuuga, unetus, paanika-ärevus, segasusseisund, iiveldus

Valdoxan 25mg 10.02.19-10.03.19, ei stabiliseerinud olukorda, Lorasepaam 10.02.19-20.02.19 vajadusel üleöö

Brintellix 5mg 10.03.19-30.06.19 ,ei stabiliseerinud olukorda, hirme, segasust ja unetust, olin haiglas 1 nädal

Olansapiin 5mg 01.03.19-02.08.19,unetuse leevendamiseks suureneb segasus, suureneb depressioon, tekib raske akatiisia Cymbalta 30mg 30.06.19-01.08.19,ei tööta enam, olukord ei stabiliseeru, jälle haiglas 2 nädalat

Levomepromasiin 5mg 03.08.19-20.12.19 aitas magada, kuid suurendas segadust ja depressiooni

Anafraniil 75mg03.08.19-15.12.19  15.12.19 , 35mg  17.05.20  , 27mg 01.01.21 16.07.21 oli päevane A19 mg 01.04.22 11mg 01.11.22 8,6mg, 01.11.23 6,5mg 01.01.24 5mg

 

 

 

                 

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1 minute ago, Estman said:

However, these symptoms will not go away, even if you have had them for a long time

You mean they will never go away? I will have akathisa forever?

June-July -21 Zyprexa 2.5-7.5 mg 

July -21 Mianserin 20 mg four days

July-Aug -21 Valium 30 mg a day, tapred, return of symptoms 

Aug-Oct -21 Oxazepam Tapred from 10 mg x 3 to zero

Dec-Jan -21/22 On and off mirtazapine 15 mg. Kindling reaction?

March 8.-19. - Zopiclone 7.5 mg to combat insomnia 

March 20 - 5 mg valium because of akathisia and panic 

April 3. - 5 mg x 2

 

 
 

 

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40 minutes ago, Sofa said:

You mean they will never go away? I will have akathisa forever?

 

40 minutes ago, Sofa said:

 

 

40 minutes ago, Sofa said:

 

I have been reducing my antidepressant for 2.5 years.
At first it lasted longer and then I reduced my dose too quickly.
At present, agitation usually occurs after dose reduction
However, for a while it passes or changes with periods of fatigue.
But this is due to the reduction of the antidepressant
If it is no longer necessary to do this, the agitation will eventually disappear

Xanax 0,5mg 1999-2019 a Xanax 0,5mg paar korda kuus, vajadusel

Cymbalta 30mg 2012-25.04.2018 kitsenev 2-3 kuud,rasked sümptomid 1 nädal pärast viimast annust

Amitriptüliin 25mg 25.05.18-20.01.19 ,kitsenev 2-3 kuuga, unetus, paanika-ärevus, segasusseisund, iiveldus

Valdoxan 25mg 10.02.19-10.03.19, ei stabiliseerinud olukorda, Lorasepaam 10.02.19-20.02.19 vajadusel üleöö

Brintellix 5mg 10.03.19-30.06.19 ,ei stabiliseerinud olukorda, hirme, segasust ja unetust, olin haiglas 1 nädal

Olansapiin 5mg 01.03.19-02.08.19,unetuse leevendamiseks suureneb segasus, suureneb depressioon, tekib raske akatiisia Cymbalta 30mg 30.06.19-01.08.19,ei tööta enam, olukord ei stabiliseeru, jälle haiglas 2 nädalat

Levomepromasiin 5mg 03.08.19-20.12.19 aitas magada, kuid suurendas segadust ja depressiooni

Anafraniil 75mg03.08.19-15.12.19  15.12.19 , 35mg  17.05.20  , 27mg 01.01.21 16.07.21 oli päevane A19 mg 01.04.22 11mg 01.11.22 8,6mg, 01.11.23 6,5mg 01.01.24 5mg

 

 

 

                 

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Estman,

 

My B12 and folate levels were measured in different units. One of my levels of B12 was 132pg/mL. My folate was 6.1 ng/mL. (Bottom of range). I can’t compare your levels to mine. Do  your test results show you are above or below range?

 

A caution about beta-blockers. I have a friend who went many years on psych drugs. She managed to get off them. This winter she got very sick with COVID and it brought back a lot of symptoms. She gave into taking a beta-blocker. Once she wanted off the beta-blocker, she started tapering and is having a terrible time. The point is, some people experience withdrawal syndrome after short-term use of beta-blockers. That said, I understand your need to mitigate the agitation. I think stopping the B vitamins, especially the methyl-folate will help. 
 

Grace

  • amitriptyline from 1980-2002,
  • intermittent  use of benzos over 2 decades prior to 2002
  • 2002-2010 Klonopin 1-2 mg., ambien 10--20, mg, remeron 4 mg. and  trileptal 300 mg
  • 2011 Stopped ambien and crossed over to valium 17.5 mg. (updosing 2.5 mg. to cover ambien C/T )
  • tapered valium w/ long holds to 12.74 mg. from a high of approximately 20-30 mg/day
  • 2015-present tapered trileptal aggressively for a year; now intermittently; interacts w/ other drugs
  • currently 2024 still on 96 mg. trileptal and 4 mg. remeron
  •  Currently on benzo hold as I have to cross-over from brand-name valium to generic diazepam.  
  • Current dose of diazepam is 8.8 and valium is 5.7.  I had to up-dose the total valium/diazepam from 12.74 to 14.5 where I have stayed since June 2023.  I am crossing over to generic at a somewhat tolerable rate of .3mg/month after about 2 months of trial/error w/ updosing.  I am not currently tapering; will continue to cross over. 

 

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On 4/26/2022 at 7:44 PM, savinggrace said:

Estman,

 

My B12 and folate levels were measured in different units. One of my levels of B12 was 132pg/mL. My folate was 6.1 ng/mL. (Bottom of range). I can’t compare your levels to mine. Do  your test results show you are above or below range?

 

A caution about beta-blockers. I have a friend who went many years on psych drugs. She managed to get off them. This winter she got very sick with COVID and it brought back a lot of symptoms. She gave into taking a beta-blocker. Once she wanted off the beta-blocker, she started tapering and is having a terrible time. The point is, some people experience withdrawal syndrome after short-term use of beta-blockers. That said, I understand your need to mitigate the agitation. I think stopping the B vitamins, especially the methyl-folate will help. 
 

Grace

Hi Grace,

When I had akathisia 3-4 days ago, I took half a tablet of Betaloc (metropolol) in the evening
Interestingly, the next day it relieved the symptoms of akathisia such as restlessness and especially weakness in the legs and arms.
Then I thought B12 and folic acid must have caused this akathisia
Now I remembered that the day before Akathisia, I took half a tablet of Telmisartan (a micardist) to lower my high blood pressure.
I didn't know the connection, but when I read my new blood pressure medicine leaflet, I started thinking
Your doctor has prescribed Prenessa (Perindopril) for testing, but this leaflet says that it may cause weakness in your hands and feet.
This is exactly the symptom I had with Telmisartan. I also felt great akathisia and anxiety.
For some reason, my blood pressure medicine caused me to have a fast pulse, even the next day
That's why for some reason I took another half of Betaloc (Metropolol) yesterday morning.
However, my depression has increased since yesterday afternoon.
I have a feeling that a beta blocker causes an increase in depression
And it seems that the blood pressure medicine Telmisartan can cause akathisia.
Could that be the case?
I have to lower my blood pressure if I have a severe headache, like a migraine. Often my blood pressure rises
There is a characteristic headache, especially in the neck.
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Saada tagasisidet
Külgpaneelid

Xanax 0,5mg 1999-2019 a Xanax 0,5mg paar korda kuus, vajadusel

Cymbalta 30mg 2012-25.04.2018 kitsenev 2-3 kuud,rasked sümptomid 1 nädal pärast viimast annust

Amitriptüliin 25mg 25.05.18-20.01.19 ,kitsenev 2-3 kuuga, unetus, paanika-ärevus, segasusseisund, iiveldus

Valdoxan 25mg 10.02.19-10.03.19, ei stabiliseerinud olukorda, Lorasepaam 10.02.19-20.02.19 vajadusel üleöö

Brintellix 5mg 10.03.19-30.06.19 ,ei stabiliseerinud olukorda, hirme, segasust ja unetust, olin haiglas 1 nädal

Olansapiin 5mg 01.03.19-02.08.19,unetuse leevendamiseks suureneb segasus, suureneb depressioon, tekib raske akatiisia Cymbalta 30mg 30.06.19-01.08.19,ei tööta enam, olukord ei stabiliseeru, jälle haiglas 2 nädalat

Levomepromasiin 5mg 03.08.19-20.12.19 aitas magada, kuid suurendas segadust ja depressiooni

Anafraniil 75mg03.08.19-15.12.19  15.12.19 , 35mg  17.05.20  , 27mg 01.01.21 16.07.21 oli päevane A19 mg 01.04.22 11mg 01.11.22 8,6mg, 01.11.23 6,5mg 01.01.24 5mg

 

 

 

                 

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Estman

 

My best advice to you would be not to try and manage all of your symptoms with a pill or a supplement.  Try to go "through it" instead of around it.  When there are too many variables (1/2 tablet of this, some of that....) you really don't know what is causing what.  Often just letting your brain settle down will calm things like akathisia.  But you have to be patient and wait.  Often times, meds and supplements can cause high blood pressure.   The instability caused by the stress of so much change will not help.  Try looking for natural (non-pill or supplement) ways to ease your symptoms.  Be careful with your diet, get some gentle exercise, try to avoid avoidable stress, and sleep when you can.  Accepting that you aren't going to get a normal night's sleep is probably best.  The thing is when you take these temporary remedies, your body reacts to them when they leave your body and wants more.  This causes a viscous cycle that makes tapering so much more difficult.

 

I use heat, ice, distraction, exercise (gentle), prayers, meditation as my only remedies.  I have a lot of chronic pain 24/7 and gut problems and insomnia as well.  I never take anything but these darn drugs I haven't been able to get off.  Even "natural" supplements and foods interact with the blood levels of your medicine and destabilize you.  There is no remedy for withdrawal except time.

 

Grace

  • amitriptyline from 1980-2002,
  • intermittent  use of benzos over 2 decades prior to 2002
  • 2002-2010 Klonopin 1-2 mg., ambien 10--20, mg, remeron 4 mg. and  trileptal 300 mg
  • 2011 Stopped ambien and crossed over to valium 17.5 mg. (updosing 2.5 mg. to cover ambien C/T )
  • tapered valium w/ long holds to 12.74 mg. from a high of approximately 20-30 mg/day
  • 2015-present tapered trileptal aggressively for a year; now intermittently; interacts w/ other drugs
  • currently 2024 still on 96 mg. trileptal and 4 mg. remeron
  •  Currently on benzo hold as I have to cross-over from brand-name valium to generic diazepam.  
  • Current dose of diazepam is 8.8 and valium is 5.7.  I had to up-dose the total valium/diazepam from 12.74 to 14.5 where I have stayed since June 2023.  I am crossing over to generic at a somewhat tolerable rate of .3mg/month after about 2 months of trial/error w/ updosing.  I am not currently tapering; will continue to cross over. 

 

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  • 1 month later...

Vit B6 and akathisia:

https://www.madinamerica.com/2018/01/vitamin-b6-effective-reducing-antipsychotic-induced-akathisia/

I wonder why noone has found this so far... 

Ad's since 2016 (I was 16 then...) (Escitalopram) 

Nov 2018 switch to venlafaxin 150mg

Nov 2019 to march 2020 tapered by 37,5mg to cero. (breakdown, minor w/d symptoms for a few days only panic attacks followed by deep depression came a month later duo to stress). 

Reinstated venla 150mg in Juli 2020.

Nov 2020 to April 2021 tapering by 15mg every month or so until I reached approximately 50 mg(no w/d symptoms) 

Since April 2021 tapered once by 5% and once by 10% of the last dose because I'm not stable enough for w/d. 

Current dose 50mg venlafaxin

No other medication. 

No supplements

Stopped smoking 29.12.2021

No alcohol 

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  • 4 weeks later...

When I had akathisia I found it helpful to wear compression garments, for example exercise clothing (athleisure) with compression effect.

It felt comforting and helped calm me down. 

1996-2018 - misc. polypharmacy, incl. SSRIs, SNRIs, neuroleptics, lithium, benzos, stimulants, antihistamines, etc. (approx. 30+ drugs)

2012-2018 - 10mg lexapro/escitalopram (20mg?)    Jan. 2018 - 10mg -> 5mg, then from 5mg -> 2.5mg, then 0mg  -->  July 2018 - 0mg

2017(?)-2020 - vyvanse/lisdexamfetamine 60-70mg    2020-2021 - 70mg down to 0mg  -->  July 2021 - 0mg

March-April 2021 - vortioxetine 5-10mg (approx. 7 weeks total; CT)  -->  April 28th, 2021 - 0mg

supplements: magnesium powder (dissolved in water) as needed throughout the day; 1 tsp fish oil w/ morning meal; 2mg melatonin 

August 1, 2022 - 1 mg melatonin

 

Courage is fear that has said its prayers.  - Karle Wilson Baker

love and justice are not two. without inner change, there can be no outer change; without collective change, no change matters.  - Rev. angel Kyodo williams

Holding multiple truths. Knowing that everyone has their own accurate view of the way things are.  - text on homemade banner at Afiya house

 

I am not a medical professional; this is not medical advice. 

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On 6/28/2022 at 10:11 AM, Ariel said:

When I had akathisia I found it helpful to wear compression garments, for example exercise clothing (athleisure) with compression effect.

It felt comforting and helped calm me down. 

@Ariel, could you tell me if I really have akathisia?
In bad days my body cannot calm down. I feel resteless and I can't function, I just cry. 
I have a sense of discomfort. I keep moving my legs and feets. Suicidal ideation happens at times, mostly in the afternoom. I became agressive and incapable to work and do daily tasks. Tks

Past meds:

  • 2013-2019 = 100mg Quetiapine
  • mar20 - aug20 = 50mg Quetiapine
  • aug20 - jun21 = 25mg Quetiapine + 5mg melatonin
  • jun21 - aug21 = 12,5mg Quetiapine + 5mg melatonin
  • aug21 = 6,25mg Quetiapine + 5mg melatonin
  • sep21 - oct21 =  5mg melatonin
  • oct21 - dec21 = 0,5mg Clonazepam + 5mg melatonin 
  • 25th dec 21 - 5th jan 22 = 5mg melatonin  
  • 5th jan 22 - 17th jan 22 = 0,3mg Clonazepam + 5mg melatonin + 12mg CBD full spectrum
  • 17th jan 22 - 19th fev 22 = 0,2mg Clonazepam + 5mg melatonin 
  • 19th fev 22 - 25th fev 22 = 12,5mg Quetiapine

Current meds:

  • 01st mar 22 = 50mg Pregablin (Lyrica) 
  •  50mg Pregablin = 30 mg 10:30 PM + 12,5mg 10:30 AM + 7,5 mg 5:00 AM
  • 23 mar = 6,25mg Quetiapine  /  31 mar = 5,0 mg / 11 apr - until now = 4,0 mg at 04:30AM
  • (Between 15 may - 20 may) 0,5 mg Quetiapine 03:30 AM 
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On 7/6/2022 at 2:46 AM, Valerio said:

@Ariel, could you tell me if I really have akathisia?
In bad days my body cannot calm down. I feel resteless and I can't function, I just cry. 
I have a sense of discomfort. I keep moving my legs and feets. Suicidal ideation happens at times, mostly in the afternoom. I became agressive and incapable to work and do daily tasks. Tks

Yes sounds like akathisia to me... It's very likely a dopamine issue. I have heard vit b6 and niacin can help. 

Edited by kostakonkordia

Ad's since 2016 (I was 16 then...) (Escitalopram) 

Nov 2018 switch to venlafaxin 150mg

Nov 2019 to march 2020 tapered by 37,5mg to cero. (breakdown, minor w/d symptoms for a few days only panic attacks followed by deep depression came a month later duo to stress). 

Reinstated venla 150mg in Juli 2020.

Nov 2020 to April 2021 tapering by 15mg every month or so until I reached approximately 50 mg(no w/d symptoms) 

Since April 2021 tapered once by 5% and once by 10% of the last dose because I'm not stable enough for w/d. 

Current dose 50mg venlafaxin

No other medication. 

No supplements

Stopped smoking 29.12.2021

No alcohol 

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Has anyone tried an antihistamine or anti inflammatory diet to help?

2000-2018 150-200mg Sertraline and Vyvanse

2018- vyvanse 60mg to 0 over 6mo. 200mg Sertraline to 150mg. 2019- 150mg Sertraline to 100mg. Early 2021- 100mg to 87.5, two weeks later 87.5 to 75mg, 1.25-4mg bromazepam PRN. Mid 2021 - Feb 2022 taper 2.5%-5% 75mg to 50mg. March 2022 bromazepam for 3 weeks. May 9th 2022 started Propranolol, 10mg in the morning and 10mg in the evening. July 2022- off propranolol Oct 2022- off birth control. Dec 2022- updose sertraline 100mg, benztropine 1mg and Ativan 1mg. March 2023- stop benztropine. May 2023 - ativan taper finished. May 2023 - updose Sertraline to 125mg added propranolol 40mg added Ativan 1mg. July 5- sertraline 112.5mg propranolol 60mg, quick 2 week Ativan taper. Current meds: propranolol 60mg, sertraline 106.25mg, Ativan .025mg, B6, CoQ10, Magnesium Glycinate

 

 

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  • 1 month later...

I am so afraid of akathisia. It is simply a terrible condition. I read so much about it and it scares me. Can akathisia be mild? Is every akathisia a feeling of terror that prevents normal functioning?

05.2021 mirtazapine (first 15 mg, after 2 weeks 30 mg)

08.2021 citalopram (?mg)

10.2021 switching from citalopram to duloxetine (60 mg), mirtazapine 15 mg

04.2022 switching from duloxetine to vortioxetine 10 mg (4 weeks on 30 mg duloxetine), mirtazapine 7.5

06.2022 off mirtazapine

07.2022 off vortioxetine 5 mg (irregular taking - can be called CT)

07.2022 back to vortioxetine 10 mg and mirtazapine 7.5 mg

03.09.2022 reduce 10 mg vortioxetine to 5 mg

10.2022 off vortioxetine

11.2022 reduce mirtazapine to 3.75

12.2022 off mirtazapine (ALL MEDS OFF)

 

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I’ve had Akathisia for around 20 days. It seemed to have been triggered by going CT on 5mg of Abilify (which is a pretty low dose). It was extremely bad the first few days, I paced one day 20.000 steps. 
 

Around two days after it appeared, I reinstated the 5mg Abilify. I believe that improved the symptoms quite a lot, but it still is there. I also experience what I believe are waves at certain times.

 

I haven’t been suicidal for a few months, but I could become suicidal again if this does not go away quickly. It isn’t that bad compared to how some people get it, but it still is uncomfortable and has the ability to put my life on hold as long as it is present. Reading the horror stories on Reddit and on sites like this really doesn’t make it any better. I can’t survive years or even several months with this. Will it likely go away as I stabilise on Abilify?

Clonidine 0,3mg / 0,15mg x 2 (2015-)
Seroquel 25mg (2021-2022), reinstated for insomnia (increased to 100mg, only several days), stopped | Sertraline/Zoloft (2015-2022), switched to Effexor | Lamotrigine/Lamictal 25mg, increased to 50mg, stopped (2022 - June 2022)| Venlafaxine/Effexor (January 2022 - 21 July 2022), 150mg, tapered to 75mg, then to 37,5mg, stopped | Benzatropine/Cogentin (unsure of dosage, 1mg??), taken with Haloperidol, stopped (June 2022 - July 2022)| Prozac 10mg, bridge for Effexor, (21 July 2022 - 8 August 2022), stopped | Haloperidol 2mg (June 2022 - July 2022), quit cold turkey | Paspertin 10mg, proscribed for nausea, taken for around two days, stopped (August 2022 - August 2022) | Lorazepam 1mg, taken for several days for insomnia, increased to 2,5mg for three days, stopped (2022-2022) | Abilify 5mg (July 2022 - August 2022), quit cold turkey, edit: might reinstate due to discontinuation Akathisia | Hydroxyzine / Atarax 50mg x 3 (August 2022-)

 

 

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  • Moderator

I know it’s hard but try to stop reading the horror stories @Sturm. All the different websites and forums you frequent are skewed because people who recover get on with life. 90% of the people you interact with are suffering to some extent, which makes it difficult to find the people who have healed. 
 

You’ve probably read it but there’s some more information on people recovering from akathisia here: 

I’ve been dealing with it for just under 4 months now and it’s definitely changed somewhat. I’m hesitant to say improved as it keeps coming back. I’m hopeful though.

Active Monday-Friday UK time

 

MEDICATION:

1) Sertraline:

50mg - Oct 2020, 100mg - Dec 2020, 50mg - April 2021, 75mg - May 2021, 50mg - Sep 2021; Failed taper attempt (50 -> 49) - Jan 2024; Second attempt to start taper - 17 Feb 2024

Current dose: 48.9mg (Feb 2024)

2) Mirtazapine:

15mg  - Nov 2020

SUPPLEMENTS:

Cod liver oil

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I have often a feeling of internal terror, like my brain is tight and I cannot exist in the present moment. This seizes me internally and mentally and I am consumed by the fear of what if I never feel at peace or happy again and am driven to SI. 
 

i also experience emotional anesthesia and can’t tell if this is my internal reaction to how scary the flatness is or if this something separate from the flatness. 
 

It hasn’t been this way non stop for the last 4 months, but lately it seems more consistent and unrelenting. 
 

my body does not feel propelled to pace or move- it is just in my brain and I feel consumed internally.

 

in the last when I have been convinced I will feel better again and this will be a thing of the past I have been able to forget about it and even enjoy certain moments. 
 

help determine if this is inner akathisia is? 

Aug 2020 - Feb 2022 on and off Lexapro 5 and 10mg,  Rapid taper

Nov 2021 - May 2022 on off Wellbutrin 100mg, 150mg, 75mg CT clindamycin cycle and also Plan B bc 1x 

Fall 2020- June 2022 - Xanax .5 PRN usually 4x a week, CT 

June 2022 - Z pack, Buspar 7.5 3 days

September 20-24th - low tryptophan diet and 20-30g beef gelatin powder

Oct 3- 16 - Xanax .5 for sleep each pm, 1 mg Ativan in ER, .25 Xanax —> .125–>0 

Oct 14-17Trazadone 50/75, Lunesta 3mg 

Oct 24-  start Belsomra, 4 days to20mg 

Nov 3-5 10mg Belsomra and 300mg Gabapentin 

Oct 13-Dec 1 Buspar 7.5 2x/day rapid taper over 2 weeks due to ADR 

Recent: Belsomra 20mg since 10/23/2022 to 15mg mid December for 2 nights —> 20mg —> 15 mg since 12/22/2022 —>14 mg compounded 02/11/2023 —> 15 mg 2/13 —> 10mg 2/22 —> 5mg 3/1 —> 0mg 3/8/2023 

Current:  Propanolol 20mg AM, 10mg 4pm, 20mg PM since 11/30/2022

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  • 1 month later...

That is almost a textbook definition, yes.

From what I have learned by talking with all sorts of people there are two main components of akathisia, one or the other can be more prevalent:

1) agitation/restlessness; it can be internal, external or both; there is an inability to relax that is relentless and merciless.
2) terror; like you are being chased by a serial killer, doom, dread.

Lots of people mainly have one or the other, others have both. For some people, one resolves before the other, for others they go at the same time.

In my case the second has much improved, maybe 70%, the first aspect... maybe only 20%. I am 6 months out from the causative agent and on mirt 15mg.

December 2021 - Metoclopramide started. Akathisia symptoms start; Metoclopramide gets changed to PRN.

March 2022 - Akathisia diagnosed; Metoclopramide stopped; Propranolol 10mg x twice a day. Biperiden PRN (0.5mg to 1mg).

April 2022 - Tandospirone 30mg (10mg 3x day), Quetiapine 25mg (only taken once, immediate adr). Mirtazapine 7.5mg. . Discontinued Propranolol.

May 2022 - Mirtazapine upped to 15mg. Tandospirone cut to 2x 10mg. Low dose Depakote for the month; 100 to 200 to 100 to 0. Mirtazapine cut back to 11.75mg (3/4 of a 15mg pill).
June 2022 - Mirtazapine updose to 15mg. Tandospirone, Biperiden discontinued. Klonopin started PRN (0.5mg). 
September 2022 - Akathisia slowly starts improving, WD/ADR normal sets in in mid September. Hold for 4 months.
March 2023 - Off mirtazapine; no Klonopin for 5 months either! Started quercetin (250mg x 2) to soften the histamine rebound.

May 2023 - Stopped quercetin and changed from magnesium carbonate to oxide - reacted badly. Reverted back to carbonate. 
June 2023 - Added fish oil.
Current regimen: CALM Magnesium (Carbonate into Citrate) 175mg x2; Vitamin E 268mg x2; Fish oil (100mg Omega3; EPA 30mg; DHA 37mg)x2
Intro thread: 
https://www.survivingantidepressants.org/topic/27095-portuguesesea-metoclopramide-akathisia-and-mirtazapine/

 

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  • 4 weeks later...

Does anyone experience a lot of discomfort in their esophorgus and or ear canals during an Akathisia storm? 
 

i will feel very gassy, heartburny, etc.  

 

is this related in any way? 

Aug 2020 - Feb 2022 on and off Lexapro 5 and 10mg,  Rapid taper

Nov 2021 - May 2022 on off Wellbutrin 100mg, 150mg, 75mg CT clindamycin cycle and also Plan B bc 1x 

Fall 2020- June 2022 - Xanax .5 PRN usually 4x a week, CT 

June 2022 - Z pack, Buspar 7.5 3 days

September 20-24th - low tryptophan diet and 20-30g beef gelatin powder

Oct 3- 16 - Xanax .5 for sleep each pm, 1 mg Ativan in ER, .25 Xanax —> .125–>0 

Oct 14-17Trazadone 50/75, Lunesta 3mg 

Oct 24-  start Belsomra, 4 days to20mg 

Nov 3-5 10mg Belsomra and 300mg Gabapentin 

Oct 13-Dec 1 Buspar 7.5 2x/day rapid taper over 2 weeks due to ADR 

Recent: Belsomra 20mg since 10/23/2022 to 15mg mid December for 2 nights —> 20mg —> 15 mg since 12/22/2022 —>14 mg compounded 02/11/2023 —> 15 mg 2/13 —> 10mg 2/22 —> 5mg 3/1 —> 0mg 3/8/2023 

Current:  Propanolol 20mg AM, 10mg 4pm, 20mg PM since 11/30/2022

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On 6/1/2020 at 4:03 AM, hennie86 said:

 

I don't know what was the cause of my akathisia. Maybe a combination of med side effects and wd. I decided to write my whole akathisia story because I hope it would help someone.

 

Lexapro withdrawal started my battle with it (felt inner restlessness a bit and restlessness in my limbs) but meds I was prescribed  after it including trying to reinstate Lexapro, mirtazapine, zyprexa, seroquel made it worse. I did not feel better that time with any meds. I got worse and worse and were prescribed benzos with the meds to help me with "anxiety" and insomnia (that I think were connected a lot to akathisia). During Zyprexa when using it for some time the side effects calmed a bit  but after taking the dose every night I felt more akathisia and I had to take benzo at the same time . I could not use any med without taking benzo at the same time and it tells a lot. During that time one doctor took me away from daily benzos I had used for months and it was horrible.

Benzos somewhat helped but did not take it away completely. I wanted to stop other meds because every pill seemed to cause restlessness but stopping Zyprexa CT triggered even worse akathisia again

 

In that point I was diagnosed akathisia and prescribed propranonol and more benzos but propranonol was useless and stopped it. Then it was the worst. I was pacing all day long, falling asleep only with help of benzo battling with insomnia. I could not be still at all. I felt this awful inner terror, panic 24/7, wanting to crawl out of my skin. It lasted for a long time, months, slowly getting a bit better and I started to be able to lay down more.

 

I started to stabilize after holding benzos for many months. I tried to taper benzos during akathisia because I did not feel good using so much of them but it was fail and holding dose was best idea after it.  I started to get windows when akathisia was better and slowly it was almost gone. Then  I felt safe to continue tapering. In that point I read a lot about akathisia, and decided to avoid any new meds and try to avoid things that could make it worse.

I am really sensitive to meds, supplements and have been really strict with my diet after akathisia, being careful not to eat or drink anything that would make aka worse. I have experiences of supplements making aka worse.

 

During my slow benzo taper I have felt symptoms of akathisia during waves. Inner "itching"/tingling/vibrations, leg pulling/crawling sensation, difficult to be still and feeling anxious about being still(even though can be still nowadays better with willpower),  inner restlessness/tension, not being able to calm down and relax cause my body feels so jittery. I somehow connect akathisia to adrenaline because when I have adrenaline surges during night, I usually feel worse akathisia during day.

 

During the end of my taper, my aka symptoms have started to get a bit  worse. Positive thing is my insomnia is a lot of better and aka hasnt completely ruined my sleep this time. I try to calm my body as much as I can even though I feel like this but it is sometimes really hard. It can easily become a cycle of anxiety when you get symptoms of akathisia because its so traumatic experience. I dont know how much of this is my body not liking benzos any more and interdose wd symptoms.


 

How are you doing with akathisia these days?

2000-2018 150-200mg Sertraline and Vyvanse

2018- vyvanse 60mg to 0 over 6mo. 200mg Sertraline to 150mg. 2019- 150mg Sertraline to 100mg. Early 2021- 100mg to 87.5, two weeks later 87.5 to 75mg, 1.25-4mg bromazepam PRN. Mid 2021 - Feb 2022 taper 2.5%-5% 75mg to 50mg. March 2022 bromazepam for 3 weeks. May 9th 2022 started Propranolol, 10mg in the morning and 10mg in the evening. July 2022- off propranolol Oct 2022- off birth control. Dec 2022- updose sertraline 100mg, benztropine 1mg and Ativan 1mg. March 2023- stop benztropine. May 2023 - ativan taper finished. May 2023 - updose Sertraline to 125mg added propranolol 40mg added Ativan 1mg. July 5- sertraline 112.5mg propranolol 60mg, quick 2 week Ativan taper. Current meds: propranolol 60mg, sertraline 106.25mg, Ativan .025mg, B6, CoQ10, Magnesium Glycinate

 

 

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On 12/12/2022 at 12:35 AM, Lauren90 said:

How are you doing with akathisia these days?

I still deal with some type of restlessness and inner agitation and occasionally my symptoms spike a bit (still tapering though) but otherwise I am in better place what it comes to akathisia. I am still vulnerable to stress during withdrawal that could be one factor thay caused my recent akathisia spike. There are luckily long time from it. I have tried to be careful with supplements because I have had experience of akathisia spikes after supplements and always start from small dose if I try something. If it causes spike it usually calms down pretty soon. 

 

I made major progress few months ago when I was able to exercise(go to gym and do strength training) for the first time in yeas without feeling  restlessness, agitation, restless legs worsening. I think some type of exercise activate  CNS too much such as gym. Unfortunately I caught Covid that caused a setback and after it I have had worsening of many symptoms and have been unable to exercise. Akathisia is still gone though. (The feeling I need to constantly move and terror because of it).

2005-2009 Lexapro 10-20mg & Remeron 7,5mg: cold turkey

2010 tried Venlafaxine (month),

2011-2012 Seroquel 25mg (few months)

2014 6 days Cipro(antibiotics) adverse reaction

2011-2015 Lexapro 10-20mg (tapered off during 4 months) 

2015-2016 (all these drugs during 9 months during SSRI wd,did not tolerate most of them ) : tried Remeron, Temazepam. Reinstatement of Lexapro 3 months after stopping it: fail. Akathisia, insomnia. Zyprexa10mg, Sodium Valproate, Temazepam(20mg), Oxazepam 30-45 mgs. Switching meds: Seroquel 50-100mg, Oxazepam  30-45mg , Temazepam 20mg. Then back to Zyprexa 10mg, Temazepam20mg, doctor took me off Oxazepam fast. Then Zyprexa 20mg, Temazepam 20mg, melatonin10mg ( sometimes very rarely Valium 10 mg.) Zyprexa: cold turkey because 20 mg Zyprexa made akathisia intolerable after every dose. After it insomnia, 24/7 akathisia, adverse reactions to supplements.

2016 spring daily  Valium 15mg (for akathisia)>0mg (used for 4 months and during that time slowly tapered off), tried Betablockers (shortly), Temazepam 40 mg > 25 mg (tapered in 3 months)

2016 summer Temazepam 25 mg > 20 mg, melatonin 2,5 mg

2016 november Melatonin 0,5 mg, Temazepam 20 mg.  Started tapering again.

2024 May 1,8 mg  Temazepam Supplements: Probiotics, magnesium oil occasionally, vitamin E occasionally, melatonin 0,5 mg

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  • 2 weeks later...

Titled:  Risk of Getting Akathisia after Completing SSRI Withdrawal

 

Hi everyone.  I'm hoping someone with expertise will answer my questions below re: akathisia.  Hopefully the response(s) will benefit others as well.

 

I recently read an article by Dr. Stuart Shipko (link below), which was posted on the Mad in America website in 2020.  According to Dr. Shipko, "The speed of tapering does not seem to be related to long-term outcome.  Slower tapering is generally more comfortable on the way down than faster tapering and facilitates stopping completely with a minimum of discomfort. However, success or failure after stopping completely mostly relates to whether tardive akathisia occurs.  Around three to six months after the last dose of antidepressant, akathisia emerges suddenly, often as an overreaction to something seemingly minor.  It is an intensely anxious, agitated, and gloomy state, so uncomfortable that it is often disabling.  People take comfort in considering the possibility of suicide if they don’t get better.  Because of this possibility, tapering should not be undertaken lightly.  The duration of total use of all current and past SSRIs is related to long-term outcome. In my clinical practice tardive akathisia seems to be fairly common in people who taper to cessation after 10 years or more of cumulative use."

 

SSRI Withdrawal's Elephant in the Room: Tardive Akathisia - Mad In America

 

I've been taking an SSRI for 20 years for mild depression. During the past 20 months, I've reduced my dose of sertraline from 50 mg to ~5 mg. I'm currently struggling with mild insomnia, crying spells, loss of appetite, and despair.  I'm not planning to taper again for at least 2 months, even if my symptoms resolve soon.

 

My questions are:

Are the odds of getting akathisia after many years of SSRI use significant?

If so, would it be better to stay on a low dose of an SSRI indefinitely to (hopefully) avoid getting akathisia? I don't want to commit suicide. 

Does being on a lower dose reduce the potential harm caused by SSRIs?

 

Thank you, in advance, for your help. 

 

LizzieTish

Edited by manymoretodays
merged and added title

Lexapro: 2002-2006 (dose unknown)

Sertraline: 2006-April 2021 (50 mg/day) with exception of 2 failed discontinuation attempts in previous 5 years.

April - Aug 2021 (25 mg/day [half tablet]). Experienced flu-like symptoms in April. Also experienced insomnia and rage/irritability, which eventually subsided. Sept 2021 - Jan 2022 (12.5 mg/day [quarter tablet]). Feb 1-12, 2022 (~10 mg/day). Experienced depression and new onset acute anxiety. Discovered SA.org and realized I was tapering too fast. Feb 13, 2022, dose increased back to 12.5 mg/day to mitigate symptoms. April 2022 (~10 mg/day; switched to liquid formulation). May 2022 (~9 mg/day). Jun-Jul 2022 (~8 mg/day). Aug 2022 (~7 mg/day). Oct 2022 (~6.5 mg/day). Nov 2022 (~6 mg/day). Dec 2022 (~5 mg/day). Holding dose for at least 2-3 months due to crying spells and poor appetite/weight loss. Began taking Mg and fish oil supplements.  March 17, 2023 - increased dose to 6 mg/day. Feeling better. May 17, 2023 - decreased dose to 5.5 mg/day. July 22, 2023 - still haven't stabilized. Experiencing excruciating and unrelenting suffering.  July 28, 2023 - increased dose to 6/6.5 mg/day

August 2, 2023 - increased dose to 7 mg/day due to persistent dread and panic attacks.

October 2023 - increased dose to 10 mg/day.

January 2024 - Still feel bad despite 10 mg/day dose.

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  • Moderator

You’re thinking of the worst case scenario after reading Mr Shipko’s thoughts. If he’s somebody with a reputation for dealing with akathisia patients then his data on the likelihood of it developing is going to be skewed.

 

After a quick read of your signature I can see you’re still moving things quicker than we recommend. 20 years on SSRI’s would be expected to take 4-5 years to taper off in a completely safe manner. Holding is a good idea for the foreseeable future. When you make your next cut I wouldn’t drop another 1mg. The lower the dose the larger the drop in SERT occupancy rate which means your brain is making much more changes from 5 -> 4mg than 50 -> 49mg. Read more about this here: 

 

Read this information and then the information on how to micro taper, that’s your best bet going forward re taper method. It’s much easier if you’ve got an already formulated solution.

Active Monday-Friday UK time

 

MEDICATION:

1) Sertraline:

50mg - Oct 2020, 100mg - Dec 2020, 50mg - April 2021, 75mg - May 2021, 50mg - Sep 2021; Failed taper attempt (50 -> 49) - Jan 2024; Second attempt to start taper - 17 Feb 2024

Current dose: 48.9mg (Feb 2024)

2) Mirtazapine:

15mg  - Nov 2020

SUPPLEMENTS:

Cod liver oil

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Thank you for the information. I'm using a liquid formulation of sertraline that comes in 20 mg/mL bottles. I'll dilute the sertraline so that I can reduce the dosage in smaller and more precise increments. 

Lexapro: 2002-2006 (dose unknown)

Sertraline: 2006-April 2021 (50 mg/day) with exception of 2 failed discontinuation attempts in previous 5 years.

April - Aug 2021 (25 mg/day [half tablet]). Experienced flu-like symptoms in April. Also experienced insomnia and rage/irritability, which eventually subsided. Sept 2021 - Jan 2022 (12.5 mg/day [quarter tablet]). Feb 1-12, 2022 (~10 mg/day). Experienced depression and new onset acute anxiety. Discovered SA.org and realized I was tapering too fast. Feb 13, 2022, dose increased back to 12.5 mg/day to mitigate symptoms. April 2022 (~10 mg/day; switched to liquid formulation). May 2022 (~9 mg/day). Jun-Jul 2022 (~8 mg/day). Aug 2022 (~7 mg/day). Oct 2022 (~6.5 mg/day). Nov 2022 (~6 mg/day). Dec 2022 (~5 mg/day). Holding dose for at least 2-3 months due to crying spells and poor appetite/weight loss. Began taking Mg and fish oil supplements.  March 17, 2023 - increased dose to 6 mg/day. Feeling better. May 17, 2023 - decreased dose to 5.5 mg/day. July 22, 2023 - still haven't stabilized. Experiencing excruciating and unrelenting suffering.  July 28, 2023 - increased dose to 6/6.5 mg/day

August 2, 2023 - increased dose to 7 mg/day due to persistent dread and panic attacks.

October 2023 - increased dose to 10 mg/day.

January 2024 - Still feel bad despite 10 mg/day dose.

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I’m trying to understand my symptoms as best I can. 
 

Is the feeling of a current running through your muscles, especially legs and back, sometimes head/brain akithisia? I guess it does lead to movement in me trying to distract from it by standing up, or moving to disguise the feeling because it’s uncomfortable and scary to me as it’s foreign. 

 

additionally, sometime I feel a burning down my back and in my legs, sometimes brain. 
 

Sometimes I’ll notice twitches or jerks. Tongue spasms. 
 

are these separate symptoms or is this what akathisa is?

Aug 2020 - Feb 2022 on and off Lexapro 5 and 10mg,  Rapid taper

Nov 2021 - May 2022 on off Wellbutrin 100mg, 150mg, 75mg CT clindamycin cycle and also Plan B bc 1x 

Fall 2020- June 2022 - Xanax .5 PRN usually 4x a week, CT 

June 2022 - Z pack, Buspar 7.5 3 days

September 20-24th - low tryptophan diet and 20-30g beef gelatin powder

Oct 3- 16 - Xanax .5 for sleep each pm, 1 mg Ativan in ER, .25 Xanax —> .125–>0 

Oct 14-17Trazadone 50/75, Lunesta 3mg 

Oct 24-  start Belsomra, 4 days to20mg 

Nov 3-5 10mg Belsomra and 300mg Gabapentin 

Oct 13-Dec 1 Buspar 7.5 2x/day rapid taper over 2 weeks due to ADR 

Recent: Belsomra 20mg since 10/23/2022 to 15mg mid December for 2 nights —> 20mg —> 15 mg since 12/22/2022 —>14 mg compounded 02/11/2023 —> 15 mg 2/13 —> 10mg 2/22 —> 5mg 3/1 —> 0mg 3/8/2023 

Current:  Propanolol 20mg AM, 10mg 4pm, 20mg PM since 11/30/2022

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  • Moderator Emeritus

@LizzieTishI just went ahead and merged your topic with our existing topic on Akathisia.

Good to keep similiar topics together and now, you can peruse this whole topic at ease.

 

I love how Erimus replied and agree.

Try, try not to focus on worst case or negatives around tapering.

Tapering may not cure you of all your negative thinking and so do take measures to learn and practice non-drug coping to improve your circumstances and general well being. 

 

You might post your thought on your tapering technique back on your Introduction topic too, as it is good to have your information all in one place too.

 

Okay, and best.  Happy healing.

L, P, H, and G,

mmt

 

@ElaineBenes5Did you get a read through the topic to decide?  I go with akathisia being the extreme restlessness, and feeling so internally agitated.......and also when it is impossible to be still or sit in one place, or stay laying down.

My own thankfully brief experiences with it responded well to pacing and then also to just mummy wrapping myself up in a blanket(I actually had to do that once while in the hospital to just begin to chill and stay safe).

 

So I would suggest weighed blankets......you'll see them linked to in this topic, or even mummy wrapping yourself up if needed......until calming comes even a little bit.

 

And then yah......maybe your symptoms are more something else WD related.  Go back to the main Symptoms and Self Care forum, and then put those descriptions of symptoms in the search box at the top right.  Do them one at a time.  And you'll find other topics too, that might give you a name for what you experience.....?  if that is what you think will help. 

 

Personally, I like your descriptions.  They tell me more than using a term does.

And then........put those in your Introduction topic too.  Then tell us what relieves them, or what you find that helps you cope with them.  That will get you moving in a more positive direction of healing, or I think it will.

 

And yes, we do see your symptoms a lot here and in WD.  Yours specifically, above.......they don't sound like akathisia to me........if that is any consolation.  I hope so.  And I hope that they pass or come on in Waves and then you have Windows where they are not present too.

 

Okay, and best.

L, P, H, and G,

mmt

Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks.

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021. Lapsed.  Redo of quit smoking 9/28/2022.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider.  My success story:  Blue skies ahead, clear sailing

 

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Hi@manymoretodays

 

Thank you for your feedback. You are correct that I do have negative thoughts, which have increased exponentially during tapering. However, I think it's prudent to consider all the potential risks so that I can potentially avoid them. I will be micro-tapering from now on rather than making 0.5 mg dose decreases.

 

Wishing you a joyous 2023!

 

LizzieTish

Lexapro: 2002-2006 (dose unknown)

Sertraline: 2006-April 2021 (50 mg/day) with exception of 2 failed discontinuation attempts in previous 5 years.

April - Aug 2021 (25 mg/day [half tablet]). Experienced flu-like symptoms in April. Also experienced insomnia and rage/irritability, which eventually subsided. Sept 2021 - Jan 2022 (12.5 mg/day [quarter tablet]). Feb 1-12, 2022 (~10 mg/day). Experienced depression and new onset acute anxiety. Discovered SA.org and realized I was tapering too fast. Feb 13, 2022, dose increased back to 12.5 mg/day to mitigate symptoms. April 2022 (~10 mg/day; switched to liquid formulation). May 2022 (~9 mg/day). Jun-Jul 2022 (~8 mg/day). Aug 2022 (~7 mg/day). Oct 2022 (~6.5 mg/day). Nov 2022 (~6 mg/day). Dec 2022 (~5 mg/day). Holding dose for at least 2-3 months due to crying spells and poor appetite/weight loss. Began taking Mg and fish oil supplements.  March 17, 2023 - increased dose to 6 mg/day. Feeling better. May 17, 2023 - decreased dose to 5.5 mg/day. July 22, 2023 - still haven't stabilized. Experiencing excruciating and unrelenting suffering.  July 28, 2023 - increased dose to 6/6.5 mg/day

August 2, 2023 - increased dose to 7 mg/day due to persistent dread and panic attacks.

October 2023 - increased dose to 10 mg/day.

January 2024 - Still feel bad despite 10 mg/day dose.

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  • 4 weeks later...

Today I am really struggling. The inner intrusive thoughts are there, the depersonalization, the inner restlessness, the restless legs, the feeling like everything is hopeless and scary. I hadn’t experienced it this badly in about 3 weeks. Geez- I did not miss this feeling. 

Aug 2020 - Feb 2022 on and off Lexapro 5 and 10mg,  Rapid taper

Nov 2021 - May 2022 on off Wellbutrin 100mg, 150mg, 75mg CT clindamycin cycle and also Plan B bc 1x 

Fall 2020- June 2022 - Xanax .5 PRN usually 4x a week, CT 

June 2022 - Z pack, Buspar 7.5 3 days

September 20-24th - low tryptophan diet and 20-30g beef gelatin powder

Oct 3- 16 - Xanax .5 for sleep each pm, 1 mg Ativan in ER, .25 Xanax —> .125–>0 

Oct 14-17Trazadone 50/75, Lunesta 3mg 

Oct 24-  start Belsomra, 4 days to20mg 

Nov 3-5 10mg Belsomra and 300mg Gabapentin 

Oct 13-Dec 1 Buspar 7.5 2x/day rapid taper over 2 weeks due to ADR 

Recent: Belsomra 20mg since 10/23/2022 to 15mg mid December for 2 nights —> 20mg —> 15 mg since 12/22/2022 —>14 mg compounded 02/11/2023 —> 15 mg 2/13 —> 10mg 2/22 —> 5mg 3/1 —> 0mg 3/8/2023 

Current:  Propanolol 20mg AM, 10mg 4pm, 20mg PM since 11/30/2022

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We all get sick, fight cancer, broken bones, lose money, careers, loved ones... but people who experience akathisia (including myself) say "it's impossible to describe"

and then - almost invariably - use the word, "torture" proceeded by a "really" or "truly," as if to indicate they wish to be taken literally.

 

Why is this? 

 

20+ years on ADs & benzos
2016 - finished 2 year benzo taper from 6mg Xanax to done

     Jan   Started Effexor taper @ 300mg.  A mistake.  May - 37mg to 18mg too big of a drop -> Akathisia , June 6 re-instating 75mg Effexor with Prozac more Akathisia

    June 24 holding 65mg Effexor + 2.5 mg Olanzapine - stabilized Aug  - discontinued olanzapine without issue

2017 - finished Effexor taper  2018 - drug free

2020 - few doses of SSRI -> Akathisia  Lamictal 200mg  
             Have added Lithium 900. Yes... I want to try everything.:rolleyes:

2023 - Lamictal tapered to 0mg. 

Drug free. B-complex, fish oil,

 

exercise.

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