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Akathisia vs restlessness, anxiety, agitation

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I'm finding B6 makes me really drowsy, so taking it at bedtime is a must for me. The first dose I tried was 50mg, which seemed to help but made me drowsy/spacey. I tried taking 12.5mg (1/4 tablet) but it didn't seem to do much. 25mg helped, but I took it in the evening, hoping it would last until morning so I'd wake up akathisia-free. Unfortunately, it wore off by morning, so I'm going to try 50mg before bed to see if the higher dose lasts longer.

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Interesting effect from vitamin B6. Maybe take in in divided doses, 25mg at night and 25mg in the daytime?

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Ok 50mg in the evening does not prevent morning akathisia. It does improve sleep though. Gonna try 25mg in the morning next. Hopefully it won't be too sedating.

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Hello,

 

Part of the reason why I decided to stop taking fluoxetine 2 years ago was because I believed that it was causing me a lot of restlessness/agitation.

 

I was on 20mg of fluoxetine from 2003-2008, then took 8 months off it, then went back on in late 2008 (because of depression, which I now realise was fluoxetine withdrawal). However, up until around early 2011, it worked fairly well for me - but then I started getting increased restlessness/agitation.

 

Since around mid 2004 I've drank fairly regularly - not excessively, but still, most nights, I would have around 1.5 to 2 litres of beer (around 4.5% alcohol). I noticed around mid 2011 that the increased restlessness was occurring the day after I had drank the night before. Lack of sleep and caffeine intake also compounded the restlessness. The thing is though, is that I'd never reacted this way before, either on or off medication, so why would it start happening to me now? Could it be that the fluoxetine messed with my gaba/glutamate system? Or could maybe the alcohol have sensitised my system?

 

Incidentally, I found that as soon as I stopped taking fluoxetine, my system could handle alcohol/caffeine again. However, it brought the depression back, which led to citalopram...and then my withdrawal nightmare really began.

 

Could anyone explain why I suddenly started developing a sensitive CNS even whilst ON 20mg of fluoxetine?

 

Thanks for reading.

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Your nervous system has been changed by your drug and alcohol history. It might have become more sensitive to Prozac.

 

Activation is a well-known side effect of SSRIs.

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Yikes. You're drinking over a liter of beer everyday! Why are you doing that?

 

More importantly I don't know exactly why at this moment you could no longer drink alcohol, coffee and take pharmaceutical drugs and not feel your best. But eventually if you consume all that stuff you're not going to feel well. In my case I think toxicity underlied a lot of my symptoms. The thinking is that the organs, specifically the liver can not keep up with all the metabolic demands you are putting on it and the body gets bogged down.

 

I noticed a developed fat pads on the limbs when I lived in a moldy home. After a year of a detox protocol the fat pads have gone away and my elevated mycotoxin levels appear to have normalized. The pads may have been body storage for the toxicity I was overwhelmed with.

 

My advice is to stop drinking alcohol and coffee until you are more well. Good luck.

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It's not unusual for people's reactions to ADs and other psych drugs to change over the years. And fluoxetine is known to be activating. Agitation and akathisia are pretty common side effects of it, so much so that in order to get it to pass the FDA they had to give the patients in the studies Xanax (I don't have a citation for that but it's in Anatomy of an Epidemic).

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i experimented with niacin(nicotinic acid) and it worked for low moods. same with d-phenylalanine. i noticed the next day i got kind of restless i feel like walking around the block. i tried propranolol again today and 125mcg xanor and it seemed to relieve the restlessness, is it okay to take b1+b6+b12 if you dont have b6 alone? thanks all. 

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A lot of people find the B vitamins too activating. Be careful about taking them in any amount.

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Hi all.

 

This is my experience of akathisia. I warn you, it's not pretty, in fact it's downright disturbing. I have the severe version. It started on citalopram and I've had it for 7 months straight with no windows. I will say, though, that it's changed somewhat in nature over time.

 

During my first week on citalopram, I developed severe, 24/7 suicidal ideation (which I still have) and constant terror. The terror is a state rather than a fear of anything in particular, just like happiness is a state. Simple tasks, like getting out of bed, walking across the room and getting dressed are like climbing Everest. You simply can't function with severe akathisia.

 

That first week, I started to get adrenaline rushes throughout my body, particularly in my legs, arms and pelvis. The feeling is so hard to describe. It's like carrying hell inside your body, literally. You'd do just about anything to escape it but you can't. It's 24/7. Very early on, I found I had to keep jigging my legs up and down all the time. This is typical of akathisia. I'd bang the walls with my fists. It makes you pace and pace and walk and walk. You can't keep still. It's a horrific feeling inside that makes you want to scream and scream and scream. There is no relief. While you are going through this, psychiatrists slap a label on you and as good as force you to take more drugs which just make you even worse.

 

Throughout this experience, I've felt like my legs are not attached to my body.

 

I also found that every thought, negative or positive, made my stomach churn. I'd do something simple like look at my phone or hear a piece of music and I would feel terrified.

 

It's impossible to get comfortable in any position, sitting down or lying down. It's torture. Nothing makes it go away.

 

I will say, though, that it's changed over time. I sleep now which I couldn't early on. I do manage to sit. It's hard but I do it. Better than pacing endlessly. Symptoms have come and gone throughout this journey.

 

Akathisia has been the most horrific experience of my life. I can't imagine anything worse. To cap it all, I got withdrawal after coming off sertraline. Marvellous! (I reckon I'm entitled to a dollop of self pity at this stage!) I've reinstated at a low dose to take care of that but I'm scared that this will aggravate my akathisia. The adrenaline rushes had mostly gone but I think I can feel them building up again so I will have to be careful. I just hope this horror will go away in time.

 

This has been my experience with akathisia. It's rambly and it's not nice, but it's honest. I found this on the internet. I think it describes akathisia beautifully:

 

'There are different ranges of intensity from a mild irritation or anxiety to a total inability to lie or sit still; from not being able to keep the body still, shuffling hands and feet, pacing the floor to producing overwhelming anxiety, malaise, and severe dysphoria (manifesting as an almost indescribable sense of terror and doom).'

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This inclusion surprised me:

 

"...producing overwhelming anxiety, malaise, and severe dysphoria (manifesting as an almost indescribable sense of terror and doom).'"

 

Where did you find this description? I haven't seen the mood or psychological effects of akathisia discussed, only the physical. Thanks for sharing.

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I got this description from the citizens commission on human rights website:

 

Www.cchr.org.uk/campaign-overview/drug-treatment/irreversible-effects

 

I ignore the irreversible bit!

 

Another website you might want to look at is:

 

MISSD.co, a charity that are raising awareness of the condition

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It's not irreversible.  I had it in severe form as well.  I am sitting here right now perfectly able to type and sit still.  I do have a bit of a residual concentration issue which I think links to akathisia but that's it. 

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Another website you might want to look at is:

 

MISSD.co, a charity that are raising awareness of the condition

 

Interesting find.  They don't mention there though that benzodiazepines and antipsychotics also can cause akathisia, either while you take them or in withdrawal.  

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Hi unfoldingsky. I am so sorry to hear about what you have been through. I am so glad you got through the akathisia. That's given me a lot of hope too. Thank you.

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Thank you WinningThrough.  Reading your description really brought back to me how difficult that time period was.  I am sorry for what you are going through as well.  Do know though that it will end. 

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I believe akathisia is most commonly associated with use of neuroleptics (antipsychotics) due to their strong dopamine blockade. I mention this only because many docs have likely not heard of akathisia, EPS or other movement disorders with antidepressant use or withdrawal. (Bruxism is an example)

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Thanks unfoldingSky. I am sorry I dredged up horrible memories for you. I hope you don't mind my asking but roughly how long did it take for the akathisia to clear up? Was it from an ssri?

 

Barbarannamated, yes you're right,it is most commonly associated with anti psychotic use. I really hope doctors start to recognise that this can happen with anti depressants too.

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it is my understanding that there are 2 causes and manifestations of akathisia

 

the MOVEMENT disorder as described and experienced in parkinsons, and/or after AP treatment - this seems to be dopamine 

 

the inner turmoil and hell which seems to be more associated with epinephrine/norepinefrine

 

i could be wrong but that seems to be the case

 

I have akathisia but its the NE version, another interesting thing for me is that actute stress can relive the sensation, i read a study where cortisol actually decreases the levels of E/NE so maybe thats why, and also why I only get this symptom after 12 midday

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Thanks unfoldingSky. I am sorry I dredged up horrible memories for you. I hope you don't mind my asking but roughly how long did it take for the akathisia to clear up? Was it from an ssri?

 

 

 

Oh don't worry WinningThrough, revisiting the past like that is something I can handle.  You didn't do anything wrong.

 

My situation was complicated, I had it for a long time but in different forms and that was because I was put on drugs that cause it after developing it. It started with an SSRI, I had it in a mild way (if you can call it mild) while reacting to Celexa.  Then after I stopped it I was put on Zyprexa off label for "agitation" (at that point I didn't have akathisia, though I still don't get where they got the idea i was "agitated"--a c/t off Celexa made me intensely suicidal and caused panic attacks but I wasn't running around screaming or anything that to me would make me look like I was agitated), stayed on that a few weeks then tapered it once I learned it's actually an antipsychotic.  That is when the akathisia got really bad, pacing all the time, could barely sleep, etc...I walked all day one day and that was when I knew something was very wrong.  So I went back to hospital, where they actually lied to me, put me back on Zyprexa while telling me it was something else. 

 

Then I was on it and Ativan for a month, and all that time I'd have feelings of terror which I link to akathisia, and when the drugs wore off I would not be able to sit still usually (the odd time for some reason I'd have severe cog fog and on those occasions for some reason I could sit still.  So it was a horrible trade-off; either my mind was clear but I couldn't sit still, or I was severely impaired cognitively but could sit still.  I still don't know why it fluctuated like that.) 

 

After about a month I was taken off Zyprexa, and later realized I'd been reacting to it (had some physical issues I later learned were a sign of an ADR), so it definitely made things worse. 

 

Then for the next three years I was stuck on Ativan, which both masked the need to pace but would cause the most severe inner agitation and feelings of raw terror, and as it wore off of course I would have difficulty staying in one place.  Finally figured out how to get off it and when I did that it was gone.  So all told it was about three years and varied in how it expressed itself.  Most of that time though was on drugs that cause it, so for anyone reading this who is drug-free don't presume that it will go on for that long for you.  For all I know it might have cleared up in a few weeks when I was off drugs had I simply not been given more drugs that can cause it.

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UnfoldingSky, thank you for your kind reply. I really appreciate it. I'm so very sorry you had to suffer so long but it's good to hear from someone who has been through this and come out the other side.

 

It's just terrible that the hospital lied to you and put you back on the same drug! That's outrageous!

 

I can totally relate about the cog fog. I have all the inner turmoil and cog fog together. It's like I'm restless and want to move around all the time but I'm too mashed in the head and exhausted! Mine has varied over time in how it's expressed itself too.

 

Interesting that you were on Ativan. I've been taking an 'as required' Ativan since Christmas. I've used 1mg very sporadically, once a week, twice a week, once a fortnight. At first it worked beautifully and knocked the akathisia on its head when I took it. Now, it's lost it's efficacy and I wonder if I get interdose withdrawals which contribute to the whole thing. I took one last Sunday and I'm going to try very hard from now to never take it again.

 

Mm100, I'm really sorry to hear you have this awful condition too.

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Hi WinningThrough,

 

I am sorry to hear you have the cog fog as well.  I remember early in withdrawal thinking that the point of the drugs was "leave nothing unscathed".  They surely don't seem to give you any respite from suffering do they...But take heart, the cog fog will get better over time too, as it has for me, and I had it bad.

 

I am surprised to hear that a PRN Ativan stopped working that quickly, I didn't realize that would happen.  I know taking it daily was not a good thing for me, but I always thought had I taken it here or there instead it might have been a bit more helpful...I am sorry to hear that is not the case for you, as i know too well how much relief is longed for in your state.  Someone once said on a board that they should not be allowed to invent drugs that don't have antidotes.  After having akathisia I must say I strongly agree.

 

I do hope relief is around the corner for you and everyone else on this thread (or reading this.)  

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When i had akathisia what i think it was i had an extreme inner restless ness i coudlnt sit, i coudlnt stand, coudlt lay down, it was unbeliveble and creepy! I had to run around it was such a fear!

I associate this feeling with akathisia

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I just had a one day bout of restlessness, far less severe than before but enough to call back to mind how awful it was to have akathisia (shockingly, once it is gone eventually you forget how severe it was).  This was because of something I did that must have caused the flare up, something most people aren't likely to do here, so as not to worry anyone.  My point in writing this though is, I used a weighted heating pad which I normally use for back pain on my legs and it helped me sleep.  I didn't heat the pad, just laid it across my legs.

 

I am now thinking I will try out those old weighted leg wraps they used for muscle strengthening exercises if it gets bad again.  Who knows, maybe that would even ease things while awake too.

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Anyone seen the Wallace and Grommit film 'The Wrong trousers?' Akathisia is a bit like that! 'It's the wrong trousers, Grommit!'

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So true!

 

"It's the wrong trousers Grommit, and they've gone wrong!"

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Just wondering what exactly this is? If anyone has experienced it? What, if anything can be done? For years at least nearly 2 years now I have experienced constant agitation (actually I think apart from in the few windows the last couple of months). It is a racing mind and my mind is desperately seeking a calm place but can never seem to rest but there is also a feeling in my body of not been able to settle in the present moment..I don't feel a need to move all the time but it has led to a lot of outward movement due not been able to settle anywhere, in my mind, body or anyplace physical. The past 5 /6 years I have experienced this a lot and it feels like I have just been skimming along the surface of life, never really enjoying or even present for anything as I feel constant agitation. It feels like life and the years are racing by while I'm never present for any of it.

 

Thank you for the replies.

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I get bouts of this.  It's not constant, like some other people here, and I'd like to try and develop self-help strategies to keep this low.

 

How on earth do I calm myself down out of it?  

 

Does anybody have any strategies?  Natural strategies?  Can anybody who's gotten over this please talk to me about it?

 

I tried to find an akathisia-only thread, but couldn't.  Maybe there is something buried way, way back.  Mods, if you need to combo this with something else, go for it.

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Are there any non-supplement and non-medicinal techniques to deal with this symptom? I like the idea of weighted blankets and waited leg wraps.

 

I find that when I am having a bout of akathisia, I can be snapped out of it by a happy external trigger. This tells me that it IS possible to snap out of it myself, if only I could find the correct happy internal trigger to get myself out of it. So far, I have not been able to find an effective, happy internal trigger to get myself out. But if a happy external trigger can do it, surely it means that happy internal trigger can help me in these moments. So far, if I pray or tell myself to calm down, I seem to ironically add more pressure to myself, which makes the symptom worse.

 

But like I said, I am hopeful that there must be a technique out there that can help in the grips of this symptom.

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Thanks, Petunia! I have looked through the first link so far, and it did not quite contain the answers I am looking for, but I have yet to look through the second link that you posted to see if it is helpful.

 

What I am looking for our non-supplement, non-medicinal techniques to help. Thank you so much for your response!

 

Basically, I have noticed that if I am having a boat of acathisia, a happy external trigger can snap me out of it. I believe it is possible to find an internal happy trigger to snap me out of it, too. After all, getting snapped out of it by something external proves that it is possible for the symptom to get some relief; The journey now is to find how I can help myself in these moments, instead of waiting for an external factor to help me.

 

That's kind of what I'm looking for, so if you happen to run across anything like that, I would greatly appreciate a response. Maybe the second link you posted will contain something like that, so I will dig into that next. Thanks again!

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Can anyone who is experiencing or has experienced akathisia please explain what exactly is feels like? And also does it go away?

I read the wikipedia article about it but still don't understand (my mind is not very clear at the moment).

 

I started experiencing what I can best describe as a torturous feeling of extreme inner horror, terror, dread, anxiety, despair, and hopelessness. I think it happened because I messed with the antipsychotic I'm taking - Flupentixol and lowered the dose from 1 mg to 0.5 mg for a week, now I updosed and I'm back on 1 mg. It all started the day before I updosed and I am wondering if it could be akathisia.

 

I don't feel the need to move though, not at all. But I have this horrible feeling of inner torture that I can't escape from. It started slowly on Monday (day before I reinstated), and it's progressively getting worse and now it's there 24/7. I'm wondering what it is and will it get better? It's especially bad when I try to relax and fall asleep. When I try to fall asleep I get it really bad and also my muscles start jerking and twitching. Could I be freaking out because of all this withdrawal stuff because it scares me so much, or is it neurological in nature? 

 

I'm finding it very hard to get through each day feeling like this. 

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Akathisia has been described as an unrelenting inner restlessness which isn't relieved by movement.  Some people move around or pace, in an attempt to find relief, but it doesn't work, the sensation is still there.  I've heard it also described as in inner dread/terror/horror, that's how I describe it.  To me it felt like I was being slowly electrocuted from the inside, there was too much energy flowing through my body on the inside and I couldn't deal with it.  I would lay in bed shaking, counting my breaths, waiting for it to stop.

 

It does eventually go away. These links have more information.

Akathisia vs restlessness, anxiety, agitation * topics merged

Blog: My Akathisia Experience

Edited by Petunia

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Those of you who had WD akathisia which has resolved--how long after you were off the meds did it take for this to resolve? I am 9 months off a much too rapid taper (6 weeks), and have had constant akathisia since a month out from my last dose. Sometimes it is worse than other times, but it never entirely goes away. Lately, it has been worse than ever. I do have the physical restlessness, but the psychological symptoms (agitation, SI, etc.) are the worst for me. Is there still hope this will go away?

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What has been working for my internal agitation/restlesness due to withdrawal is Lithinase which is a natural lithium chelate supplement. Remarkably I go from wanting to crawl out of my skin w mental agony to feeling calm. It's amazing!

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