I was on Risperdal from the day it touched the market until about 6 or 8 months ago. It caused the internal kind of akathisia the entire time. I did not know what akathisia was so I thought I was anxious...a restlessness that can't stop but doesn't have a common word associated with it?? How are we to explain to anyone.

My doctor treated it by giving me MORE Risperdal the CAUSE of the akathisia. I did not become fully aware of this until I was almost off the 11 mg of Risperdal I finally ended up on. You got that 11 mg!! Criminal! I was never even psychotic when it was first prescribed. It was given to make me sleep supposedly...with ever increasing doses to get rid of the side effects.

god I feel like vomiting right now. sometimes it's just sickening to think what some of us have been through.

Before I started coming off the Risperdal, Seroquel was added.

fucking idiots.

no more akathisia now. I'm drug free and sane but the detox has left me physically ill. So ill.

When I was a teenager, I was put on Abilify for anxiety. I got horrible, severe akathisia from it. I felt extremely internally restless. I could not stop moving. I remember when it started. I felt like I was crawling out of my skin. I would stand up, pace around, jump up and down, start dancing and jumping and move my entire body. I kept kicking my legs out and my arms. My entire body felt like it was alive, I could not stop moving. I couldn't sit still for more than a couple seconds. I couldn't sleep. I couldn't sit down. I had the jitters. I missed a lot of school, but eventually had to go to school. I didn't know what this was, i was a teenager. I thought something was physically wrong with me and this would last forever. I looked up restless leg syndrome, thought that I had it and this would never go away. Eventually I was told that it might be from the new pill I started. The doctor said to give it a few more weeks, however, I was takien off the pill. The akathisia died down and went away after a few weeks. It was hell and I didn't know what it was that happened. I was a teen, I didn't manage my medication. Akathisia wasn't that common a reason to miss a lot of school back then. The akathisia was awful. For so long I had no idea what that torture was. Years later, I told a different doctor that I got akathisia from Abilfiy and how awful it was and the doctor is like "How severe was it" like they were trying to recommend Abilfy again and then they tried to get me on Geodon, another antipsychotic just like it. The akathisia from Abilfy was awful and these doctors just kept recommended more and more of these awful antipsychotics. For awhile I didn't really think it was from the pill, I thought it would lat forever. I wonder how many other people can say that they experienced that kind of torture. It's funny, back when I had the akathisia, I didn't know it was from an antipsychotic or what it was called, so I would tell people "This pill I took one time made me really jittery and fidgety, like I had the jitters" and that was so not what it was. Akathisia is so horrible, but it's good to experience it once in your life to know what it's like.

Hi Phil,

Love your blog. You say "One well-known quality of anti-depressants is their tendency to induce akathisia in a large number of patients,..."

That's a complete new one on me, and I'm pretty knowledgeable in this area. An expert, actually. Could you post some actual references? I'm not being a jerk, it's that this is really really new to me, and I know you know your stuff. Thanks

Thanks and the best. Keep up the good work.

Philip Dawdy responds: david, there are so many reported cases of patients developing the jumping out of one's skin feeling and getting very wound up and manicky on anti-deps that it approaches common knowledge among patients and docs. nassir ghaemi has written about this phenomenon. google away!

wow. what a shock an expert not knowing how patients actually feel on psych meds.

Philip,

The first thing I did was Google "akathisia ssri". Read the list that comes up. Not a single reputable source in the first score or so. But sites such as "www.yourlawyer.com", "www.lawyersandsettlements.com", "personalconsult.com" are replete. Akathisia is a technical medical term that seems to be applied by non-experts to claimed side effects of SSRI's. And this is being used by lawyers to enrich themselves.

Are you aware of any studies using Cogentin, an old medication used to control true akathisia from antipsychotics, to control these so called feelings arising from SSRI's? It's quite effective, and as a generic now, quite cheap.

Philip Dawdy responds: i did the same google search and the first two items were a wikipedia entry and then a journal article. but where you should really be searching is via google scholar.

Being well-versed in most all psych meds due to witnessing side effects for a decade of use in upward to a dozen or more drugs used on my daughter I can speak freely here about my knowledge which some can refute as being anecdotal--so be it.

Cogentin increased my daughter's psychosis, as well as gave hand tremors. Benadryl in low doses had less side effects, though one hospital that gave her 300mg of Benadryl for EPS of antipsychotics also increases psychosis.

My point, is that Cogentin is over-used and most of the time patients are put on it before EPS show up, especially in psych wards, and a drug with serious side effects such as :

Toxic psychosis, including confusion, disorientation, memory impairment, visual hallucinations; exacerbation of pre-existing psychotic symptoms; nervousness; depression; listlessness; numbness of fingers.

Shouldn't be cast here as a simple and handy drug to use to prevent any EPS.

Any expert in the field would know far more than David B. appears to know, and questions for Philip here prove that this person isn't as expert as they claim--I also recommend at minimum using Google scholar for reference for research, dig and dig deep, it's not hard to find information.For that matter many University hospitals have medical libraries and abstracts galore for reading if that needs applying here.

Most ppl do not know Cogentin is often replaced with Benadryl and most have never seen extreme drug-induced psychosis in someone when on high doses of antipsychotics, Cogentin etc.

I HAVE and it's not a pretty site.

In fact it gives more reason for any professional/expert to sit back and wonder just what efficacy factor these meds have opposed to benefit.

No need for anyone to come here and tell me the risk outweighs benefit or that drugs help; if that was the case psych wards would be empty and my daughter wouldn't be damaged from a decade of psych med use she should for all intent and purpose, be healed, or cured!

(based on the defunct psych med treatment paradigm this country runs on)

Also, simple drug checker sites such as rxlist dot com give simple package insert info on these drugs: (for example, Prozac's fine print)

The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have been reported in adult and pediatric patients being treated with antidepressants for Major Depressive Disorder as well as for other indications, both psychiatric and nonpsychiatric. Although a causal link between the emergence of such symptoms and either the worsening of depression and/or the emergence of suicidal impulses has not been established, there is concern that such symptoms may represent precursors to emerging suicidality.

http://www.rxlist.com/prozac-drug.htm#

Beneficial effect of low-dose mianserin on fluvoxamine-induced akathisia in an obsessive-compulsive patient

"Extrapyramidal side effects induced by some selective serotonin reuptake inhibitors (SSRIs), i.e. fluoxetine and sertraline, have been previously reported in patients with depression and obsessive-compulsive disorder (OCD). However, the occurrence and management of akathisia induced by fluvoxamine have not been described. In the presented case fluvoxamine-induced akathisia in an OCD patient was partially resistant to the anticholinergic agent biperiden, and was successfully treated with the 5-HT2A/5-HT2C antagonist mianserin. Mianserin (15 mg/day at 21.00 h) was discontinued and then reinstituled (off-on-off-on design). Biperiden was transiently effective in the acute akathisia, while the more persistent akathisia was alleviated by mianserin. Discontinuation of mianserin resulted in recurrence of akathisia, while lull amelioration of the symptoms of akathisia was noted when mianserin was reinstituted. No aggravation of OCD symptoms was noted during mianserin administration."

(C) Lippincott-Raven Publishers.