This blog entry is for people who are wondering what the cause is for their anxious suffering. I have put together this information to educate people who may be suffering from drug-induced Akathisia and the people who care for them. I believe strongly with as many prescriptions that are written these days for psychotropic medication (antidepressants, antipsychotics) that consumers, as well as those in the helping professions (such as doctors, nurses, EMT’s, psychologists, psychiatrists, counselors, and the like) need to be aware of the risk of Akathisia.
I am not a doctor. I’m just a consumer interested in helping educate other consumers.
The information I provide for you here is in no way exhaustive, nor is it meant to replace medical care. It is here as a support and to help guide you to figure out if this may be what you’re going through, so you can take the next appropriate steps.
I believe there is a lot of preventable suffering and even preventable suicides that have happened because people simply don’t realize what they are going through is an actual syndrome and that it will go away once they stop taking the offending medication and their brain gets back in balance. You see, when Akathisia hits most people have no clue that such a reaction even exists, so they think it’s just that they’re going crazy. In assuming that, they believe it’s only going to get worse and in steps hopelessness and a compounding of the terror they are already feeling.
Akathisia is almost always a physiological and psychological response to a medication. It can either be due to the introduction of a medication or come about in response to withdrawal from medication. It can last anywhere from a few hours to several months, depending on the drug, how long the drug was taken and the person’s pre-existing condition.
What are some of the main symptoms of Akathisia?
- Extreme agitation/restlessness
- Inability to sleep/insomnia
- Profound anxiety/terror/panic
- Feeling like you’re jumping out of your skin or want to rip your skin off and escape
- Feeling a need to run away
- Dark, scary thoughts
- Psychotic-type behaviors
- Self-harm or thoughts of self harm
- Inability to sit still or lie down
- Feeling like it will never end
- Muscular tension/strain/weakness/ticks
- Blurred vision
- Loss of appetite
- Memory loss/amnesia
- Flushing/hot flashes
- Erratic heart beat
- Erratic blood pressure
- Extreme, chronic thirst
Medications that may cause Akathisia*:
- Anti-emetic (anti-nausea) medications, such as; Compazine (prochlorperazine), Reglan (metoclopramide).
- Antibiotics (Various)
- Anti-psychotic medications (some are also used as anti-emetics), such as; Haldol (haloperidol), Droleptan, Dridol or Inapsine (droperidol), Orap (pimozide), Eskazinyl, Eskazine, Jatroneural, Modalina, Stelazine, Terfluzine or Trifluoperaz (trifluoperazine), Solian (amisulpride), Risperdal (risperidone), Abilify (aripiprazole), Saphris (asenapine), Cisordinol, Clopixol or Acuphase (zuclopenthixol) and Thorazine (chlorpromazine).
- SSRI anti-depressants, SNRI anti-depressants and hypnotic anti-depressants, such as; Prozac, Rapiflux or Sarafem (fluoxetine) and Paxil or Seroxat (paroxetine), Desyrel, Beneficat, Deprax, Desirel, Molipaxin, Thombran, Trazorel, Trialodine or Trittico (trazodone), Effexor, Efexor or Trevilor (venlafaxine) and Zoloft or Lustral (sertraline hydrochloride)..
- **Tricyclic Antidepressants, such as; amineptine, amitriptyline, amitriptylinoxide, amoxapine, azepindole, butriptyline, cianopramine, clomipramine, cyanodothiepin, demexiptiline, desipramine, dibenzepine, dimetacrine, dosulepin/dothiepin, doxepin, fluotracen, hepzidine, homopipramol, imipramine, imipraminoxide, Intriptyline, Iprindole, ketipramine, litracen, lofepramine, lortalamine, losindole, loxapine, maprotiline, mariptiline, melitracen, metapramine, mezepine, mianserin, mirtazapine, naranol, nitroxazepine, nortriptyline, noxiptiline, octriptyline, opipramol , oxaprotiline, propizepine, protriptyline, quinupramine, setiptiline/teciptiline, tianeptine, tienopramine, trimipramine.
- **Tricyclic Antihistamines, such as; alimemazine, azatadine, clobenzepam, cyproheptadine, dacemazine, deptropine, desloratadine, dimebolin, epinastine, etymemazine, hydroxyethylpromethazine, isopromethazine, Isothipendyl, ketotifen, loratadine, mebhydrolin, mequitazine, methdilazine, olopatadine, oxomemazine, phenindamine, pimethixene, promethazine, rupatadine, thiazinamium.
- **Tricyclic Antipsychotics, such as; amoxapine, asenapine, carpipramine, chlorpromazine, chlorprothixene, clocapramine, clomacran, clotiapine, clozapine, flupentixol, fluphenazine, homopipramol, levomepromazine/methotrimeprazine, loxapine, maroxepin, mesoridazine, metitepine/methiothepin, mosapramine, naranol, olanzapine, perazine, perphenazine, periciazine, prochlorperazine, promazine, quetiapine, sulforidazine, thioridazine, thiothixene, trifluoperazine, triflupromazine, zotepine, zuclopenthixol.
- **Other Tricyclics, such as; carvedilol , cyclobenzaprine, pizotifen.
- Opioid withdrawal.
- dexamethasone, prednisone, hrdrocortisone , betamethasone, triamcilone.
- ALSO – Many natural substances may cause reactions as severe as Akathisia as well. The ones noted for helping with anxiety and depression seem to be the biggest offenders. Vitamins, herbs and supplements such as: Vitamin D, 5HTP, SAMe, Fish Oil, St. John’s Wart, Gingko Biloba, etc. Be cautious and thoughtful even when taking naturally derived supplements. Add only one at a time to your diet and watch closely for any reactions. If you feel you may be reacting poorly, STOP taking the offending supplement. Period.
And as a further note, some drugs and some natural supplements may feel great while you’re taking them then only once you try to stop taking them will you react badly or encounter Akathisia. The brain is a very complex structure, and I’m not a doctor, so I cannot explain the hows and whys, I only know that all of these things are possible and we (as consumers) must be proactive, careful and methodical when endeavoring to take or titrate off ANY substance. The doctors will not admit their precious drugs are a problem, drugs are their business. You have to look out for YOU.
*Please understand this list is not exhaustive, as people react differently to different types of medications. These are just the most well known for the potential to cause Akathisia. (If you can help me add to the list feel free to email me.)
Often times what happens is, a person is given one of these medications, they have a reaction (within minutes, days, weeks or even months, it totally varies per medication and individual) and they don’t correlate the reaction (Akathisia) to the medication. What they think is, “I was put on this medication because I’m mentally unstable and now I’m getting worse”. Then they end up getting the dosage upped, or other medications are added, and the Akathisia gets even worse! This is where many people lose hope and resign to a life of intolerable suffering or they decide they can’t handle it and sadly, end their lives.
The other common occurrence is, someone gets put on a medication for depression, anxiety or some other mental issue, eventually they decide to try life without the meds or are feeling much better and they decide to come off the medication. Then within days or months they have a withdrawal onset of Akathisia and because they aren’t aware of this possible reaction, they think the problem is organic and they assume they are not okay without the drug, so they go back on it and get caught up in an endless loop of Akathisia reactivity.
Sadly, many of the prescribing physicians aren’t fully aware of, or willing to admit, the prevalence of Akathisia so they unwittingly make things worse with misinformed advice and often times even more prescriptions being written, which compounds the problem.
For the lucky ones, such as myself, they are given a medication for something not related to mental health issues (for example, anti-nausea medication), so they quickly realize the connection between their distress and the medication.
Many anti-nausea medications are actually anti-psychotics and they mess with the functioning of important brain chemicals. Most people given such medications, like Compazine, are unaware of this. And most that do find out after the fact state if they had known they were being given something that could potentially mess with their brain they would have happily opted to keep the nausea and forgo the risk of Akathisia.
One of the most common situations where this happens is when someone is treated for nausea or migraines with one or more of these offending medications. Then, of course, people who are being treated for anxiety and/or depression or other mental/personality disorders with one or more of these medications.
So, if you have been treated with medication(s) for anxiety, depression, migraines, nausea, psychotic episodes, schizophrenia, bi-polar disorder or other mental/emotional disorders and you have found yourself suffering one or more of the symptoms listed above then please read on…
What can you do?
First and foremost, I have to say if you think you may be suffering an Akathisia reaction to a medication/medications please contact your doctor. If they don’t seem to believe you, or understand what you’re talking about, just call around until you find a doctor that has their head on straight that understands what you’re going through. If they don’t understand or don’t react with integrity and empathy they won’t be of any help anyway. So find someone who KNOWS WHAT AKATHISIA IS. Don’t waste your time trying to convince a closed-minded doctor that you’re having a drug reaction. It seems many doctors just don’t, or won’t, get it. (Neurologists seem to have the most experience with, and understanding of, Akathisia. You may want to find a psychopharmacologist as well, or a neuropsychiatrist.)
If Western Physicians are of no help, I highly recommend finding a naturopath/holistic doctor. They are much more willing to admit that pharmaceuticals are dangerous and to help you find good, clean ways to detox and get back in balance.
All medications and supplements should be used under the care of a physician.
Please understand I’m in no way affiliated with ANY pharmaceutical or natural supplement companies, I’m only listing this information I’ve learned to help you make informed decisions to help yourself navigate and overcome Akathisia.
The information I’m giving you here is simply things I learned that has worked for people or worked for me. There aren’t any medications that I’m aware of that will alleviate Akathisia for everyone. It’s hit and miss to find something that works and many people find no relief with pharmaceuticals. Akathisia simply hasn’t been studied enough for them to know truly how and why it happens. It manifests differently for different people and the recovery is different for everyone. BUT, there are many similarities for a lot of folks and some basic things you can do to help your body detox and get back in to balance.
I’m going to give you info on medications that may help, if you want to try that route and also info on natural ways to help alleviate the symptoms of Akathisia and get your body moving back toward homeostasis. SOME SAY GETTING YOUR BODY AS CLEAN AS POSSIBLE IS REALLY THE QUICKEST WAY TO RESOLVE AKATHISIA, WHICH MEANS TAKING THE LEAST AMOUNT OF MEDS/SUPPLEMENTS POSSIBLE. I can’t give medical advice, but after all the research I’ve done and people I’ve talked with as they have gone through the healing process, I’ll just say, I pretty much agree.
Medications that may help alleviate some of the symptoms/shorten the duration of Akathisia*:
- Anti-histamines, such as; Benadryl (diphenhydramine), Periactin (cyproheptadine).
- Cogentin (benztropine)
- **Benziodiazepines, such as; Xanax (alprazolam), Ativan (lorazepam), Valium (diazepam).
- Beta-blockers, such as; propranolol, metoprolol.
- Artane (trihexyphenidyl)
*Since initially writing this section more than 5 years ago, I have learned these meds can actually cause or worsen akathisia for some. The ONLY ONE I’ve never heard of causing things to get worse is Propranolol.
**Benzodiazapines are VERY addictive to both body and mind, so use caution and wean off of them slowly with the help of a physician as your symptoms improve.
High doses of Benadryl is the first course of action for treatment of Akathisia almost anywhere you go. (It won’t really help if you’re still on the offending med though. It’s more for people who have discontinued the offending med.) It does help lessen or stop Akathisia for many people, so it’s definitely worth a try (UNLESS you know you are allergic to it, in that case other meds need to be tried. I’ve heard of a few people even having success with Claritin, which is also available over the counter and usually well tolerated, so it could be worth a try.) If you go to the ER they will likely give you a very large amount of Benadryl for the treatment of Akathisia, but if you’re doing it at home please treat yourself with a reasonable dosage. The ER nurse told me to take 50mg every 4-5 hours, for a few days. Even if you are feeling relief from the first dosage some say you need to carry on with treatment for a few days, to prevent relapse.
Supplements/Herbs that may help alleviate the symptoms/shorten the duration of Akathisia and detox:
- B-Complex (Pref a whole food vitamin), B-6
- High doses of Vitamin C (I personally find Emergen-C to be well assimilated and tolerated)
- Natural CALM (THIS HELPED ME MORE THAN ANYTHING, PLEASE GIVE IT A TRY)
- Decaf green tea
- Green drink (I personally like “Greens First” over all other brands)
- Chamomile tea
- Bach Rescue Remedy
Things you can do to help soothe and detoxify the body and boost your good brain chemistry:
- Drink plenty of water
- Stretching/mild exercise
- Soak in bath/steam in shower
- Soothing music (classical music has been proven to have a positive effect on brain chemistry!)
- Only watch positive or funny shows/movies
- Loving support from friends and family
- Don’t drink alcohol or caffeine
- *Nicotine may actually help (boosts “happy” brain chemicals that are low, which is the cause of Akathisia)
- Fresh air
- Positive thinking/healing visualizations
- Eat healthy, fresh foods rather than prepackaged, processed, fast foods
- Keep in mind it’s going to go away/ it’s only a transient condition
- Progesterone (Yam) cream (For females) as recommended on box [Can get it at nutrition store]
*I would NEVER normally advocate smoking, but if you’re in total crisis with the anxiety/panic/terror part of Akathisia then I absolutely do advocate giving nicotine gum or smoking a try. Just be responsible and wean yourself slowly back off of it as you start feeling better. You will know right away if it’s helping or not.
Cyndi posted a request that I also include here the importance of letting others know about your allergies. I totally agree. I keep a sheet of paper in my purse at all times with the names of drugs I’ve had an allergic reaction to in the past, but I too think I’ll go make a laminated card for my wallet. It’s also a good idea to inform your family doctor and any other doctors you may see on a regular basis, as well as, the local hospital. Ask all of them to note your record for allergies. Especially the drug that induced Akathisia!
You may also want to make up a living will, which basically states what exactly you want done with your health care should you be unconscious. It’s important for each of us to be proactive in helping ourselves receive the best possible health care when needed, especially when you have special needs such as avoiding drug allergies.
Please take the time to read the comments that follow this blog, it can be very helpful to hear what other people have been through and how things are playing out for them. I want this to be a place where everyone can talk openly and share info, so feel free to share your current or past experiences.
I wish you a speedy recovery!
PS – I was talking with a doctor the other day about Akathisia and he recommended talking to a neuropsychiatrist. So, for any of you out there who are going through Akathisia, you may consider starting THERE instead of with folks who seem to be clueless to how it works, as so many doctors seem to be. From what I know, psychiatrists of all the physicians are most well-versed in how meds work and so a neuro – psychiatrist understands the neurological effects of meds. Interestingly, as I was looking up neuropsychiatrist I found that the man who coined the phrase Akathisia was indeed a neuropsychiatrist. Here’s the link to some good info, including that tidbit – http://www.answers.com/topic/akathisia
If you have any questions send a comment and I’ll get back to you.
Please read the following post! If you can’t easily locate it, here’s the URL to the same article –