Akathisia INFO

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
  • Agoraphobia/claustrophobia
  • Dark, scary thoughts
  • Psychotic-type behaviors
  • Anger/aggression
  • 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
  • Confusion
  • Memory loss/amnesia
  • Nausea/retching/vomiting
  • 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)
  • 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)..
  • 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
  • Massage
  • Soak in bath/steam in shower
  • Sleep/rest
  • 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
  • Sunshine
  • Laughter
  • Positive thinking/healing visualizations
  • Meditation
  • 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 –

http://www.antidepressantsfacts.com/reaction.htm

Drug Reaction INFO from another source…

 Since I started this blog I have never added to it. But this article, which was sent to me by one of the blog readers, is so important and informative I just have to put it right up here where you can easily find it. It’s just one person’s opinion, but from everything I know, he truly GETS it and gives some highly valuable suggestions. Please just read with an open mind and take away whatever makes sense to you.
All my best,
Angie

*Please note that everything written on this blog is written by a mere concerned citizen, who’s just looking to share what she knows and help link people together, so they may help one another through a trying time. None of the material here should replace medical and/or psychiatric help, where it is needed. If you are in need, please contact a professional immediately. And remember, you are never alone, even when it may feel that way.

By Charly Groenendijk
The Netherlands
Sept 9, 2000 ~ 2009

  You experienced a negative reaction to an (SSRI/SNRI) AntiDepressant, what (not) to do Now?  

“Who does Not Know the Truth, is simply a Fool…
Yet who Knows the Truth and Calls it a Lie, is a Criminal.”
– In “Galileo Galilei” by Berthold Brecht (1898-1956)

Go to General Side-Effects SSRI/SNRI/SSNRI Antidepressants: cases, reviews, articles & studies
Go to Tapering Off Anti-depressants
Go to Introduction

Take notice that also non SSRI anti-depressants (and even Ritalin) may interact (primary or secondary) with the serotonergic (or serotoninergic) system in the brain.

After your reaction to an (SSRI/SSNRI) Anti-Depressant
The first 3-18 months
One of the long term side-effects after experiencing a reaction to an (SSRI) antidepressant, is an extreme hyper-sensitivity of the nervous system to light, sound, supplements, herbs and fabricated synthetic vitamins. Furthermore physical symptoms such as muscle tightness, electrical shocks through the brain and the body, feelings of burning on the surface or inside of the skin (deregulation of pain perception), visual and/or auditory hallucinations, as well as emotional and psychological problems. For a more detailed discussion regarding above mentioned side-effects click here.

We do not recommend to expose your body to synthetic chemicals whilst experiencing more or less severe hypersensitivity of the nervous system. We rather recommend to get your essential elements from preferably organic low acid food. Low acidic foods have a high pH value which is ALKALINE or BASIC! You need to ‘alkalinize’ your system (body) above a pH value of   ‘7’ !

Eat enough fruit and vegetables in a variable alkalinizing balanced diet, and drink lots of water. For instance tomatoes, bananas, kiwi’s, broccoli, aloe vera, carrots, cabbage, beans, cucumbers, etc., are a very rich source of essential minerals, vitamins and amino acids. Do not take 5-HTP to create more serotonin in your brain. By simply leaving your serotonergic neural system alone, you will assist it the most to find it’s own natural balance again. Unfortunately this will take some time.

Do not charge your nervous system like you always did before your reaction to an (SSRI) antidepressant. If you charge your nervous system too much, like too much stress, a surgery, unhealthy eating patterns, etc., you actually delay your recovery. You will have to learn to listen to your body, what means that you know when to withdraw and when to get active.

When you suffered a reaction to an (SSRI) antidepressant your nervous system becomes hyper-sensitive to ALL stimuli. What are stimuli? It is everything that acts on your nervous system (directly or indirectly) like light, sound, but also violence on TV, stressors, certain supplements or fabricated vitamins, etc. All these things act as stimulants to your nervous system. Actually the effects of a psychoactive drug and watching a horror movie are very much comparative to each other…that is: they BOTH act on your nervous system!

The key solution to recovery is NOT to stimulate your nervous system, but, to sedate your nervous system. Every time when you stimulate a nervous system that in fact needs to be sedated to recover, you delay the process of healing. We know it will be impossible to lock your self up in a dark, silent room and this is definitely not what we are trying to say. You just have to learn when to withdraw yourself (and thus your nervous system) from stimuli and when to come out.

Consider sweat baths (sauna baths). This is a very healthy habit. Sweat baths are extremely sedating to the nervous system. When you take a sweat bath on a regular base this will strengthen your cardiovascular system and improve the blood circulation. Next to this, go out in nature, trees, green, oxygen, gentle walking, etc..

About taking supplements
We learned that everyone who is experiencing (SSRI) antidepressant side-effects, is looking for the quick relief. People are experimenting with whatever supplement or fabricated synthetic vitamin they can get their hands on. Simply avoid this if that is possible.

As previously mentioned above, we do not recommend to expose your body to synthetic chemicals whilst experiencing more or less severe hypersensitivity of the nervous system. We rather recommend to get your essential elements from preferably organic low acid food in a variable balanced diet.

Two to three simple bananas and kiwi‘s, an egg-sandwich, 2-3 glasses of milk, a few tomatoes and an avocado a day provides many of the essential vitamins, (trace)minerals & amino acids you need on a daily base. Vegetables especially rich in essential elements are: Peas, Potatoes, Broccoli, Squash (Summer), Spinach, Lima Beans & Kale. The taste of nature is nice and it saves you money on unnecessary supplements too!

However we also understand that getting your essentials from a variable diet requires some skills in preparation and cooking of your daily meal. Not everyone is able or willing to do that. In that case you need to add your essential elements otherwise. We understand if you feel the need to take a daily multi-vitamin complex. There are many different multi-vitamin complex products, unfortunately a lot of rubbish amongst them. Most of them contain extra added synthetic chemicals which you must avoid. If you are going to take a multi-vitamin complex you need to be aware of the following:

  • make sure that it doesn’t contain Vitamin K. Vitamin K plays a role in the manufacture of blood clotting. Too much of this vitamin might interact with plasma serotonin which is also known to make blood form cloths (see article, “2.a. Serotonergic functioning”). Although there is more research needed regarding this matter, the anecdotal reports of (former) (SSRI) antidepressant users imply fabricated vitamin K as a cause for the worsening of their already exisiting symptoms.
  • make sure that ALL B-vitamins are low(never above the daily recommended standard). It is important to note that most B-vitamins work as stimulants to the nervous system. You need to avoid that.
  • make sure that the B3 compound is as niacinamide and NEVER as niacine (this will give a flush which could make you re-live all of your symptoms again).

Depending on the severeness of the reaction you experienced to an (SSRI) antidepressant we also recommend that if you decide to take your essential elements otherwise, to take calcium/magnesium/zinc in a vegetarian formula. Never exceed the daily dose of Calcium 1000mg, Magnesium 400mg and Zinc 15mg. Although calcium/magnesium/zinc are not known to act as stimulants, caution is needed. Always start with small amounts (1/6 of the daily dose), gradually build up and keep monitoring yourself.

In these first 3-18 months the cycles or the emotional rollercoasters (the tricks your brain is playing on you) can be extremely frightening. And it will seem like it never ends, especially when you find a bit of hope in the evening to be back at square one in the morning. Be firm! We all understand its the most frustrating experience right now for you. It’s serotonin related and that’s why you are experiencing delayed (withdrawal) side effects and flashbacks, but gradually it will get better. Evaluate your recovery by weeks and months, not days.

You are going to experience minutes, hours and days that you will start to feel better. The cycles will get longer in duration and eventually you will have more good then bad days. Though, it is most important you also treat your nervous system with care during these better days. Don’t think when the better days arrive that you can charge your nervous system like you always did before. It will give you a major set-back! Stick to the list we provide you below, on how to assist your recovery during this period.

Friends and Family
These times are very tough to experience. Your friends and family cannot even imagine the powerful influence these drugs have on your mind and your sub-consciousness. They simply cannot believe that these drugs can have such a powerful effect on someone’s brain. You might loose your trust in them after this. Try to accept and understand their ignorant and frustrating reactions. Avoid them for a while, if that’s possible.
How can I assist my recovery during this period?

  • Avoid any psycho-stimulants such as medications, herbs, but especially: violence on TV. Why? Because right now your nervous system has become hyper-sensitive and extremely susceptible to every input from your surroundings, not only light and sound! You must also protect your sub-consciousness until you reach a level of emotional stability.
  • Ingest low acid foods and try to minimize the ingestion of high acidic foods with a low pH-grade! REMEMBER: You need to ‘alkalinize’ your system (body) above a pH value of   ‘7’ !
  • Avoid Grapefruit Juice. Grapefruit juice is an inhibitor of the cytochrome P-450 enzymes. These enzymes are known to metabolise (break down) (SSRI) antidepressants in the liver. Drinking grapefruit juice whilst you are taking an (SSRI) antidepressant can create a serious toxic reaction, because the (SSRI) antidepressant will build to toxic levels in the bloodstream! For more information click here.
  • No caffeine. Drink lots of chamomile tea, sweetened with honey.
  • No alcohol.
  • Don’t take Saint John’s Worth. St. John’s Worth works more or less as a natural SSRI (on post synaptic receptors), also interacting with your serotonergic neural system
  • Don’t take Ma-Huang (Ephedra) because it’s a powerful adrenalin (epinephrine) stimulant, triggering adrenalin rushes.
  • Don’t take Kava Kava, it can intensify (SSRI) antidepressant (withdrawal) side-effects or give flashbacks to previous side-effects you experienced.
  • Eat neutral alkaloids, vegetables, etc..
  • Consider fasting for 1 to 10 days. Fasting detoxifies your body, but be careful and monitor your bloodsugar levels daily.
  • Don’t do any intensive exercise like jogging or aerobics, but instead try meditation, gentle stretching, gentle walking.
  • Go out in Nature, or go to a Sauna, or whatever environment where you may find a little peace of mind and body.
  • Listen to light Classic music or New Age music, watch cartoons (or anything else without violence), go walking, take hot or cold showers, anything that might work for you, anything to “manage” the “twilight zone” of suicidal and offensive thoughts and dissociated emotions.
  • Focus on memories of events in your past (like childhood memories) which will recall positive emotions. Hang on to them!
  • Learn during this period, which thought or view will give you any positive emotional response and write this down into the form of an affirmation! Read these affirmations for yourself every morning when you wake up! In this way you will slightly re-program your brain to tune into positive emotions.

Time and Nature will be your best friends in your healing process. In this battle you don’t fight to win because you can’t. You simply will survive it. Focus on the thought to survive this, and you will, just as other individuals did. Don’t force yourself to become the person again that you were before this, but make a statement to yourself that you will come out of this “trip.” Make this statement to your self everyday, every hour.

Whilst You are Recovering…
We strongly persist not to take any supplements, herbs and/or synthetic vitamins until your nervous system has strengthened over time. Continue to ingest proper food, vegetables and fruit during this period. Treat your nervous system with care. As mentioned above: don’t think when the better days arrive that you can charge your nervous system like you always did before. It will give you a major set-back! Be careful and monitor your body closely whilst you are ingesting a supplement or herb.

By Charly Groenendijk
The Netherlands
Sept 9, 2000 ~ 2009