Managing neuroleptic-induced akathisia

[It's a baby!]

So I've been dealing with akathisia ever since I got put on neuroleptic drugs. It manifests as a feeling that I cannot sit still. I'll be listening to music and I'll be tapping my feet, then moving my head. I pace constantly. My psychotherapist suggested that this might be because I feel "trapped" right now, but I'm really starting to think it is medication side-effect (aripiprazole), because I don't feel trapped. I just want to be able to sit down and read for extended periods of time without compulsively getting up. I just can't sit still it's always something, I take my shirt off, I put my shirt back on, I sit down to write some dumb crap online, I get up in the middle to have a cigarette, etc. It's just very frustrating! I would love to feel calm but dopaminergic antipsychotics are preventing me from being calm.

Also I am seeing a psychiatrist and by doing simple muscle tests we have confirmed that this restlessness is a medication side-effect. He gave me an anticholinergic which has gotten rid of the muscle stiffness and tremors, but the restlessness is still there. I'm going to start being tapered off on July 18, ideally.

The akathisia wakes me up at night, I'll randomly wake up at least once every night and this is from muscle spasms occurring in my sleep.

Honestly the best thing I can do is pretend it ISN'T happening, but if anyone has any other tips it'd help. Hiking used to help a lot but it is ungodly hot here and my shrink says strenuous exercise would be dangerous while on these meds, and for someone who smokes as many cigarettes as I do anything more strenuous than walking around town is strenuous, heh.

I'm mostly venting, I understand it could be MUCH worse (like this is objectively preferable to being manic/psychotic). Thank god I'm getting off this drug soon, not everyone experiences this side effect of akathisia but I sure do, it even effects the way I write.

 

[It's a baby!]

Also akathisia is too strong of a word, it's more restlessness. I am physically able to sit still and I can focus the physical tension by typing, or waving something around, etc. It's just frustrating as hell. I know it's not drug withdrawal because I haven't so much as had a beer since may 17 or so.

Edit: I think the best thing to do is to do things that make me comfortable. A cold shower helped a lot.

For people who are on these meds in the long-term they often end up being prescribed a low dose of klonopin or something. So I just need to do the sorts of things that make me feel chill, like klonopin would, without actually popping a benzo or drinking a beer, as much as that might relieve this side-effect. I'm on Cogentin and it has gotten rid of muscle tremors but also makes me a little out of it on its own and it hasn't completely gotten rid of the restlessness.

Thank god I'll be out of this state in a matter of weeks. Being on these drugs forever would significantly effect my quality of life, and I'll always feel a lot of empathy for people who are on them. And my experience isn't necessarily typical, some people don't experience any restlessness from doses even higher than what I'm on.

 

[FCJ]

Ask your psychiatrist about mirtazapine (Remeron) or low dose propranolol (Inderal). Both are quite effective at controlling the akathisia often seen with aripiprazole. Good luck.

 

[Missykins]

Fortunately, I have not experienced this somewhat-common adverse effect associated with Abilify. If I recall, you are not on a particularly high dose, either. If propranolol (a beta blocker) does not work, you might want to consider another anti-psychotic. Also, I believe that you were at the point where you and your physician were considering taking you off the drug; now might be the taper given the adverse effect you are experiencing.

Klonopin is a benzodiazepine, BTW.

 

[It's a baby!]

Fortunately, I have not experienced this somewhat-common adverse effect associated with Abilify. If I recall, you are not on a particularly high dose, either. If propranolol (a beta blocker) does not work, you might want to consider another anti-psychotic. Also, I believe that you were at the point where you and your physician were considering taking you off the drug; now might be the taper given the adverse effect you are experiencing.

Klonopin is a benzodiazepine, BTW.

Yeah it's time to start tapering, my next appointment is July 18. I haven't had a seriously deluded thought since June 13ish. So it makes sense for me to stay on these meds for the next couple of weeks and just suck it up about the restlessness, then talk to my psychiatrist about tapering. The only reason I haven't started my own tapers is that I can't cut these 10mg pills into small enough slices for the taper to be a realizable goal haha.

And yeah I know about klonopin being a benzo, so my train of thought is "well that's just a drug that'd make me feel comfortable, so I just need to make lifestyle choices that make me comfortable for now while I wait for this restlessness promoting drug to be off my plate". For now that means using ludicrous amounts of snuff and playing roguelikes, I also do at least one thing every day that's liable to stress me way out, like returning books to the library, because I don't want to respond to my addiction to drugs by getting addicted to hanging out in my parents' house haha.

Also cold showers help a lot, as does exercise, it's so hot out and it may be dangerous for me to do a lot of running (which I'd love to start doing) but I can do pull-ups and whatnot in my house and even that helps a lot. I've always been kind of restless, that's one of the things that made me fall in love with marijuana, so I have stress that's making me restless, an inner psychology that's prone to restlessness, and a drug that's known to cause restlessness inside and out due to the things it does to the dopamine receptors in my think-tank. I just need to chill out and not obsess so much over what this medication is doing to me, because this is temporary.