9 replies to this topic

[penisbreath]

While I really appreciate the efforts to spare harm here wherever possible, I was looking for a balanced opinion on dopamine agonists to treat movement issues.

I've made a couple of posts here describing a recent, very unfortunate bout of akathisia, which was triggered by withdrawal from Mirtazapine 2 months ago.

Over that period, I've tried nearly everything possible to help the symptoms, which are basically incapacitating .. including antihistamines, Cogentin, clonidine, Propranolol, opiates, Lyrica, benzos and a variety of supplements. Unfortunately, my system seems to be extremely volatile, and even stuff which should otherwise be helpful (high-dose B6) just wigs me out.

The best things so far have been a) Siberian Ginseng, which is soothing, but not a cure, and b) Uridine UMP, which pretty much addresses the restlessness, but causes a lot of anxiety/overstimulatiion, terrible bloating (weirdly?) and insomnia. I've tried between 60-250mg orally, and get the same symptoms in varying degrees. Time-release Melatonin is also pretty much a fix, but can only be taken at night obviously.

I have an appointment to see a neurologist now .. but it could take a little while (5 weeks at the moment, but he's a friend of my doctor, who's going to try push the case forward).

My doctor gave me a script for Requip, and I've basically been doing everything possible to avoid taking it because I'm presuming this is more of a withdrawal issue, rather than anything tardive, though I have always been prone to getting akathisia on ADs/atypicals in the past. My doctor was being a bit cavalier about the whole thing, and acting like going-on/coming-off Requip should be a piece-of-cake, which doesn't gel with the reading I've done.

Anyway, I'm seriously at the edge of my sanity .. and growing suicidal, and I know that's enough reason to try the Requip.

But if I do, am I doomed to being stuck on it? Would taking it for a few weeks until I can see the neurologist be plausible? And then maybe switching to something more benign, like one of the other anticholinergics (Artane?) or Neurontin. Getting to my doctor isn't possible anymore (can't drive), and I don't want to seem non-compliant by requesting something else, since he's tried quite a few things so far.

I'm just so angry and upset at myself, because I'm a perfectionist and was deliberately trying to do a wash-out from psych drugs. But that stubbornness isn't working right now. I guess I just can't foresee coming off the Requip being an easy task, and it certainly doesn't sound like a long-term cure ..

[Duchykins]

Bupropion (Wellbutrin) is often prescribed to people with Parkinson's because it is a dopamine reuptake inhibitor, among other things. It's an atypical so it shouldn't have similar effect on you as those other antis and sedatives

[BlueCloud]

I have an appointment to see a neurologist now .. but it could take a little while (5 weeks at the moment, but he's a friend of my doctor, who's going to try push the case forward).

My opinion : 5 weeks is nothing, it will pass very quickly. It's probably better to not "alter" your brain by experimenting too much during this time, and keep it in a neutral state so that when you get to see the neurologist and ( I suppose ) he will gets you to do brain scans and whatever tests are necessary to get the lowdown on your state. You have some pretty odd reactions to things, and it's better to try and find the initial source of this than to just endlessly experiment semi-random meds.
So hold on, do things that you find relaxing meanwhile , meditation , sleep, listen to music , read a few books, whatever distracts you until you get that appointement and get him to do as many tests as possible.

[Duchykins]

Oh snap I misunderstood what OP is looking for. Sorry man.

[penisbreath]

Dutch, thanks for the suggestion, but i have a lot of reason to suspect that wellbutrin might be bad news right now. Even a cup of coffee is too much stimulation!

Blue cloud, I would love to just hang on but sadly .. well, I don't know of you've experienced akathisia but it's sheer hell! I almost can't do anything to pass the time because I mostly have to lie in bed just rolling from side to side. Every hour is agony. I've survived 8 weeks somehow, but another 5 would be impossible, let alone another few days.. I'm almost not sleeping at all at this point. And I feel like just randomly screwing around with supplements isn't getting me anywhere, so it seems like the requip might be the best bet. Like I say, since things are this bad, I'm wondering if a few weeks on it might be okay. DAWS freaks me out!

[Duchykins]

Have you tried the choline route? Remeron is anticholinergenic and withdrawals from such things can cause akathisia, and at such extended lengths of time like you.



Have you tried taking something that eats up aceytlcholine, like piracetam?

Edited by Duchykins, 12 February 2014 - 06:00 PM.

[datrat]

A few years back I tried requip for a number of months. IIRC I went as high as 8mg, but normally stayed around 2 - 4mgs. When I decided it wasn't doing anything useful for me and quit, I didn't have any problems at all. Certainly a different story than the DAWS horror stories. I also think that a large number of people tried pramipexole back in the days of the old pramipexole log on mind and muscle and also came off it without any problems. I know you have unique reactions to drugs, so it's hard to say how it might affect you, but I don't think DAWS is a likely outcome for most people who try dopamine agonists.

[penisbreath]

Have you tried the choline route? Remeron is anticholinergenic and withdrawals from such things can cause akathisia, and at such extended lengths of time like you.



Have you tried taking something that eats up aceytlcholine, like piracetam?

Are you sure it's anticholinergic? I was always led to believe it wasn't. I thought the akathisia might be 5-HT sensitivity after blockade ..

Piracetam's an interesting idea. I tried it years ago and found it anxiogenic. I thought about aniracetam, since it's supposedly more calming.

Propranolol was okay, but too depressive. I found a script I had for Atenolol, so going to try that + melatonin at night for a couple of days. If that doesn't work, I'll have to stop screwing around and try the Requip .. wasted way too much money on supplements etc. so far.

Neurologist appointment has been moved to 2 weeks from now, which is good.

[penisbreath]

Have you tried taking something that eats up aceytlcholine, like piracetam?

There seem to be one or two textbook references suggesting Piracetam can work. One said it was tremendously helpful, but that the methodology used wasn't very reliable.

Piracetam increases my anxiety, though, as I mentioned. There's one guy selling Aniracetam locally, but it's pretty expensive ($60 for 100g).

There's a lot of really cheap local Noopept on Ebay (I'm in Australia). Does it share a mechanism with Piracetam at all?

[Duchykins]

Have you tried the choline route? Remeron is anticholinergenic and withdrawals from such things can cause akathisia, and at such extended lengths of time like you.



Have you tried taking something that eats up aceytlcholine, like piracetam?

Are you sure it's anticholinergic? I was always led to believe it wasn't. I thought the akathisia might be 5-HT sensitivity after blockade ..

Piracetam's an interesting idea. I tried it years ago and found it anxiogenic. I thought about aniracetam, since it's supposedly more calming.

Propranolol was okay, but too depressive. I found a script I had for Atenolol, so going to try that + melatonin at night for a couple of days. If that doesn't work, I'll have to stop screwing around and try the Requip .. wasted way too much money on supplements etc. so far.

Neurologist appointment has been moved to 2 weeks from now, which is good.

I double and triple checked. I was curious as to why a withdrawal from that drug would case such an extreme, extended reaction. You should do some checking yourself, starting with just the simple wiki article, and maybe then checking the article's references down at the bottom so you can get straight to the meat. That's where I found mentions of using Piracetam to migitate the akathisia. It's possbile, if not probable, that piracetam will effect you differently at this time due to your clearly (temporarily) altered brain chemistry. Though I am unsure if you should substitute other noots simply because they're not as well documented as piracetam.

I also had a more selfish motivation for doing so - I take bupropion and I hear it has some anticholinergenic effects, so that makes this stuff relevant to my interests.

Edited by Duchykins, 13 February 2014 - 03:47 AM.