Severe Akathisia: Self-management

This is my first post. I have searched the forum and found a few older posts on akathisia. I have read that L-theanine and magnesium has helped some people. To my understanding akathisia is different from agitation and restless legs syndrome (RLS), but from my own experience I can understand a possible relationship to the less frequent RLS.

I average 10.000 steps per day, pacing around involuntarily. If I stop walking prematurely, I have spontaneus tremor. Does anyone have any advice on how to manage this condition - apart from medications?

What I have tried so far: taking showers, rubbing my legs with a hot ointment, vigorous exercise, and taking N-acetyl-L-cysteine (NALC). These things help a little, but not completely. (I am currently not able to get pure NALC and have relied on the once that are intended for sore throats, which contain sorbitol.) I have considered B6 too, but not dared the high 500 mg dosage without medical guidance.

I am taking 7.5 mg Abilify since ~3 weeks. Previous doctor started me at 10 mg and wanted to procede to 20 mg. I am also tapering down on seroquel from 300 mg down to 25 mg. The new doc suggested we switch to amisulpride, but I still have at least six days to cope with this condition. I have tried taking Abilify at different times and am currently experimenting with 3x 2.5mg per day [1 0 1 1], but considering returning to [1 1/2 0 0] where 1 is in the morning.

I wish you all good health.

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Where r u from buddy …how old are…good to see ur post …

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From somewhere colder, maybe young

The only thing that helps me (besides walking for hours :slight_smile: ) is strong physical exercise but my restlessness is not severe.

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Meds can help. The recognised ones are benzos or cogentin. However I have found gabapentin works well too.

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Thanks for your reply. Sorry if that wasn’t clear. I am looking for nonmedical solutions for now, that is ‘self-management’.

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Oh sorry. The only one I can think of is l-theanine, maybe gaba

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Hello, here in europe i was able to get prescribed Edronax 4 mg/ day (reboxetine) alongside my Abilify 3.75 mg / day which is like a quarter of 15 mg pill. Before that i was experiencing akathisia even on a dose as low as that, but it completely disapeared when i begun to combine it with Edronax in the morning. Since i am taking meds i had problems with concentration, and negative symptoms such as lack of confidence when talking to people (maintaining eye contact) and even some of flatened effect and low energy with inabillity to experience pleasure… The problems were resolved thanks to Edronax, which really doesn’t have any dangerous or disturbing side effect. On top of that i look into the research, where it shows, that reboxetine augmentation even helps elevating positive symptoms when combined with d2 / d3 antagonists, and facilliates dopamine output because it is a selective norepinephrine reuptake inhibitor. I also found information that it helps the NMDA currents in a positive manner, because elevated levels of norepinephrine bind to alpha 2 receptors which are already blocked by almost any antipsychotic out there which is good for NMDA transmission (and consecuently negative symptoms) as theese receptors are actually found on NMDAr itself and when they are blocked it happens that they actually activate glutamate systems to work properly as a result. In my case there was enourmous reduction in all symptoms, i now have like hours and hours of good concentration and focus which lasts all day without any signs of fatigue when i have to study (i am a geology student). Before that i was put on Ritalin 10 mg as needed which i drop- off because it’ s too dangerous for schizoprenic to take it as it can cause changes in plasticity and neurostructural abnormalities and it’s also addictive. Focus, i get from Ritalin is not as clean as that from Edronax, and the next day your ability to concentrate is ruined because of the crash. In conclusion i think that reboxetine is more suitable because it doesn’t produce crash and it is as good at providing the same ammount and quality of focus as ritalin but it lasts way longer cause of the 12- hour half life. I have no idea why it’s not more frequently prescribed for negative symptoms. It’ s one of those rare newer antidepressant agents that are not sigma receptor 1 agonists which in turn are not as good for schizos as for example sigma antagonist. For example : Haldol is sigma antagonist and Cocaine, Methylphenidate, Methamphetamine, Escitalopram, Dxm, PCP, … are all sigma agonists which i think is bad thing. It’s just my opinion, but let’s see : you can cure depression efectivly with reboxetine which is so speedy that you think you are on aderall or something but instead of causing panic or paranoia, it actually helps panic disorder, because it’ s one of the things which it is off-labeled form. It’ s simillar to strattera in mode of action but with longer half life, but it worked instantly at producing it’s effects. It helped me passed matura with good grades and i was absent from school two years and i barely studied anything at that time because of my quest of searching the right therapy with my doctor and my constant struggle with akathisia , so i managed to pass all the matura exams in 20 days (time from the point when i was prescribed edronax to the start of school exams). I am now completely healthy without any symptoms and i am cronically ill. So i am functioning even better than ‘‘normal’’ healthy persons with so little dosage of my two meds, that i don’t feel i am being drugged with side effect- causing high dosages. My progress was gradual and i had to be on higher dosages for 2 years to become what i am now, i was suffering a great deal because i’ d rather suffer akathisia sh*t than being on benzos for longer time. So if someone is in my place when maintaining health is the main goal i would definetly recomend edronax (not available in USA), if you had already come through acute phase of treating psychosis.In conclusion i have to say that my focus is insanely good and it doesn’t seem to be getting any weaker even though i am on that drug for almost three months now. Edronax does not cause any tolerance or addiction because it’ s a pure NRI, although it has somewhat euphoric properties but without mania ( the abilify dose is low enough). I am not a doctor but i recomend a drug as it’ s very helpful and thankfull substance. I am not saying it suits in all cases with all kinds of meds , so listen to your doctor, this was only my experience and i hope it Will help someone . I am expecting questions and am ready to answer you in any way because i have been self-educating on the field of neuropharmacology for over a year now because i didn’t like how my doctors treated me and was ready to take a deal in my own hands, and my doctor approved this combination so it’s safe i think. Yes, i know very well that inital phase of treating schizoprenia is not that easy and you may require different combination or higher dosages, but i think it’ s a right thing for me to share my experience with the world. I’ m from slovenia btw.

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benzos helped me when i was on abilify

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I know you’re looking for non-medicine advice, but Cogentin is the only thing that has really helped my severe akathisia. I tried heat, tens unit, muscle rub, CBD oil, Valium, and Propranolol. Nothing has helped enough except for Cogentin for me.

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Thanks for a great reply. I could only find preclinical studies on reboxitine related to EPS and my doc suggested that we need something long-term. I was able to reach him and we are switching to amisulpride.

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