[xRavenx]

I keep getting involuntary twitching from my recent medication increase. I am not scheduled to see my pdoc until a few weeks from now.

For those of you on antipsychotics who get twitching/involuntary movements, what has been effective for you? Has your pdoc prescribed you anything to help with that?

Also, has there been cases where your body has gotten used to an AP med increase where those symptoms disappeared?

[~Christina]

Originally Posted by xRavenx

I keep getting involuntary twitching from my recent medication increase. I am not scheduled to see my pdoc until a few weeks from now.


For those of you on antipsychotics who get twitching/involuntary movements, what has been effective for you? Has your pdoc prescribed you anything to help with that?


Also, has there been cases where your body has gotten used to an AP med increase where those symptoms disappeared?

You need to get into see your Pdoc ASAP , could be TD and that can sometimes be permanent.

Cogentin might help.. but id be calling tomorrow first thing in the morning

[bpcyclist]

Where is the twitching on your person? Face? Ankle?

The reason I stopped my Abilify against psychiatric advice some months ago was because I had developed a horrific tremor (not due to lithium, due to Abilify) and could not sign my name. It made me mad, so I stopped it. Then last month, I had a massive psychotic and manic episode. Big surprise.

Since resuming Abilify and adding Seroquel, I now have Periodic Limb Movement Disorder. It is awful and hard to treat, but if I stop my APs, I will just get psychotic again and next time, probably end up back in the hospital for who-knows-how-long.

Sooooo, I totally agree that you must tell your pdoc what is happening now. Don't wait. But just remember, as you are deciding together what to do, that stopping atypicals is not without its own risks for us. Just keep that in mind. Sending you positive vibes and calm muscles...

[*Beth*]

I have a hand tremor for many years from meds. I take Cogentin from it, which helps so,e. Weird thing is, my left hand has a stronger tremor than my right hand does.

I agree that you should notify your pdoc. TD is no joke.

Hi xRavenx. You should definitely let your psychiatrist know about your twitches and any other involuntary movements. I do suggest being a little bit more specific about what and where they are, as bpcyclist suggested. Again, definitely tell your psychiatrist, but the type and location of any twitches could make a difference in terms of concern. For example, as a kid and young woman (before any medications whatsoever) I used to have a frequent twitch below my eye (lower eyelid). I never knew what caused them, but they were not constant. Just occasional. They felt weird as hell, though. On the other hand, one time when I was taking a 1st generation antipsychotic, I had involuntary lip pursing. That was freaky and my psychiatrist quickly lowered that medication, and eventually took me off. That was a different category of involuntary movement, for sure.

I had pretty significant hand tremors the first time I took Lithium. That time, I was on 1,200 mg per day. I did complain about it, but it wasn't really worrisome, because I knew Lithium caused such things and my work wasn't affected. IOW, I wasn't a violinist, sharp shooter, or any other profession really requiring precision. Sure, my handwriting was very shaky looking, but I rarely hand write anything, anyway. I type everything, and that wasn't affected. Nevertheless, that psychiatrist had mentioned prescribing propranolol, but took me off Lithium instead. A few years later, I went back on Lithium at 900 mg per day. Coincidentally, I had been taking propranolol for something else. I did not have significant hand tremors that time.

[xRavenx]

Thank you everyone for encouraging me to reach out to my pdoc ASAP instead of waiting. I will do so first thing tomorrow.

[xRavenx]

Originally Posted by bpcyclist

Where is the twitching on your person? Face? Ankle?

The reason I stopped my Abilify against psychiatric advice some months ago was because I had developed a horrific tremor (not due to lithium, due to Abilify) and could not sign my name. It made me mad, so I stopped it. Then last month, I had a massive psychotic and manic episode. Big surprise.

Since resuming Abilify and adding Seroquel, I now have Periodic Limb Movement Disorder. It is awful and hard to treat, but if I stop my APs, I will just get psychotic again and next time, probably end up back in the hospital for who-knows-how-long.

Sooooo, I totally agree that you must tell your pdoc what is happening now. Don't wait. But just remember, as you are deciding together what to do, that stopping atypicals is not without its own risks for us. Just keep that in mind. Sending you positive vibes and calm muscles...

Thank you. I have twitching in my thigh and foot pretty bad. Just hoping this won't be permanent.

[still_crazy]

hi. yes, please call psych. TD is not as common with atypicals and is supposedly more likely to go away than with, say, massive injections of Haldol. and yet...

not good, at all. my #1, speaking as a person not an 'expert' piece of advice/suggestion to you would be to at least ask about getting down to just -1- antipsychotic. seroquel is supposed to be less TD-inducing than many other options, because its low potency (kind of like 400mgs/Thorazine would be less likely to cause TD than the equivalent of Haldol or Prolixin), but it still happens. my psych claims that Abilify is lower on the TD making scale, too, because of the D2 partial agonism (both blocks the dopamine receptor and stimulates it, avoiding as much EPS, hopefully TD).

other than that... once this situation is resolved, I'd -personally, as a non-expert- ask that you talk to a psych about just how necessary an antipsychotic is for you, for long term treatment. might be the less horrible option, maybe there's a better way to hand things...I have no idea, I just encourage you to take a good look at options, with a psych.

[bpcyclist]

Originally Posted by still_crazy

hi. yes, please call psych. TD is not as common with atypicals and is supposedly more likely to go away than with, say, massive injections of Haldol. and yet...

not good, at all. my #1, speaking as a person not an 'expert' piece of advice/suggestion to you would be to at least ask about getting down to just -1- antipsychotic. seroquel is supposed to be less TD-inducing than many other options, because its low potency (kind of like 400mgs/Thorazine would be less likely to cause TD than the equivalent of Haldol or Prolixin), but it still happens. my psych claims that Abilify is lower on the TD making scale, too, because of the D2 partial agonism (both blocks the dopamine receptor and stimulates it, avoiding as much EPS, hopefully TD).

other than that... once this situation is resolved, I'd -personally, as a non-expert- ask that you talk to a psych about just how necessary an antipsychotic is for you, for long term treatment. might be the less horrible option, maybe there's a better way to hand things...I have no idea, I just encourage you to take a good look at options, with a psych.

I agree with all of this. The only problem with Seroquel is that it is much, much worse on the metabolic angle. It quite literally causes diabetes. So, buyer beware (yes, I am on Seroquel, but a very low dose).

[Misfit Toy]

I have been on Abilify for over a year. Just started noticing some slight tremors in my hands. My new pdoc is lowering my dose gradually. I am currently on 2 mg and I am going to try to quit soon. The only problem is that it stopped my migraines at the lowest dose. I am hoping that the Welbutrin that pdoc prescribed will keep them from coming back. If not, I am considering continuing the lowest dose of Abilify. It is a hard decision because the migraines were chronic, frequent, and disabling.

[xRavenx]

It is strange for me that some of the twitching I've been experiencing has subsided, although it comes and goes on occasion. Maybe this is because I am getting used to the higher dose? Strange. However, on the dose increase, I've been getting other side effects (like I mentioned in another post), like anhedonia and sexual side effects. I have not been able to get in with my pdoc earlier. We only had a conversation on the phone, and she said she does not want to make any immediate changes until I see her at my next appointment. So I am waiting it out until I see her next Friday. Although I need them, psych meds can be so annoying!!!!

[Misfit Toy]

[QUOTE=xRavenx;6732969] Strange. However, on the dose increase, I've been getting other side effects (like I mentioned in another post), like anhedonia and sexual side effects. /QUOTE]

I have never heard of anhedonia, but I just looked it up. That happened to me on 10 mg Abilify. I sunk into a terrible depression where I was miserable all the time. No pleasure. Thanks for the information. I would have never thought the Abilify could cause the depression. My husband kept saying it was the medication, but I really doubted it.

[still_crazy]

the EPS stuff, twitching and all, sometimes subsides as the brain and body adjust a bit. the anhedonia...-eek- . antipsychotic induced misery (the underused clinical term is 'neuroleptic induced dysphoria,' apparently)...that's rough stuff. im prone to it, myself. i do OK with abilify, unless the dose gets too high (or an add on med bumps blood levels...same difference, really), and then its..odd. no eps, usually...no akathisia...but veggie time, all the time. its worth noting...

when Thorazine first hit psych wards, they combined relatively low doses of it with other drugs (not sure which ones...I'm guessing that barbiturates were involved?) to put the patients into 'artificial hibernation.' old psych text books are ridiculously blunt about what these drugs do...apathy, indifference, loss of interest in surroundings and any hallucinations, etc....

but, hey; some people do better on a reasonably dosed tranquilizer than on anything else, or nothing at all. blah. im one of them, so I "feel your pain," but...not really, because I'm not smarmy enough to say that and actually mean it.

relatively recent research, according to my current psych, shows that about 60% of the D2 receptors need to be blocked for anti-manic and anti-psychotic effects. I think she said...80% or so...twitches, cognitive problems, depression. some drugs are better than others. Haldol is ridiculously neuro-toxic and can reliably cause TD, even at low doses. it has a toxic metabolite that does some of the dirty work, apparently. Seroquel is kind of interesting...its low potency (like Thorazine...100s/mgs for required effects, usually), and low potency drugs generally cause more sedation, less EPS, TD -does- occur, but its less frequent than with the high potency drugs (Risperidone comes to mind...Haldol, Prolixin).

ok. rambling...one reason I politely decline 2+ antipsychotic drug-drug combinations is because...all antipsychotics work on the D2 receptors. im not a doctor or any kind of expert, but...that's their core target. don't hit D2, its not an antipsychotic. the other thing is...after a certain point, adding more antipsychotic a) probably makes EPS and maybe TD more likely and b) the doctor is probably going more for sedation and just calming someone down, not an actual 'antipsychotic' and/or 'anti-manic' effect. example: I now take 15mgs/Abilify. I was on 20. 15 is just as effective in terms of -core- problems (schizophrenia, some forms of Bipolar I), but it isn't as tranquilizing/mildly sedating as the 20 or 30 Abilify, both of which are FDA-approved, available dosages. inpatient/hospital treatment often involves higher antipsychotic doses than needed...

for behavioral control (a docile patient is, apparently, a 'good patient...').

sorry to ramble. i just think the safest, easiest thing would be to talk to shrinky shrink about what his/her goals are in your treatment and if its possible to get the cocktail down to 1 antipsychotic, at least long term. it also dawned on me...my shrink is forever pushing Vraylar on me, but im kinda stuck with Abilify...but, Vraylar is supposed to be kind of like Abilify (read: fewer noxious adverse effects, for a lot of people) with a more pronounced anti-manic, anti-agitation effect.

just random thoughts, etc. i do hope things get better for you. :-)

[xRavenx]

Thanks for your help and response still_crazy! I do hope I can get down to 1 antipsychotic. The Seroquel has been amazing when it comes to helping me sleep and some mood stabilization. The Latuda has been helping a little bit with more stabilization. But there's definitely risks to staying on both at the same time, which you explained. Sleep is such a big factor for me, because I have struggled with insomnia my entire life, and if I don't sleep, I get manic or hypo. Yesterday, my pdoc decided to lower my Latuda, just a bit, to see if the side effects are less worse. That would be best-case-scenario, because maybe I won't get the twitching---or at least not as much with the decrease, while still getting some of the mood stabilization effect. Plus, I am on very high dose Lamictal and clonazepam (occasionally Xanax). So I am hoping for the best. I'm sure a long the way there will be more changes, like when mania occurs. I've been more depressive lately with some mixed features along the way.

I've also been on Abilify, but only for a brief period of time, so I do not have much memory as to why that was changed. My pdoc said that would be her next-in-line choice for me, if I'm not benefiting enough from Latuda. Other one she would consider are Lithium being second next-in-line, followed by risperdal or olanzepine if those ones fail, with exception of maybe trying Abilify or if push came to shove then Lithium. I definitely want to avoid the olazepine and risperidol. I don't like the idea of being on antipsychotics, but they do help with symptoms.

Has anyone else here experienced sexual side effects on AP's? This has never been a problem for me until Latuda was added. Seroquel and Abilify did not cause this. I don't want to deal with sexual dysfunction forever, so Latuda just might not be the med for me to stay on long-term. Only until I'm a bit more stable. Sorry for the long post...I've just been struggling with these changes and needed to put it out there.

[MickeyCheeky]

I can't help You Unfortunately, @xRavenx, as I have never experienced it myself! Hopefully your Pdoc will be able to help You though. Let us know how it goes on Friday! In the meantime, try to hang on as much as you can! You're the STRONGEST! Sending many safe, warm hugs to BOTH you, @xRavenx, your Family, your Friends, your Pdoc and ALL of your Loved Ones! Keep fighting and keep rocking NO MATTER WHAT HAPPENS, OK?!

[xRavenx]

Thank you so much, @MickeyCheeky!!! That means a lot to me. I appreciate all the support here. Sending you hugs and best wishes as well.

[still_crazy]

hi. i think...well, the 'atypicals' aren't supposed to be as bad for prolactin elevation (except risperidone...nightmare horror stories from that one...), but latuda might raise them. maybe lautda+seroquel have boosted your prolactin levels? there's a blood test...and I think Rx stuff to lower it. Abilify doesn't generally raise Prolactin, but I'm not saying "get abilify," just...I think it may be the only neuroleptic that does not do it, as a rule (the others, I think...its not as bad as with the older ones, but still happens? not really clear on all this...).

other than, I don't really know...maybe the sexual stuff is secondary the anhedonia? that would make sense, intuitively. but, that'd put a very -real- problem back in psych territory which...isn't helpful, and might prevent you from seeking out the underlying cause(s).

hope things get better. oh, and...there's a xanax xr, now. not to play Dr. with you (I'm just typing things out, not any kind of expert, so please talk to a real doctor, preferably yours) , but there's a xanax xr. I think the idea is 1 pill, all day coverage. downside: the PI sheet says you might wake up with anxiety, kind of like the anxiety people get between doses of....any benzodiazepine, now that I think about it.

thing is...klonopin can be helpful and all, but it can also make depression worse. or...cause depression (I suspect I had klonopin-induced depression in my late teens). xanax kind of has a bad reputation right now, but...on the plus side...its got mild mood lifting/mood brightening/antidepressant qualities. maybe, if its something that you think might help you, you could see about going from Klonopin+xanax to just xanax xr, maybe with some of the old school xanax to cover night time (for me, xanax and ativan were -always- better for sleep than Klonopin...) ?

i think xanax xr is now generic...I think whole deal with it is to cover long term, more or less stable benzodiazepine people, reduce dosage increases, etc. something like that.

just some random thoughts... hope things get better for you. :-)

[bpcyclist]

I had bad Klonopin depression. It was awful.