[bpcyclist]

Hi, gang. So, I've been on and off Abilify for a long time and it has worked really well, overall. I did get a really bad tremor in my hands on it several months ago. We stopped it and the tremor went away right away, so it's not the lithium--we know that now.

We resumed it after I got really psychotic and manic last month. I am at 30 mg, where I have been for years. I went out for a ride on my bike the other day and after about forty minutes or so, I began having the muscles in my upper body that support me on the bars start to basically jerk up and down. Totally involuntary. Kind of like a spasm. It happened no matter which position on the bars my hands were in.

The closest thing I can compare this to is, if you have ever worked out with weights to the point of exhaustion and you rmuscles, whichever group you are working, start to sort of shake becuase of the effort. That is almost exactly what this feels like. Except I was not even remotely fatigued. I can ride a hunderd miles, no problem. I had only gone maybe 7 miles when this started.

Anyhoo, this continues and it is making it very difficult for me to ride. This is bad, because other than one or two other modest little things, riding my bicycle is pretty much my only source of enjoyment right now. Plus, it's my exercise.

Has anyone on an atypical ever heard of something like this? Would love to hear of any weird neuro-type side effects people have had. Thanks!!

[still_crazy]

hi. i didn't respond earlier because...holy ****, that's scary!...and also...I'm not any sort of expert. however...based upon my extensive Google-ing...


what's going on in your situation? i don't know, honestly. just that...a) Bipolar I people are more prone to TD, possibly other tardive syndromes, than Schizophrenia people. This is important, because the risk with any neuroleptic is -never- 0, not even with clozapine b) lithium may be the best bet in some cases, but it makes the toxic ill effects of the neuroleptics more pronounced, at least in larger studies. short term, there's some indication that lithium with neuroleptics increases the NMS and EPS risk.

my best, completely out of no where guess would be that you might want to get your lithium levels checked, see about either reducing the seroquel or dropping the zyprexa, maybe see about taking a Benadryl at night time and see if you wake up OK (please talk to a health professional...I'm just sharing random stuff that's kinda sorta worked for me, but guess what? I'm...still crazy. ha!)

oh, and...2 neuroleptics. have you recently taken the zyprexa? don't get me wrong; keep the crazy under control, by all means, its just...even without lithium, 2 neuroleptics=increased adverse effects. its strange. pretty much any neuroleptic can be converted into a chlorpromazine (thorazine) equivalent, right? Right. what gets strange is...taking, say, 400/mgs thorazine equivalent in -1- antipsychotic is probably less likely to set off the twitches, dystonic reactions, etc., than taking 400mgs/thorazine equivalents in 2 different neuroleptics, combined. why this should be the case, but then the 2 neuroleptic drug combos work beautifully for some people now and then...no one really knows. its psychiatry, not...science.

that's all i can come up with. do you have an Rx for benztropine or something similar? its a good thing to have, just in case....but of course, please talk to your psychiatrist. oh, wait...instead of zyprexa for prn madness control, maybe a sedative? gabapentin, a benzodiazepine, lyrica, anything, really...to simmer down for a minute...that doesn't block D2 receptors. i do OK with as needed gabapentin, personally.

sorry about the bad experience.

[bpcyclist]

Originally Posted by still_crazy

hi. i didn't respond earlier because...holy ****, that's scary!...and also...I'm not any sort of expert. however...based upon my extensive Google-ing...


what's going on in your situation? i don't know, honestly. just that...a) Bipolar I people are more prone to TD, possibly other tardive syndromes, than Schizophrenia people. This is important, because the risk with any neuroleptic is -never- 0, not even with clozapine b) lithium may be the best bet in some cases, but it makes the toxic ill effects of the neuroleptics more pronounced, at least in larger studies. short term, there's some indication that lithium with neuroleptics increases the NMS and EPS risk.

my best, completely out of no where guess would be that you might want to get your lithium levels checked, see about either reducing the seroquel or dropping the zyprexa, maybe see about taking a Benadryl at night time and see if you wake up OK (please talk to a health professional...I'm just sharing random stuff that's kinda sorta worked for me, but guess what? I'm...still crazy. ha!)

oh, and...2 neuroleptics. have you recently taken the zyprexa? don't get me wrong; keep the crazy under control, by all means, its just...even without lithium, 2 neuroleptics=increased adverse effects. its strange. pretty much any neuroleptic can be converted into a chlorpromazine (thorazine) equivalent, right? Right. what gets strange is...taking, say, 400/mgs thorazine equivalent in -1- antipsychotic is probably less likely to set off the twitches, dystonic reactions, etc., than taking 400mgs/thorazine equivalents in 2 different neuroleptics, combined. why this should be the case, but then the 2 neuroleptic drug combos work beautifully for some people now and then...no one really knows. its psychiatry, not...science.

that's all i can come up with. do you have an Rx for benztropine or something similar? its a good thing to have, just in case....but of course, please talk to your psychiatrist. oh, wait...instead of zyprexa for prn madness control, maybe a sedative? gabapentin, a benzodiazepine, lyrica, anything, really...to simmer down for a minute...that doesn't block D2 receptors. i do OK with as needed gabapentin, personally.

sorry about the bad experience.

Thanks a million for the incredibly thoughtful and helpful reply. No, I didn't know any of that. I do now Abilifry is supposed to be among the safest wrt neuro SE. Was not aware that concomitant lithium elevated risk, so that is interesting. Lord knows what I would do without my lithium.

Seeing doc again this coming week. Talking about Clozaril. I dunno. Maybe you're right. Maybe a prn benzo could help without incresaing neuro risks. I'll mention it. I have an addiction history, but sober a very long time and benzos were never a problem for me. I actually don't like them. But I will gladly take them if it helps.

Will keep you posted. Thanks again for all the info. Really appreciate it.

[*Beth*]

I had some odd side effects from Abilify, but what you're described wasn't one of them. I did take benzotropine (Cogentin) with the Abilify, though. It's interesting that you were riding when the muscle issue occurred...I wonder if you would have been experiencing akathesia too, had you not been in motion.

[bpcyclist]

I have never gotten akathesia from Abilify, even at 30 mg. But Zyprexa induces it all the time in me. even at low doses. Weird. I'm weird.

[Sometimes psychotic]

Do you think this is a dystonia? I know APs can cause this but have never experienced it thank goodness.

[bpcyclist]

It is possible in my opinion that this could just be my own bizarre version of dystonia. We'll see what Dr. C thinks--thanks for that thought.

[*Beth*]

Originally Posted by bpcyclist

I have never gotten akathesia from Abilify, even at 30 mg. But Zyprexa induces it all the time in me. even at low doses. Weird. I'm weird.

We're all weird here