[MuddyBoots]

Does anyone else confuse mixed/manic states with akathisia and vice versa? I feel like they feel similar with lots of agitation.

How do you tell them apart? Do benzos help with akathisia?
I’m questioning what I’m experiencing and Klonopin helped a lot so idk. I know its helped temporarily for mood states but I’ve never tried it on for sure akathisia. I’m already on propranolol and cogentin but I am on a decent dose of 2 APs and am extremely prone to akathisia so not sure.

[babs.superbird]

Dear Sapien,

I feel for you. I have Bipolar I and I have experienced rapid cycling. My issues are compounded by cPTSD and extreme anxiety. My psych doc agreed to prescribe Klonopin 0.5 mg twice a day because I could not function even though I was already taking 150 mg Seroquel ER at night and 225 mg Effexor ER in the morning. It has helped immensely. I never feel the need to take more than that but my p.doc still doesn’t want me taking it forever. I hope you can find the relief you need.

[Soupe du jour]

I can only speak from my own experience with akathisia. The severe akathisia I experienced on Geodon was totally separate from any kind of bipolar episode, including mixed episodes, which I've had plenty of. I know this because I suffered with akathisia on Geodon for well over a year (maybe two), and during that time my moods were mostly stable.

I have taken a small dose of propranolol for another health issue, but that certainly didn't help my past akathisia. I had been trialed on Cogentin, as well. It did help, but I had to go off because it gave me severe constipation. In the end, my psychiatrist had me taking Ativan (a benzo) for it. I took between 1 and 2 mg per day, on average. I had also been taking a small dose of Klonopin (0.5 mg) but that was not really for my akathisia. That was just for no good reason other than to avoid benzo withdrawal. I much prefer(ed) Ativan, so had no desire to have my Klonopin dose upped.

I had had some milder akathisia on medications like Abilify and Zyprexa, but they just made me want to pace a lot. The akathisia on Geodon was downright torturous. It's difficult to even describe. But in contrast to the other experiences, I mostly just stayed in bed rocking back and forth as if I was having a severe migraine (but with no pain), and sometimes almost (or even actually) screaming a bit. The only relief was when the Ativan kicked in again. Its effects would wear off after so many hours.

Eventually I was weaned off of Geodon (the most difficult medication I've had to go off), so the akathisia subsided. Then I was left having to be weaned off of Ativan. Boo!

[Moose72]

Originally Posted by Soupe du jour

I can only speak from my own experience with akathisia. The severe akathisia I experienced on Geodon was totally separate from any kind of bipolar episode, including mixed episodes, which I've had plenty of. I know this because I suffered with akathisia on Geodon for well over a year (maybe two), and during that time my moods were mostly stable.

I have taken a small dose of propranolol for another health issue, but that certainly didn't help my past akathisia. I had been trialed on Cogentin, as well. It did help, but I had to go off because it gave me severe constipation. In the end, my psychiatrist had me taking Ativan (a benzo) for it. I took between 1 and 2 mg per day, on average. I had also been taking a small dose of Klonopin (0.5 mg) but that was not really for my akathisia. That was just for no good reason other than to avoid benzo withdrawal. I much prefer(ed) Ativan, so had no desire to have my Klonopin dose upped.

I had had some milder akathisia on medications like Abilify and Zyprexa, but they just made me want to pace a lot. The akathisia on Geodon was downright torturous. It's difficult to even describe. But in contrast to the other experiences, I mostly just stayed in bed rocking back and forth as if I was having a severe migraine (but with no pain), and sometimes almost (or even actually) screaming a bit. The only relief was when the Ativan kicked in again. Its effects would wear off after so many hours.

Eventually I was weaned off of Geodon (the most difficult medication I've had to go off, so the akathisia subsided. Then I was left having to be weaned off of Ativan. Boo!

This! I had akathisia where I couldn't stop pacing, dancing, bouncing, and when it got really bad, I was in bed on my hands and knees with my head on the pillow just rocking back and forth over and over and over. I wanted to scream! Ativan helped it but I went off it too quickly I guess because I had horrible withdrawal symptoms- my legs shook and wouldn't stop. I couldn't sleep. I guess you might call that restless leg syndrome?

[*Beth*]

I have asked myself exactly the same question...is this akathesia, or is it mania? I think the difference for me is that akathesia somehow feels like it's med-induced. There's a very specific physicality to it, whereas mania feels more internal (both mind and body).

I take Amantidine for hand tremor and akathesia, and recently my pdoc added a small dose of Cogentin to take "as needed." The Cogentin is specifically for tremor in my jaw, arms and shoulders and for akathesia. The Amantadine is more effective than Cogentin is. Although, Cogentin is somewhat helpful.

I still feel like I have to have some part of my body in constant movement. For example, I'm noticing that as I'm typing this I'm slightly rocking back and forth. If I stop doing that I want to jiggle my leg.