Akathisia symptoms

Hi Ro Starting and stopping drugs was the cause. Once the nervous system is shocked changing drugs usually only makes it worse. Buspirone may help and it may make it worse. It depends on the condition the autoreceptor is in. If the autoreceptor is functioning reasonably well then yes it would help. If the autoreceptor is in bad shape then it will have the opposite effect and make it worse. It's a coin flip. The good news is akathisia usually doesn't last forever. The bad news is it often ranges from a couple days to a couple months. Try to avoid what causes flare ups and note what you are doing when feeling calmer. That'll help you manage and avoid stimulants like coffee.

"Buspirone may help and it may make it worse. It depends on the condition the autoreceptor is in. If the autoreceptor is functioning reasonably well then yes it would help. If the autoreceptor is in bad shape then it will have the opposite effect and make it worse. It's a co..." — @Kevin Roy

Thank you for your reply. My GP did prescribe me Buspirone which I was taking together with Fluoxetine, but only took it for one week as it made my parasthesia symptoms twice as bad. I think my burning and electrical sensations are some form of parasthesia which was drug induced. I think this parasthesia is to do with serotonin. Unfortunately I can’t control the electrical burning sensations which are inside my muscles, but I guess it just needs time to repair. All I can do is try and distract myself. The sensation has got worse but my guess is that it could be that Prozac has now left my system and so my system is raw and firing.

So yeah, my research says that it’s actually parasthesia symptoms rather than akathisia. I’ve not been seen by a neurologist yet as it’s very hard to get one in UK, but listing my symptoms on Google, it tells me that it’s parasthesia symptoms. Who knows, could be some and some. The symptoms are very severe electric burning inside my muscles especially the legs and bum.

"RO 100% it is. Being drug free is good, unfortunately until the nervous system settles down... I had the same problem. It was always my left arm for some reason. Tremors and burning in the nerves. It did heal though :)" — @Kevin Roy

Oh that’s such good news that it healed. What drug caused it? Was it an SSRI?

Lexapro.

My electric burning symptoms are so severe that it’s unbearable. I get this morning switch that the moment my brain wakes up I can feel it turns it on, when asleep my symptoms come down. It’s really hard to ignore this electric burning which is there non stop. Strange that it also got worse in the last couple of weeks. Prozac should be out of my system and the burning is worse than before. How does that make sense? 7 weeks till I stopped the drug, how long till the symptoms come down at least a bit?

"Prozac should be out of my system and the burning is worse than before. How does that make sense?" — @RO

I'm sorry you're struggling so much RO 😢. Please know that it will get better in time. In the meantime, try your best to implement some non-drug coping techniques to help you endure the best you can. Distraction is a great tool to use. If moving makes you feel better, then keep doing that. It's important to not get discouraged and think you'll never heal - you will. Everyone I've seen that has dealt with akathisia (including me) has eventually improved. Sending you much empathy and support...hang in there my friend. 💜

Thank you 🙏 It really helps having reassurance to keep going. I’d find this restlessness more manageable if it didn’t cause my parasthesia electrical burning inside the muscles.

It make sense, serotonin levels rise when you wake, and they lower when you sleep. There is a thing called serotonin rebound, which I found in the research. When you quit the drug, serotonin goes up even higher than when on it. I wrote the theoretical paper suggesting that people with long term withdrawal problems it stays abnormally high. When on a SSRI your body slows down the production of serotonin to counter there being to much of it in your brain fluid. Normally it would slow the speed at which the cell releases serotonin into the brain fluid it. But it can't do that since the SSRI broke it. So the body uses this secondary method. When you stop the SSRI the cell fire rate of serotonin is still to fast, but now with the SERT working again the body increases the production of serotonin. This causes serotonin in the brain and body to go up when you stop the drug. How long this effect lasts in protracted withdrawal, nobody knows. It has never been measured beyond 1 week. But there is evidence of problems at 60 days in rodents which is the longest test ever done.

I seem to have a somewhat mild akathisia which comes in ebbs and flows over the day. When this hits me in the night, sleeping becomes impossible. Yesterday night I got 5-6 hours of decent sleep. I went to school and I was feeling a little bit better at 10am. At 11pm the activation kicked in. I don’t understand how this happen from tapering. I have been so careful from 100mg down to 6,8mg. Never akathisia. Different withdrawal symptoms yes. Severe lethargy, apathy, anhedonia, mild insomnia. Also some very mild inner restlessness. But never this one. Horowitz’ tapering technique hit me bad. But the worst mistake was on my part. I after a series of tapering for 6 days I got activation for the first time before going to bed. And waking up. I paused there the tapering. After some lingering insomnia, anhedonia and anxiety, I was sure I need to hold. But I stabilized again. And then I pushed 8 more days. And even though I didn’t have any symptoms, I just wanted to hold because my apprenticeship was beginning and I wanted to be stable. I became in all terms gradually worse over the next 30 days. Anhedonia got worse, emotional numbness got worse, my neuropathic pain as well. Don’t forget that I’m holding all the time! And then one day I took a nap. Waking up to a stinging headache, with severe cognitive problems. There I knew, something is going very wrong. I developed severe anxiety about my mind getting completely blank and never getting better. That was the first incident that led me to insomnia. I couldn’t sleep. And then activation/akathisia kicked in again. Then I decided to updose. Because in all the forums people say go back to the dose you felt good when the withdrawal symptoms are too bad. My problem was that the dose where I was feeling good was 37-38 days away. So updosing had a risk on its own. But I still did it. 5 days ago I went up from 6,52mg to 6,6mg. 0,08mg. That’s approximately 1% increase in SERT. I don’t know if I feel better or worse through the updose. But now I need to hold until I stabilize. I’m feared that this drug began to become acutely toxic. Or that my body rejects the drug. As you know reinstating is always an issue if you cold turkey. For updosing I always thought it could work. Mark Horowitz told me to updose carefully for 0,01mg every few days. That sounds like a good strategy, but I can not measure reliably the last digit of that dose. I might take one day 6,61 and the other 6,605 again. I want to stick with this solid 6,6mg now. I hope that at least my inner activation gets solved by the next week. I want to sleep again. @Kevin Roy

@Leminaseri "At 11pm the activation kicked in." Stress and exhaustion makes a struggling nervous system work harder, it makes akathisia worse. You feel better in the morning because you achieved some relaxation when you do sleep calming the nerves. It's a weird concept, but insomnia promotes insomnia, akathisia promotes akathisia and rumination promotes rumination. This is because the conditions are a result of a stressed nervous system, and when you don't sleep you are stacking more stress on top of what is already there. Rumination is the brain working fast jumping from worry to worry quickly which serves as fuel to keep the nervous system in the stressed state. When you can't sleep. Often times you can get up for a hour, read a book, then before you know it you are ready to go back to bed and sleep. To break the cycle a shift needed to take place moving your state of arousal into a different direction. Once you have moved your doses around and develop problems. All you can do is wait the symptoms out. Most of the time they settle in that 3-4 week taper window you use. This is why a dose reduction once a month is popular. @Maria A. Honestly it took me around 3 months or of borderline unbearable symptoms, then another year or so of cognitive difficulties. But when the symptoms started to clear and proper emotions returned, about 1.75 years after quitting Lexapro. It all started come back really fast, in a span of 4 weeks my grammar, memory, math, energy levels, quality of sleep, emotional range increased quickly. During the bad phase I found it helpful to focus on the little gains. The improvements are there, you can see them if you look for them. Comparing yourself today to 1-2 weeks ago is helpful. Then little day by day you will see the improvement grow. It feels slow at first but as time moves forward the improvement accelerates as you recover. Also try to remember to go outside if you can. Sunlight and nature goes a long way, although it may not seem like it right now.

@Maria A. Does your burning feel electric? Mine feels like I’m being pumped electricity and burning. I’ve had mine since I started Prozac and finished it after 19 days, the electric burning got worse in the last two weeks as Prozac has come out of the system. So altogether burning now for 10 weeks and praying for little improvements which I can’t see yet.

It’s it varies from like a sunburn burning to a harsher fire like burning. I don’t have it all the time though, it comes and goes during my waves. I recently went with a Dr. Christian Monsalve who was recommended in the withdrawal community and he prescribed me low dose mirtazapine for night and a B6 vitamin regimen for 5 days. I started it last night and today so will report back on how it goes. The plan is that once I stabilize on the Zoloft, I can come come off the mirtazapine.

"Does your burning feel electric? Mine feels like I’m being pumped electricity and burning." — @RO

"It’s it varies from like a sunburn burning to a harsher fire like burning." — @Maria A.

Are you guys talking about your skin? For me it’s the inner side of my chest. My skin is ok.

It’s like inside the skin.

@Leminaseri For me it’s more in my limbs and tummy area, but the legs is the worst. There’s some in my chest but it’s mild compared to the rest of it. I also get it in my cheeks to some degree. I think the burning part is to do with serotonin which is out of balance caused by SSRI, Prozac in my case. What medication caused your symptoms, do you have some burning too?

@Leminaseri Did you cold turkey yours and then reinstated it?

Unfortunately I’m in day 2 of taking the B6 for akathisia but the burning pain is worse. I had it all night and only got fragmented sleep. Mine is worse in my arms and sometimes it goes down to my legs.

@Maria A. Very sorry to hear that. It’s really hard to bear it, I know what it feels like and it’s really hard to know what could help and take away this electric burning. Do you think that Mirtazapine might be also making it worse or you think it’s only B6? Might be hard to know which one is causing it if you started them both together. Do you have electricity feel with your burning?

I don’t think it’s the mirtazapine. I think it was the B6 but I had it before starting the B6 too. It was caused by the Zoloft updose.

@Maria A. Keep up the hope, I’m with you there and understand what you are going through. It’s hard to believe that things will get better when you are in the middle of it, but people do get better with time. I’m waiting for my turn to feel better too.