In this episode of Akathisia Stories, Heather McCarthy discusses the prescribed harm and akathisia-induced death of her son, Shea. A talented artist and musician, Shea was a college student at Purdue when he was prescribed an extremely large dose of the antibiotic Levaquin after a minor operation. He suffered Levaquin side effects to include anxiety, cardiac issues, and insomnia. However, doctors misdiagnosed these adverse effects as "bipolar disorder." Shea was then further harmed by Risperdal, Lamictal, and Ativan. Heather, who successfully fought to hold doctors accountable, discusses her family's avoidable loss and her advocacy efforts to ensure others are safer and better informed.

Discover the hidden dangers of akathisia, a severe condition often caused by medications like antidepressants, benzodiazepines, or even nausea drugs. This reaction, marked by unbearable restlessness, inner turmoil, and alarming symptoms such as suicidal thoughts, is frequently misdiagnosed. Akathisia is not just anxiety—it feels like mental torture and requires urgent recognition for effective medical treatment.

Key points covered in this video include:
- Recognizing the symptoms: constant pacing, grimacing, or feeling like your mind is on fire.
- Understanding possible causes, including starting, stopping, or changing medications.
- The critical need for advocacy: document symptoms and ask your doctor directly about akathisia.

For patients managing conditions like opioid addiction or benzodiazepine dependence, gradual tapering methods and informed medical decisions play a vital role in safe treatment. Early recognition and patient care can save lives. If you or someone you know is experiencing these symptoms, seek medical advice immediately.

Your health matters—educate yourself about potential medication side effects, ask questions about tapering methods, and explore reliable resources to make informed decisions. Watch now to learn how to protect yourself and advocate for better patient care.

#suicideprevention #akathisia #wellnessjourney #anxiety #anxietymedication

Janet Schiel discusses her husband Joe's avoidable akathisia-induced death in this episode of Akathisia Stories. Joe, who was getting ready to retire after a long and successful career in the pharmaceutical industry, died weeks after starting the SSRI, Lexapro. After Joe's death, Janet founded the nonprofit, Butterflies for Joe.

Akathisia Stories, a co-production of MISSD and Studio C Chicago, is a podcast series that features interviews and news concerning the adverse drug reaction akathisia and medication-induced suicide. MISSD, the Medication-Induced Suicide Prevention and Education Foundation in Memory of Stewart Dolin, is a unique nonprofit organization dedicated to honoring the memory of Stewart and other victims of akathisia by raising awareness and educating the public about the dangers of akathisia. MISSD aims to ensure that people suffering from akathisia's symptoms are accurately diagnosed so that needless deaths are prevented. The foundation advocates truth in disclosure, honesty in reporting, and legitimate drug trials.

Akathisia is a movement disorder caused by different medication, including for psychosis, depression, and nausea. It is also caused by certain brain disorders.
It is characterised by inner restlessness causing the person to want to be constantly on the move and being unable to sit still. The person may pace up and down, march on the spot, shift their weight from one leg to another, cross and uncross their legs, rock to and fro. They also have a feeling of inner terror. It can cause suicidal thoughts.

Gail Regenbogen discusses her late husband, Howard, and his akathisia-induced death in this second podcast of the MISSD Akathisia Stories series. At the end of 2009, Gail's husband, Howard, was prescribed the antidepressant Cymbalta; in just three weeks after starting the drug, Howard changed from the "very outgoing, happy" man Gail had known him to be through 30 years of marriage, to someone who was "real quiet and withdrawn."

She married Howard Regenbogen in 1980 and together they raised three daughters. Regenbogen was born in Detroit, Michigan and raised 14 miles north of Chicago in the village of Wilmette. She studied elementary education and history at Bradley University in Peoria, Illinois, and was an elementary school teacher in the Chicago public school system.

Interview: What akathisia feels like. Presented by Dr. Tom Perry.

We delve into the adverse side effects of antipsychotics, including akathisia, and neuroleptic malignant syndrome, as well as discussing treatments and the drugs involved. Our aim is to provide essential information on managing these challenging conditions. Thank you for joining us. #Antipsychotics #SideEffects #MentalHealth #Akathisia #NeurolepticMalignantSyndrome #Pharmacology #Psychiatry #MedicalEducation #Haloperidol #MentalHealthAwareness

MISSD was pleased to recently present akathisia and antidepressant-induced alcoholism info to Chicago's Hazelden Betty Ford Center on June 25th as part of the Center's virtual education program. Akathisia can cause suicidality and iatrogenic deaths, but if prescribers, consumers, and caregivers know the warning signs, prescribed suffering and deaths can be prevented.

Join us in this informative video to explore the intricate differences between Akathisia and Restless Leg Syndrome (RLS).
Consultant psychiatrist Dr Sanil Rege provides valuable insights into these often perplexing conditions, shedding light on their symptoms, treatments, and underlying mechanisms.

In this must-watch video, Dr Rege expertly guides you through the complexities of Akathisia and RLS. Discover how antipsychotic medications can trigger Akathisia and how this differs from the effects of SSRIs, which can also induce similar symptoms. Gain a comprehensive understanding of how these medications impact the body and learn effective strategies to manage associated side effects.
Time stamps:
0:10 Introduction to Akathisia
2:04 Patient’s clinical experience of akathisia
4:15 Chronic Akathisia
6:22 What are the medications that lead to akathisia?
8:31 The pathophysiology of Akathisia
10:59 The ventral striatum and nucleus accumbens.
13:20 Distinguishing between akathisia and restless leg syndrome.
16:12 How to reduce the dose?
18:06 Medications that modulate the dopaminergic system in the treatment of akathisia
19:23 Reduce dose and add anti-akathisia agents

#akathisia #antipsychotics #antipsychoticsideeffects

Akathisia is defined as :
Subjective complaints of restlessness, often accompanied by observed excessive movements (e.g. fidgety movements of the legs, rocking from foot to foot, pacing, inability to sit or stand still), developing within a few weeks of starting or raising the dosage of a medication (such as a neuroleptic) or after reducing the dosage of a medication used to treat extrapyramidal symptoms.

The pathophysiology of akathisia appears to be complex, involving several neurotransmitters, including dopamine, acetylcholine, y-aminobutyric acid (GABA), norepinephrine, serotonin, and neuropeptides.

The neurotransmitters most specifically linked to akathisia are gamma-aminobutyric acid (GABA) and serotonin. GABA (mainly via GABAA receptor interactions) exerts an influence on dopamine-dependent signalling, thus, increasing or reducing locomotor activity

One of the critical discussion points is the role of antipsychotic medications in causing Akathisia. We explore how these drugs may lead to this condition and how they differ from SSRIs, which can also induce Akathisia.

Not only does this video address the symptoms and treatments of Akathisia, but it also breaks down the key differences between Restless legs versus Akathisia. Both conditions can cause discomfort and distress, but knowing the distinction can be vital for accurate diagnosis and effective treatment.

Akathisia may result from efforts to compensate for dopaminergic underactivity in the nucleus accumbens
Strategies for management include:
1. Reduce dose
2. Switch to low-risk antipsychotic
3. Adjunctive approaches:
Propranolol 40-80 mg/day
5HT2A receptor antagonists (e.g. mirtazapine 15 mg PO daily, cyproheptadine 8-16 mg PO daily)
Benzodiazepines (e.g. clonazepam 0.5-1 mg PO daily, diazepam 5-15 mg PO daily)
Anticholinergics (e.g. benztropine 1-4 mg PO daily) should be used mainly for patients who have concurrent Parkinsonism
An algorithm is also covered.
#AkathisiaInsights
#RestlessLegSyndrome
#ClinicalDifferentiation
#MedicalProfessionals
#PsychiatricInsights
#Pathophysiology
#Pharmacotherapy
#TherapeuticInterventions

Akathisia [Antipsychotic induced movement disorder]

Akathisia is a neuropsychiatric syndrome that can occur as an adverse effect of antipsychotic medications and manifests as psychomotor restlessness. In recent years, akathisia has additionally been found to occur in certain individuals as an adverse effect of with calcium channel blockers, antiemetics, anti-vertigo drugs, cocaine, and sedatives used in anesthesia. Akathisia is defined as an inability to remain still. It is a neuropsychiatric syndrome that is associated with psychomotor restlessness. The individual with akathisia will generally experience an intense sensation of unease or an inner restlessness that usually involves the lower extremities. This results in a compulsion to move. In most cases the movement is repetitive. The individual may cross, uncross, swing, or shift from one foot to the other. To the observer, this may appear as a persistent fidget.

Akathisia is frequently associated with the use of antipsychotics (neuroleptics), but it can also complicate the use of selective serotonin reuptake inhibitors (SSRIs). Other causes of akathisia include anxiety disorders, drug withdrawal or discontinuation states, early serotonin syndrome, restless legs syndrome, iron deficiency anemia and endocrinopathies. It is therefore important to find the underlying cause by identifying drug precipitants and associated psychopathology and excluding general medical causes. The pathophysiology of akathisia is not fully understood, but a combination of hypodopaminergic and hyperserotonergic neurotransmission may be implicated. This hypothesis is supported by the emergence of akathisia following the initiation of antipsychotics or SSRIs, but also from the observation that dopamine agonists can alleviate psychomotor agitation associated with restless legs syndrome

Akathisia can have a significant negative impact on quality of life and is associated with increased suicidality. Treatment of this distressing condition is difficult and treatment options are limited.

Antipsychotic-induced akathisia may be managed by reducing the dose of the offending agent or switching to an alternative antipsychotic agent. Beta-blockers such as propranolol and benzodiazepines have historically been used for the treatment of akathisia although the amount of high-quality data supporting their use is limited. Anticholinergic agents such as benztropine may be utilized if concomitant pseudoparkinsonism is present. Mirtazapine may also be utilized for the management of akathisia. Low-dose mirtazapine has been found to be as effective as beta-blockers and may be considered first-line therapy.

When using beta-blockers, clinicians should be aware of the risk of bradycardia and hypotension. Many other agents, including vitamin B6, have been used to treat akathisia, but there are no randomized controlled trials to determine their efficacy

Antipsychotic-induced akathisia may be managed by reducing the dose of the offending agent or switching to an alternative antipsychotic agent.

Beta-blockers such as propranolol and benzodiazepines have historically been used for the treatment of akathisia although the amount of high-quality data supporting their use is limited.

Anticholinergic agents such as benztropine may be utilized if concomitant pseudoparkinsonism is present.

Unfortunately, once akathisia has developed it can take months for the disorder to subside. Case reports exist indicating that this movement disorder also increases the risk of suicidality. Hence, all patients with akathisia need to be closely monitored and the family should be educated about the impact of akathisia

Dystonia is a neurological movement disorder characterized by involuntary muscle contractions that cause repetitive or twisting movements and abnormal postures. These muscle contractions can be sustained or intermittent and may result in painful, awkward, or distorted movements. The condition can affect any part of the body and can range from mild to severe.

Dystonia is caused by a dysfunction in the brain's basal ganglia, which is responsible for coordinating muscle contractions. It can be classified into several types based on the affected body part or the underlying cause. Some common types of dystonia include:

1. Generalized Dystonia: This type affects multiple body parts and can lead to twisting and contorting movements that involve the limbs, trunk, and sometimes the neck and face.

2. Focal Dystonia: This type is confined to a specific body part. Examples include cervical dystonia (affecting the neck muscles, also known as spasmodic torticollis), blepharospasm (involving the eyelids), and writer's cramp (affecting the hand and forearm muscles).

3. Segmental Dystonia: In this type, adjacent body parts are affected. For instance, cranial-cervical dystonia involves the head and neck.

4. Hemidystonia: Only one side of the body is affected in this type, leading to abnormal movements and postures on that side.

5. Dystonia-plus Syndromes: These are conditions where dystonia is a prominent feature along with other neurological symptoms. Examples include Dopa-Responsive Dystonia (DRD) and Paroxysmal Nonkinesigenic Dyskinesia (PNKD).

6. Secondary Dystonia: Dystonia can also be caused by underlying factors such as brain injury, certain medications, infections, or other neurological conditions. This is known as secondary dystonia.

The exact cause of primary dystonia (dystonia without an underlying cause) is often unknown. However, genetic factors are believed to play a role in its development. Certain gene mutations have been associated with various forms of primary dystonia.

While there is no cure for dystonia, treatment options are available to manage its symptoms and improve the quality of life for individuals affected by the condition. Treatment approaches may include:

- Botulinum Toxin Injections: Botulinum toxin, commonly known as Botox, is injected into specific muscles to temporarily paralyze them and reduce abnormal movements.
- Oral Medications: Medications like anticholinergics, muscle relaxants, and dopamine-modulating drugs can help manage symptoms in some cases.
- Physical Therapy: Exercises and stretching routines can help improve muscle flexibility and coordination.
- Surgery: In severe cases where other treatments are ineffective, surgical procedures like deep brain stimulation (DBS) may be considered. DBS involves implanting electrodes into specific areas of the brain to modulate abnormal brain activity.

If you suspect you or someone you know is experiencing symptoms of dystonia, it's important to consult a medical professional, ideally a neurologist, for a proper diagnosis and treatment recommendations tailored to the individual's needs.