Akathisia remains an ongoing problem, despite the greater use of second-generation antipsychotics. The exact mechanism of development remains poorly understood, although ongoing research points to a greater involvement of other neurotransmitter systems outside of dopamine, such as acetylcholine, serotonin, and GABA. From this new theoretical foundation, treatment strategies have moved beyond longstanding regimens (eg, beta-blockers, anticholinergics, benzodiazepines) by including serotonin-based pharmacotherapy (eg, mirtazapine, mianserin). Based on akathisia’s similarity to movement disorders such as RLS, new approaches under investigation include medications that increase dopamine and GABA (eg, ropinirole, gabapentin, pregabalin, vitamin B6), which are depleted with neuroleptic use. Timely diagnosis and adequate treatment are key in maintaining patient rapport, improving medication compliance, and increasing efficacy. Thus, providers need to be aware of this phenomenon and understand how to manage it effectively using the latest research-supported treatment regimens (Table 1).
Table 1.
Treatment Recommendations

What new med are you on, Bizi?



M

I have had akathisia multiple times. It is absolute misery. I don't think it stops during the day. From the sound of your symptoms, I don't think that is what you are experiencing, but if you think it is, you need to talk to your pdoc ASAP before it gets worse.

Akathisia:

Akathisia

I skipped my dose of geodon last night and did not have it.
I think/know we went back to the geodon full strength with out a taper up.
went from 20mg of abilify to 80mg of geodon twice daily.
I can't explain it any other way except for restlessness that hits me for about an hour like right after a certain amount of geodon is released???? around 1am.
I wrote to my pdoc and told her what was happening and asked her what I should do.
bizi

It was a good idea to call your doc because of all your recent med changes.

I hope she makes changes that help with the issue

the night before I did not take the 80mg of geodon nor the 50mg of seroquel and did not sleep. So last night I took the full 80mg and woke up 2 hours later with the restless legs again and had to get up and leave the room.
Kay you may be right. IT could be the with drawl of seroquel. I was on it for a few months ( i think) then to just discontinue it quickly like that. Who knows what is causing what at this moment, too many med changes. The mobic wasn't working and I do believe that is what caused my swelling of my legs.
I think she is calling in a stronger prescription strength alieve...I think.
I have celebrex on hold at the pharmacy if I need it.
bizi

You have been on a med roller coaster with the very short taper off the Abilify onto the Geodon, the short taper off the Seroquel, and the addition of Mobic. It's no wonder why you are having all these side effects...
Hopefully once you are on your new regular meds for a little while, you will stop having all these side effects

I think she is calling in Naproxen. It could help. It could be irritating to your gastro system over a long period if you are prone to that tho...

It is another NSAID, so do not start it right away because of the edema you experienced with the Mobic! I would wait a few days to a week before taking another NSAID like Advil, Aleve, or the Naproxen. I know that you may experience pain, but it will be safer.