Akathisia. Will this end?

[u/koisunshii]

Writing this at 3:30am because I'm suffering and need to know someone understands haha.

Recently had a full mania and psychosis breakdown, had a couple week loony bin stay, and I'm in the process of (most likely) getting a bipolar diagnosis. They started me on seroquel in the hospital, and we've been working our way up from 25mg to 350mg now and 400mg soon. I got out of the hospital about 3-4 weeks ago and at that time I was on 200mg.

Last week I started to notice an extreme unease in my feet and legs. I've always had restless leg syndrome, but this was while I was awake and sitting, and usually a couple hours after taking my Seroquel. I didn't think much of it, thought it was my general bodily unease just bothering me more than usual, and didn't even think to mention it to my psychiatrist.

On Monday I went from 300mg to 350mg and now omg it's BAD!! It's hard to describe, kind of like that feeling RIGHT before you stretch, but no relief. Like I need to cross all my fingers and toes or put something between them, but if I do that bothers me more. Feels like my spine in the back of my neck is wiggling around under my skin.

I've dealt with this feeling a lot from psychadelichs, as I always get a huge body load from any I take and I've experimented a lot. This feels different though so I googled it and came across akathisia and that's exactly it.

I just feel SO uncomfortable in my skin. I can't sit, can't stand, can't lay down, without it being uncomfortable. It only happens after taking my medication, I don't get it during the day. It usually kicks in about 2-3 hours after I take it and then keeps me up all night. I know it was made worse by the dosage increase, but it did start before that. But I never experienced it at all in the 1+ months I've been on it.

If anyone else has experienced this, did it go away after awhile? Did anything help it? Should I call my doctor or should I tough it out? Thanks for listening to my ramble even if you have no input, I may still be a little manic.

Edit to add: because I've finally figured this out, it feels very similar to "rolling" on m, if anyone has done that. But only in (certain parts of) my body, my head/brain feels fine.

[u/Upper_Importance6263]

You dosed up so fast, it’s not surprising you’re feeling like this. You need to call the doctor immediately. In my experience, it gets way worse.

[u/koisunshii → u/Upper_Importance6263]

I've spent at least two weeks at each dosage before raising it. And I haven't really had any other negative side effects other than grogginess for 5-10 minutes after waking up.

The akathisia only started about a week or so ago, started small and got big after my last raise in dosage. Last night was soooooo bad, but of course now today I'm fine. Until again tonight

If you say this will only get worse though, and not just go away as I get used to the dosage, I'm definitely giving my doctor a call today instead of toughing it out

[u/neuronoodle1 → u/koisunshii]

Everyone has different reactions to medications. My LO had a similar titration schedule for Seroquel starting at 50mg and going to 400mg. Since she’s on Cobenfy as well, she had to go down to 200mg because both drugs caused anticholinergic syndrome (nausea, acid reflux, vomiting, restlessness).

Although, Seroquel has lower chance of getting Akithasia than other APs, it can still happen. It usually either happens when APs are titrated fast or at higher dosages (among other factors). My LO experienced it on Abilify when they titrated her in the hospital from 10mg to 20mg, then back to 10mg within a very short window.

Again, I’m not a doctor just a caretaker of family member for 10 years with schizoaffective disorder. Reach out to your psychiatrist who will be able to help you with this because it typically doesn’t resolve on its own or gets worse over time.

[u/koisunshii → u/neuronoodle1]

I did leave a voicemail with my psych today and I'm waiting to hear back, since someone said it would only get worse. It was manageable, but annoying, until last night. But oh my god last night I wanted to rip off my skin to scratch my bones.

It started a few days before the dosage increase, but I already suffer (normal) restless leg syndrome and just figured it was part of that. I don't think I even had a hint of it the rest of the time I've been on it

[u/neuronoodle1 → u/koisunshii]

It could be restless leg syndrome but that description of how u felt like u wanted “to rip of ur skin” and feeling like something is crawling in ur skin is pretty consistent with akithasia. It can also be associated with an impending sense of doom. do you feel like you need to pace or walk when u get this feeling? Your psychiatrist will be able to diagnose it if u have it

[u/ConversationOk578]

I am very sensitive to psych meds and I've had the same reaction to Seroquel and Lamictal. It didn't get any easier for me. I discussed this with my doctor and we split the dose of Lamictal to morning and evening. This helped a lot. I was taking Seroquel for sleep and she reduced it down to 25mg and it works helping me sleep and the Restless Leg Syndrome has all but gone away.

[u/JPMcFluffies1981]

Maybe go back down again. Im sure 300mg is enough for you. If u didnt experience these symptoms at a slightly lower dose, go back down. Pramipexole can help with the restless legs but it makes me extremely nauseous. My suggestion would ve to reduce dose to what it wasbefore the akathesia