LONGECITY

The past two nights I couldn’t figure out what was wrong with me. I had these odd muscle sensations that felt like I needed to constantly stretch and move and no matter what I did nothing helped. It was not only my legs actually it was more so my back and torso and almost even felt like my insides needed to be stretched as weird as that sounds. In the past two nights I’ve literally gotten only a few hours of sleep. I tried narrowing down what it could’ve been from. A few days ago I started 2.5 mg Memantine and made a thread about it but now I’m not so sure that was the culprit. My doctor increased my Lexapro from 10 mg to 15 mg about a week ago and I’m thinking maybe that might be it. This is odd because I’ve taken Lexapro for over seven years off and on as well as other drugs like antipsychotics and anticonvulsants I have never experienced this. But at the same time when I first started those I was using cabergoline which is probably why. I was researching all night and I’ve seen a few studies showing beta blockers can help but I’ve been on Nebivolol for a few months already. I tried taking benzodiazepines, muscle relaxants, Benadryl, melatonin, etc. pretty much everything to fall asleep you name it and nothing worked. Finally last night I decided to take .25mg Ropinirole and about two hours later I finally fell asleep and the akathisia went away. What’s confusing to me is I’ve been on all sorts of medicines for over seven years and now I am just starting to get akathisia and it just randomly happened out of the blue two days ago. It only happens at night and not even so much when I’m just sitting down relaxing watching TV it only happens when I actually lay in bed and try and go to sleep. I’m going to make a appointment with my doctor next week but I’m wondering if anyone else has experienced akathisia and what your remedies were to take care of it? Thank you.

Update: last night was much better I would say about 75% better. It’s been about three days so the Memantine is out of me and yesterday instead of taking 15 mg Lexapro I just took 10mg
3hrs before bed I took .25mg ropinirole. I think for the next few days I will stick with only 10mg Lexapro and continue the low-dose .25mg ropinirole and then I will try still take only 10 mg Lexapro but not take the ropinirole and see if I can narrow down what the cause was.

Your symptoms (including the pre-sleep aspect) sound similar to restless legs syndrome, but more body-wide.

 

Makes me wonder if the problem might be related to low dopamine, especially given the meds you're taking.

 

You might try taking Tyrosine (a dopamine precursor), to see if that gives you any relief. Also, check your current and recent meds to see if any of them might be dopamine antagonists.

 

I have an appointment this week with my doctor but now I’m debating if I’m actually suffering from Akathisia or paroxysmal nocturnal dystonia

Your symptoms (including the pre-sleep aspect) sound similar to restless legs syndrome, but more body-wide.

Makes me wonder if the problem might be related to low dopamine, especially given the meds you're taking.

You might try taking Tyrosine (a dopamine precursor), to see if that gives you any relief. Also, check your current and recent meds to see if any of them might be dopamine antagonists.

That’s what I was thinking at first but I still take 60mg Vyvanse in the morning and 15 mg Dexedrine in the afternoon. I believe when there is an imbalance in the serotonin and dopamine ratio this can be a side effect and since this just happened when I increased my Lexapro from 10 to 15 mg I’m thinking maybe it was too much serotonin which caused this.

That’s what I was thinking at first but I still take 60mg Vyvanse in the morning and 15 mg Dexedrine in the afternoon. I believe when there is an imbalance in the serotonin and dopamine ratio this can be a side effect and since this just happened when I increased my Lexapro from 10 to 15 mg I’m thinking maybe it was too much serotonin which caused this.

 

Stimulants like Dexedrine and Vyvanse release existing dopamine, but without making more of it. After a while, the result can be dopamine depletion.

 

Low dopamine can mess with your nervous system terribly. Restless legs syndrome (RLS) can be mild, or it can be horribly severe, and can involve much more than just legs. Like what you're experiencing, it comes on at night, before or during sleep. The most effective treatments for RLS are drugs that act like dopamine by binding to dopamine receptors (agonists). Ropinrole (Requip) is one such dopamine agonist. The fact that it helped is another indication that dopamine is involved. (as an aside, high levels of Iron are known to make RLS worse).

 

Lexapro is a reasonably selective SSRI, as you probably know, so it's possible serotonin is also involved. Taking multiple drugs that alter levels of neurotransmitters at the same time is normally considered a pretty risky thing to do in the long term. Doses can be tricky and difficult to tune.

I read the opposite. I read that low iron can cause the symptoms. Regardless last night was the first night I did not suffer from any of these symptoms thank goodness. It’s been about three or four days since I dropped the Lexapro dosage so I’m 99% sure that was the cause. I think the increasing serotonin from the Lexapro combined with the depletion of dopamine when the stimulants were out of my system where what caused this. All I know is I’ve had some painful stuff happened to me in my life. I’ve been in fights got punched in the face broke arms and legs, etc. but I would take all of that any day over the symptoms I was getting the past three nights. I feel so bad for people who have to take heavy antipsychotics and have to deal with those symptoms I wouldn’t wish that on my worst enemy.

Are you taking many supplements combined with the prescription medicine? If so, your problem could come from any one of those obviously or even an interaction. That's why you should check them out one at a time, see if you react well to them. 

Are you taking many supplements combined with the prescription medicine? If so, your problem could come from any one of those obviously or even an interaction. That's why you should check them out one at a time, see if you react well to them.

I do take a lot of supplements but I’ve taken the same ones for years the only change was the Lexapro increase and Memantine re introduction so it was one of those two.

I read the opposite. I read that low iron can cause the symptoms. Regardless last night was the first night I did not suffer from any of these symptoms thank goodness. It’s been about three or four days since I dropped the Lexapro dosage so I’m 99% sure that was the cause. I think the increasing serotonin from the Lexapro combined with the depletion of dopamine when the stimulants were out of my system where what caused this. All I know is I’ve had some painful stuff happened to me in my life. I’ve been in fights got punched in the face broke arms and legs, etc. but I would take all of that any day over the symptoms I was getting the past three nights. I feel so bad for people who have to take heavy antipsychotics and have to deal with those symptoms I wouldn’t wish that on my worst enemy.

 

Oh! You're right about the Iron; typo, sorry. I meant to say low Iron. However, high Iron can also be a problem, but only when combined with high-dose Vit C.

 

Glad to hear things are settling down. SSRI dose can be a tricky thing, especially when multiple meds are involved. I've experienced severe RLS first hand, and, as you said, it's a horrible, horrible thing.

 

You may want to check your future prescriptions for dopamine antagonists. One that bit me is Reglan / Metoclopramide (often prescribed for nausea). I also found that even mild withdrawal from opiates (codeine, in my case) can badly aggravate things.

Anticholinergics are sometimes used for akathisia.

Anticholinergics are sometimes used for akathisia.

Yes I read about that. Last night was another successful nights sleep. I think I’m good now thank goodness.