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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by emmanuel98 on August 23, 2009, at 19:27:57
I am taking trilafon and have developed a little akathisia. It's not too bad. I just can't sit still without feeling like I'm going to jump out of my skin. The pdoc at the day program I attend said to take benadryl, which helped. But the web says don't mix benadryl with MAOIs (I also take parnate).
Posted by yxibow on August 24, 2009, at 0:10:53
In reply to akathisia and benadryl, posted by emmanuel98 on August 23, 2009, at 19:27:57
> I am taking trilafon and have developed a little akathisia. It's not too bad. I just can't sit still without feeling like I'm going to jump out of my skin. The pdoc at the day program I attend said to take benadryl, which helped. But the web says don't mix benadryl with MAOIs (I also take parnate).
Yes, anticholinergic (atropine like) side effects can be intensified.Your doctor may be one who believes that there is a serious interaction with MAOIs (it is noted on the packaging, I believe). This may or may not be true with some people.
But I haven't seen any articles noting the seriousness other than common sense of monitoring signs of increased blurriness, dry mouth, psychosis like syndromes which can be a sign of central anticholinergic syndrome.
Artane would probably be less of a sledgehammer than Benadryl, but I can't say for sure.
But if you want to avoid all of this, one main drug of choice for akathisia is propranolol, a non cardioselective beta blocker which has little interaction with what you're taking and is commonly used.
And while one should watch for low blood pressure, all the unpleasantries of anticholinergics can be avoided.Of course then there is the issue that doctors may take into case that propranolol can cause depression (in some people), but that also isn't always the case and the dose used should be as low as possible.
-- Jay
Posted by linkadge on August 24, 2009, at 20:33:29
In reply to Re: akathisia and benadryl » emmanuel98, posted by yxibow on August 24, 2009, at 0:10:53
Be very cautious with the combination of benadryl and an MAOI. Benadryl has serotonin reuptake inhibiting properties. See if you can get some cogentin. Dimenhydrenate (Gravol) may also work.
Linkadge
Posted by yxibow on August 24, 2009, at 23:53:11
In reply to Re: akathisia and benadryl, posted by linkadge on August 24, 2009, at 20:33:29
> Be very cautious with the combination of benadryl and an MAOI. Benadryl has serotonin reuptake inhibiting properties. See if you can get some cogentin. Dimenhydrenate (Gravol) may also work.
>
> LinkadgeI was going to suggest Cogentin too but to me it has more atropine qualities than Artane. Others may react differently.
Its unfortunate that Akineton was discontinued. It had much less of that and I found it useful.
Dimenhydrinate (Dramamine I) is a related salt of diphenydramine.
The closeness to each other makes me question that, it is 1/2 the strength of Benadryl, which can also be used for sea-sickness.
(Of course so can Dramamine II, meclizine) and is less drowsy. Anyhow this isn't about seasickness. I'm not sure if meclizine can help in akathisia.
If I were to have a choice between an anticholinergic and propranolol, I'd choose the latter, it feels much less .... well, belladonna yuck. Just my 2c.
-- Jay
Posted by SLS on August 25, 2009, at 5:47:35
In reply to Re: akathisia and benadryl » linkadge, posted by yxibow on August 24, 2009, at 23:53:11
> Its unfortunate that Akineton was discontinued. It had much less of that and I found it useful.
Yes. When I was on Akineton, it didn't seem to stick me with the same intensity of side effects that cogentin did. I actually tried Akineton as an adjunct to antidepressants. We were hoping to stir up the balance between DA and ACh in the brain. It didn't help.
- Scott
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