Posted by alfie on February 19, 2012, at 15:57:05
In reply to Re: tardive akathisia, posted by ed_uk2010 on February 19, 2012, at 5:31:44
Akathisia is caused by dopamine blockade. That's why dopamine agonists work. Restlessness between the joints-- primarily the knees and the arch of the foot- is where the restlessness occurs. It is the sensation of movement between the joints which provide a fleeting relief-- hence the restlessness.
> >A dopamine agonist should work, but if it doesn't, one sure fire way to solve the problem is a botox injection into the arch of the foot. It is the joint of the primary (starting) foot in which the sensation to move is focused in. If these nerve endings are paralyized, so is the akathisia. There is research of this in tardive dykensia, yet not likely in tardive akathisia. Yet if it's bad, I suspect the patient will be welcoming of any hope.
> >
> > Fortunately, the dopamine agnoists (Aricept, etc.) should do the trick.
>
> I'm not sure how Botox could be used in akathisia. Distress is akathisia is often substantial and restlessness is widespread. Botox is used to paralyse specific muscle groups. Even a completely paralysed patient could experience akathisia subjectively, the feeling of restlessness comes from within the central nervous system.
>
> Donepezil (Aricept) is an acetylcholinesterase inhibitor. There are case reports of its use in tardive dyskinesia. I have no idea how it might affect akathisia. I have a theory that it might help TD patient whose symptoms are aggravated by anticholinergics.
>
> http://www.ncbi.nlm.nih.gov/pubmed/11816865
>
poster:alfie
thread:1010334
URL: http://www.dr-bob.org/babble/20120212/msgs/1010854.html