Posted by yxibow on March 20, 2007, at 0:06:13
In reply to physiologicaly what is occuring in akathisia?, posted by johnnyj on March 19, 2007, at 17:44:28
> Is it cortisol? I guess I am trying to figure out a way to counteract it, if that is possible. I would like to slow my body down with good stuff like vitamins?
>
> Thanks
>
> johnnyjIts EPS. Extrapyramidal symptoms, or if you want to put it in plain terms, side effects.
Neuroleptics, and to some rarer extent, TCAs and SSRIs, block various dopamine receptors.
They occupy various subreceptors, the main one being focused upon here is D2. Neuroleptics can occupy the D2 pathway up to 100%, but they vary wildly in the intensity to which they both occupy to that extent and how much they let go and start again. Stronger neuroleptics such as the typical haloperidol occupy and take a long time to let go, whereas weaker atypical neuroleptics such as Seroquel, occupy the receptors but let go much easier, grab on again, and let go, etc.
What happens in EPS, which is akathisia, pseudoparkinsonism, and other symptoms outside of the intended effect is that neurotransmitters in the nigrostriatal pathway are effected -- this pathway is responsible for movement, rather than the mesolimbic pathway, which is the intended target, responsible for various mood effects.So D2 blockade basically overruns and enters that pathway, and akathisia results. It gets more complicated, but that is a simple description of it.
courtesy wikipedia, which has an external link to explaining pathways, which happens to be on a university drug addiction explanation page, but it does illustrate these pathways :
http://learn.genetics.utah.edu/units/addiction/reward/pathways.cfm
As for counteracting it, there really isn't any other way other than reducing the amount of the drug in question, switching agents, using none of the above, or taking auxiliary agents with a neuroleptic, TCA or SSRI, primarily anticholinergics such as Artane and Cogentin, or propranolol for pseudoparkinsonism, or benzodiazepines for all of the above to some degree.Some people swear by Vitamin E as a neurotoxin blockade, I variably take it, but there is no proof that it actually does anything. A normal capsule is an usually an okay dose, beyond 400 IU, you're getting into the range of experimental studies and possible hemorrhage issues that would far negate its use.
poster:yxibow
thread:741810
URL: http://www.dr-bob.org/babble/20070314/msgs/742369.html