Wednesday 27 September 2006 This note is neccessary to warn you of the dangers of Solian and identifying akathesia as distinct from anxiety or worsening of schizophrenic disorders. Please read the progressive symptoms that occurred after I ingested Solian, which had 4 out of 13 patients develop akathisia in a clinical trial. Although I was constantly diagnosed with anxiety, the difference between anxiety and akathisia is that there is a severe component of dysphoria to akathisia and it is induced by neuroleptic drugs or SSRIs. What this means is that overtime if the condition becomes chronic, the combination of dysphoria and anxiety fuse ultimately leaving the patient in a constant hyperstate of doom, and a feeling of not being themselves, short term memory problems, depression and social withdrawal and almost complete insomnia. These symptoms ultimately lead the patient with extreme akathisia to take action. Another way of putting it is a stimulant continum beginning with lesser degrees of insomnia, nervousness, anxiety, hyperactivity and irritability, which progresses towards more severe agitation, restlessness, aggression and mania which ultimately cylcle into an agitated depression, with a high risk of suicide and violence. Panic and anxiety are common as well as the patient not feeling themselves, going mad, in turmoil and as if nothing matters. Akathisia is also distinct from anxiety as it can lead to suicide as it is intolerable. The main problem with not diagnosing akathisia immediately is that medical intervention is not started and the treatment for anxiety which is usually a SSRI will typically make the akathisia worse even if by delaying the treatment of akathisia, which could lead to irreveversible akathisia, and ultimately death. With homicidal individuals this distinction could save more lives than just that of the patient. In my case it only took a single dose of Solian (Amisulpride) to induce the akathisia which then progressed in increasing severity each month. Tuesday August 15 Progressive symptoms On June 12 2006, I was given Solian at 7pm. When I woke up the next day everything changed as I had an extreme reaction to the Solian. It felt like I was having a heart attack and that I needed to walk to stop my blood pressure from dropping too much and blacking out. I had sharp pains to my heart (palpatations), a tightness in my chest and there was a numbness and pain in both of my hands. I could not stop moving for 5 hours straight. That night I was put back on Risperidone and had my first taste of insomnia as I woke up a number of times rather than sleeping throught the night. I told Dr Pentony that I needed to stay in the PSU in order that I recover, however, she put the symptoms down to anxiety rather than anything else and insisted that I be discharged despite my pleas to investigate my problems. The next thing to happen was that on Wednesday I felt pain in my legs, both the upper and lower parts of my legs felt sore. I also had 4 hour episodes of not being able to sit still, palpatations, and generally feeling very “wired” and stressed. So after the first 3 days I had: the beginnings of insomnia, waking up in the middle of the night multiple times intermittant pain originating around my heart intermittant pain and numbness, pins and needles in my hands intermittant pain an numbness, pins and needles in my upper and lower legs episodes of up to 4 hours where I couldn't sit still and I had to pace around the room As time went on more symptoms developed and exisiting ones set in: the insomnia got worse I was now only sleeping 3-4 hours a night, I was waking at 2 or 3 in the morning and unable to sleep again Intermittant pain in my heart Constant agitation all day long The pain and numbness in my hands got worse The pain and numbness in my legs got worse I frequently found myself shaking in both my arms and legs Little pressure when urinating No desire to get or maintain an erection A constant headache Intermittant nausea around mealtimes and so I was losing weight Intermittant bitter taste appeared in my mouth, took Kefflex for it in case it was a bacterial infection but without any success. By now I was visiting the emergency department and my GP at least 2 times a week each. As my symptoms worsened I felt like there something seriously was wrong with me. However, each time I was sent away and no tests were run in hospital, although sometimes I was given a sedative by the CAT team. I think they only diagnosed it as an anxiety attack. Now 6 weeks had passed since the initial dose of solian and there was absolutely no progress in my condition, I was getting 3 hours of sleep a night, and while awake I felt wired rather than relaxed, I couldn't sit still and was in a constant state of agitation at all times. I had tried everything from reading anxiety books and techniques, to having a shower, to exercising, doing chores, pacing around the room. At this time I also only had limited number of sedatives to take, so I bought some Restavit from a chemist. So every night was terrible where I didn't want to go to bed as it was torture to only sleep 5 hours even with medication, only to wake up wired and agitated again. By now I also had already run blood tests and had a ct scan, but they didn't reveal anything. As a consequence my situation seemed doomed, with no possibility of a recovery or way around the constant hellish agitation. It was made worse by the doctors saying it was only anxiety even though I could tell that no amount of breathing exercises did anything for the pain in my limbs, besides my heart rate and pressure and pulse were normal and not indicating a stress response. So when I woke up on Friday August the 4th, I found myself with no diagnosis, no prospects for improvement in any way, waking after 3 hours of sleep to my constant state of mental agitation and requiring myself to pace around the house for 2 hours. I had enough of it and couldn't see a future for myself and so for the first time I seriously contemplated suicide, not just a minor thought but genuinely comtemplating it and how to do it. This is when I called the CAT team, told them what was happening and said I needed to go to hospital. I woke my parents up and asked my father to drive me to the hospital, I told him why. At the hospital I spoke to the CAT team who gave me 2 temazepam and told me to come back at midday. I returned to the hospital at noon and brought my parents with me so that they could understand how critical the situation was. My family and I met with the senoir psych registrar who after talking to me about my symptoms prescribed Benztropine (Cogentin) for eps including akathisia. I started with the Benztropine that afternoon. I did notice that my requirement to pace around the room was reduced a little but didn't notice anything else that night, probably because I was sedated. The next morning, Saturday August 5, I took another Benztropine tablet. Shortly after taking the medication I started to notice other symptoms: Intermittant feelings of disorientation Intermittant dizzy spells I felt like passing out Intermittant vision being in and out of focus Intermittant sore sensitive eyes, sesitive to light, with the pain directly behind my eyes Short term memory problems Depression Intermittant balance problems Intermittant problems with my legs walking straight (uncoordinated movements) Intermittant throat felt like it was swelling these symptoms were in addition to the symptoms I had already acquired from the Solian notwithstanding a reduction in pacing. I immediately went off the Benztropine and went to hospital again. Now over the last few days I have had more symptoms emerge: Intermittant shooting pain into my top row of teeth a numbness in my upper and lower lips I almost passed out while at the gym, followed by an period of a couple of hours of heighted symptoms and I almost went to hospital again Intermittant pain in my testicles particularly my left testicle started on Thursday 10 August Intermittant pain and tenderness under my right armpit noticed in shower, and intermittant pain in my penis started on Saturday August 12 Also when I tried using Celstone M on my hands due to a rash, my hands started feeling like they were burning and caused all of my symptoms to increase in severety for at least 12 hours. And when I tried some Abalon A drops for my sore eyes, it made them more painful for about 6 hours. It seems as though my entire central nervous system responds with extreme sensitivity and violence to many medications. 14 August, due to the pain in my testes and penis, I decided to test if I could have an erection and orgasm. So I masturbated and found that although I had an orgasm, but it was dry, that is there was no semen ejaculated at all. I also had hallucinations at lunch time. Pain in testes and penis persistent all day. 15 August, woke from sleep with dry mouth and swelling of the tongue. Decided not to go to the hospital and waited for the swelling to abate. 18 August, Pain in neck across the trapesius muscles if head tilted backwards or forwards. After August 18: 1.I had a constant headache that made my head fell like it was burning, and over time it felt like the entire back section of my head was being burned away. 2.My voice dropped in depth and slowed in speed and became monotone 3.My eyes stopped from being able to focus properly 4.My skin started degenerating so that it looked aged 5.My short term memory became progressively worse in line with the daily headaches 6.The attacks of restlessness became more frequent and intense, sometimes I got up at 2am and paced for 8 hours straight. Going to the shops for food became a nightmare. 7.I became socially fearfull as my talking and listening skills deteriorated 8.I became aware that I could no longer perform the cognitive taks that I used to be able to perform at all, in essence as time progressed I found myself progressively dumber to the point of not being capable of doing anything at all and thus withdrawing even more. 9.I found myself not feeling myself, but in an odd dettached sense of mind, scared of thinking down thought lest I spiral down, but not being happy just regretfull of all the pleasure I used to have. 10.As a result my depression increased as did my sense of doom. In Mid September I started antidepressant medication, Lexapro, as well as taking alprazolam for any associated anxiety. I went on a holiday with my parents and found that when we got to the hotel room in Goondiwindi in QLD, I got up at 4am and checked into the hospital with suicidal thoughts. The night before my parents were crying because my eyes looked so sick from taking the alprazolam, they were looking out of focus. The next day I checked myself into the Brisbane Mental Ward at Redlands where I was initially admitted with Akathisia, which was later rediagnosed into just anxiety. In the ward I was given lots of valium, propranolol and taken off risperidone and lexapro, but found that I still could not sleep, and paced around the ward for countless hours each day and night sleeping only a couple of hours each night, withdrawing from social interaction as each day passed and I felt more and more exhausted. Propranolol made me slow everything down, but the agitation did not cease, so now I constantly shuffled rather than walked all the time. Once I complained I was given temazepam, but instead it made me sedated but not asleep, consequently I roamed the ward at 3am, banging into walls. After coming back from Queensland, my father threw out the medications I had including sleeping tablets, which made maintenance of my condition even more difficult. 1.The severeity of the headaches continued as it felt like my head was burning all the time 2.My agitation and dysphoria continued to worsen with every passing day 3.I now sometimes had to move my legs just to sit at a table. 4.My skin now looked 4 years older after the 4 month period without any sleep and constant agitation. Bruising taking 3 times longer to heal. 5.My entire body started feeling flat with no muscular support 6.My voice continued to descend and slow 7.Each day my short term memory got increasingly worse as did my conversational and reading skills to the point where I virtually could do nothing other than eat and pace between meals. 8.My eyes were deteriorating further, in pain and unable to focus for more than short periods of time. 9.I found myself feeling like I was going mad and feeling dettached and hallucinating at times, at other times I felt wired and not myself, trapped in somebody elses world 10.I felt like in 4 months I had gone from 33 years old going on 25 to 33 years going on 95 years old. Then on Monday 25th September I woke up and found that as the day progressed I got to about 11am, and that is when I felt that my brain had been fused or wired into a perpetual state of agitated dysphoria with an almost non existent short term memory and blurred and painful vision. I litterally felt like I had died in my mind. The only thing I could think about was suicide. I told my case manager and I went to Calvalry Hospital. I didn't stay as I found a sense of calmness when I got there, and then returned home to write this article as a warning a few days later. Then on Thursday 28th September I woke up after 1 hour sleep, took 2 sleeping tablets restavit, couldn't sleep at all and felt that my mind had fused again and that ultimately there would come a time when the irritation and the restlessness will become permanent, constant and intolerable, if not today then not very far off. It feels like my mind has burned out the back of my head and has replaced my entire body with ceaseless shaking, restlessness and I mean severe restless that cannot be allieviated by doing anything to stop it, this sort of feelinig does compell action to relieve suffereing and I mean suffering including constant pain behind my eyes and as a headache and inability to sleep for more than 1 hour a night.