Anyone else experience muscle stiffness from antipsychotics

splitimage · Apr 23, 2019 at 06:04 AM

Hi everyone,

I'm on 5 mg of risperidone daily and 800 mg of seroquel daily.

Lately I've been noticing muscle stiffness, particularly in my hip and groin areas, that makes walking difficult.

I first noticed it when I was just on the risperidone, but it seems to be a lot worse now, so I think the seroquel is making it worse.

My mood is pretty good right now, so I think it would be safe to drop my dosages of one or both meds.

My question is, if I lower the doses, is the muscle stiffness likely to go away or is this something permanent?

Thanks.

splitimage

sarahsweets · Apr 23, 2019 at 06:24 AM

I think its extremely important to see your doctor right away. The have meds that help with this but sometimes not taking the antipsych is a way of removing those side effects. Some of them are dangerous side effects or could at least endanger the way you live your life. I cant stress enough how important I think it is for you to see your doctor.

Quote:

Extrapyramidal symptoms (EPS), also known as extrapyramidal side effects (EPSE), are drug-induced movement disorders that include acute and tardive symptoms. These symptoms include dystonia (continuous spasms and muscle contractions), akathisia (motor restlessness), parkinsonism (characteristic symptoms such as rigidity), bradykinesia (slowness of movement), tremor, and tardive dyskinesia (irregular, jerky movements).[1] Antipsychotics are often discontinued due to inefficacy and intolerable side effects such as extrapyramidal symptoms.[2]

Since it is difficult to measure extrapyramidal symptoms, rating scales are commonly used to assess the severity of movement disorders. The Simpson-Angus Scale (SAS), Barnes Akathisia Rating Scale (BARS), Abnormal Involuntary Movement Scale (AIMS), and Extrapyramidal Symptom Rating Scale (ESRS) are rating scales frequently used for such assessment and are not weighted for diagnostic purposes;[1] these scales can help physicians weigh the benefit/expected benefit of a medication against the degree of distress which the side effects are causing the patient, aiding in the decision to maintain, reduce, or discontinue the causative medication/s.

The extrapyramidal system regulates posture and skeletal muscle tone. Extrapyramidal symptoms (also called extrapyramidal side effects) get their name because they are symptoms of disorders in this system.

Causes
Extrapyramidal symptoms are most commonly caused by typical antipsychotic drugs that antagonize dopamine D2 receptors.[1] The most common typical antipsychotics associated with EPS are haloperidol and fluphenazine.[3] Atypical antipsychotics have lower D2 receptor affinity or higher serotonin 5-HT2A receptor affinity which lead to lower rates of EPS.[4]

Other anti-dopaminergic drugs, like the antiemetic metoclopramide, can also result in extrapyramidal side effects.[5] Short and long-term use of antidepressants such as selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI), and norepinephrine-dopamine reuptake inhibitors (NDRI) have also resulted in EPS.[6] Specifically, duloxetine, sertraline, escitalopram, fluoxetine, and bupropion have been linked to the induction of EPS.[6] Other causes of extrapyramidal symptoms can include brain damage and meningitis.[7][8]

Conditions
Acute dystonic reactions: muscular spasms of neck, jaw, back, extremities, eyes, throat, and tongue; highest risk in young men[1]
Akathisia: A feeling of internal motor restlessness that can present as tension, nervousness, or anxiety[1]

Pseudoparkinsonism: drug-induced parkinsonism (rigidity, bradykinesia, tremor, masked facies (medical), shuffling gait, stooped posture, sialorrhoea, and seborrhoea; greater risk in the elderly).[1] Although Parkinson's disease is primarily a disease of the nigrostriatal pathway and not the extrapyramidal system, loss of dopaminergic neurons in the substantia nigra leads to dysregulation of the extrapyramidal system. Since this system regulates posture and skeletal muscle tone, a result is the characteristic bradykinesia of Parkinson's.

Tardive dyskinesia: involuntary muscle movements in the lower face and distal extremities; this can be a chronic condition associated with long-term use of antipsychotics.

Treatment
Anticholinergic drugs are used to control neuroleptic-induced EPS, although akathisia may require beta blockers or even benzodiazepines. If the EPS are induced by an antipsychotic, EPS may be reduced by dose titration or by switching to an atypical antipsychotic, such as aripiprazole, ziprasidone, quetiapine, olanzapine, risperidone, or clozapine. These medications possess an additional mode of action that is believed to negate their effect on the nigrostriatal pathway, which means they are associated with fewer extrapyramidal side-effects than "conventional" antipsychotics (chlorpromazine, haloperidol, etc.)

Commonly used medications for EPS are anticholinergic agents such as Procyclidine, benztropine (Cogentin), diphenhydramine (Benadryl), and trihexyphenidyl (Artane). Another common course of treatment includes dopamine agonist agents such as pramipexole. These medications reverse the symptoms of extrapyramidal side effects caused by antipsychotics or other drugs that either directly or indirectly inhibit dopaminergic neurotransmission.

Studies are yet to be undertaken on the optimum dosage of the causative drugs to reduce their side effects (extrapyramidal symptoms (EPS)).

splitimage · Apr 24, 2019 at 08:25 AM

Thank you very much Sarahsweets for all the info. I'll call my pdoc today.

splitimage

still_crazy · Apr 24, 2019 at 06:40 PM

hi. nothing much to add, except...if possible, maybe see about 1 antipsychotic? nothing against you or your doc or anything, just...in larger studies, my understanding is that when 2+ antipsychotics are combined, one can end up with side effects that might not pop up if, instead, the choice was made to simply go with a higher dose of 1. i could tolerate a bit of risperidone for instance, and a full dose of abilify. when the 2 were combined, i ended up with side effects. just a thought.

LadyShadow · Apr 24, 2019 at 06:57 PM

Hi splitiimage!

I want to say that I have been having a lot of trouble with my knees since being on 2mg of Risperdone and 400 mg of Seroquel. Since we are kind of close in the amount of dosage we take, what I did was get a joint pill, (Ostio-Bi Flex) that helped with the pain and stiffness. I still need to tell my pdoc, but getting those supplemental pills might help.

Mountaindewed · Apr 28, 2019 at 04:33 PM

I can’t sit still for more then a few minutes at a time. I’m constantly pacing and shifting positions. I hate shows I haven’t recorded because sitting through the commercials is a nightmare for me. I am just in general very restless. My joints do seem to get stiff. Especially my fingers. It actually doesn’t really bother me though. I’ve been like this for years it’s just part of how I am I don’t really think about it. I do wonder though if the cause of it are the meds I’ve been on for 5-12 years. If I told my doctor he’d probably switch me ASAP to another psych med and since I’m on all the ones that don’t cause weight gain his solution would cause me to gain a ton of weight. So since they are not actually annoying me I don’t plan on talking to him about it.

zippity-dooda · Apr 29, 2019 at 01:47 PM

Quote:

Originally Posted by splitimage

Hi everyone,

I'm on 5 mg of risperidone daily and 800 mg of seroquel daily.

Lately I've been noticing muscle stiffness, particularly in my hip and groin areas, that makes walking difficult.

I first noticed it when I was just on the risperidone, but it seems to be a lot worse now, so I think the seroquel is making it worse.

My mood is pretty good right now, so I think it would be safe to drop my dosages of one or both meds.

My question is, if I lower the doses, is the muscle stiffness likely to go away or is this something permanent?

Thanks.

splitimage

i wish i could say congratulations, but i wont. if you want my opinion i think you are achieving what i refer to as zombieism. i cannot fathom anyone taking 800mg of it ? i took it for 6-7 years and now i feel like a walking deadman. i have a very bad attitude towards the whole program. have you googled it ? google it and class action lawsuits. i thought when i stopped taking all the drugs they would flush out of my body and i would return to normal ?not so it seems the damage is done. but nobody seems to care about the ones that get hurt.best of luck to u

Wonderfalls · May 01, 2019 at 12:16 AM

I don't know if this is relevant in any way, but the second time I was on Seroquel I developed very painful muscle or joint (I didn't know which or both) pain if I was in the same position too long. This happened every night and woke me up at least once. It hurt enough that I would have considered it an emergency, but I could walk it off. It only once happened in the day when we on an hour or two car drive and we had to stop the car and pull over on the side of the highway. My psychiatrist didn't want to prescribe any type of muscle relaxant on top of the drugs I was already taking--and rightly so. We knew it was the Seroquel. I don't know why I put up with it as long as I did; I think because I found the Seroquel to be pretty mellow otherwise. It wasn't dystonia or akathisia and I never ran into a forum post that had the same side effect. When I switched to Latuda it went away but I had akathisia (I had had it before badly on Abilify). I take propranolol (a beta blocker) for that and it works. As I said, this doesn't even sound like what you have. There it is anyway.

splitimage · May 01, 2019 at 08:29 AM

Thanks for the replies everyone. I'm going to try reducing my risperidone dose from 5 to 4 mg/day and see if that helps.

splitimage

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splitimage Moderator Community Support Team Member Since Mar 2006 Location: Ontario, Canada Posts: 11,268 18 75 hugs given	Apr 24, 2019 at 08:25 AM #3 Thank you very much Sarahsweets for all the info. I'll call my pdoc today. splitimage __________________ "I danced in the morning when the world was begun. I danced in the moon and the stars and the sun". From my favourite hymn. "If you see the wonder in a fairy tale, you can take the future even if you fail." Abba
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splitimage Moderator Community Support Team Member Since Mar 2006 Location: Ontario, Canada Posts: 11,268 18 75 hugs given	May 01, 2019 at 08:29 AM #9 Thanks for the replies everyone. I'm going to try reducing my risperidone dose from 5 to 4 mg/day and see if that helps. splitimage __________________ "I danced in the morning when the world was begun. I danced in the moon and the stars and the sun". From my favourite hymn. "If you see the wonder in a fairy tale, you can take the future even if you fail." Abba
	Reply With Quote