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Suggest Treatment For Withdrawal Symptoms Of Latuda

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Posted on Tue, 13 Dec 2016
Question: I have electric shocks/muscle twitches/contractions in various parts of my body when I lay down to rest or when I go to bed at night. It takes about an hour to go to sleep at night. I will usually have approx. 10-30 twitches in an hour. When I lay down to rest in the day for 20 minutes, I will have between 4-20. My hands, my feet, my legs, my sides, my back, my stomach, it's like an electrical shock, that can escalate to a full contraction of lets say, my hand, to where my whole hand will litterally shake several times, back and forth, like it is having a seizure. I also had one experience where I had a full surge go through my entire body. The full surge went through my body about 10 to 12 times. It was terrifying. It happened like 4 times while I was laying in bed, each about 30 seconds apart and I got up and sat at the kitchen table, thinking what just happened to me. I know this sounds crazy, but It felt like a spirit going trough me. I knew I had taken my night time meds and would be going to sleep soon, so I went back to bed, where it happened again, like 6 to 8 more times, again, just 30 seconds apart. I have only had a full body experience like that one other time. but 8-10 times a week, I will have one that spreads through my torso. I twitch every time I lay down, sometimes I'll twitch 4 times in a minute and have a 15 minute break before another one, but at a minimum, one ever 10 minutes, if not, like I said, much more frequently. There is no predictability and the waves through my torso also come out of nowhere. They all come out of no where. The very, very, very strange thing, is that I do not twitch when I am standing or sitting, only when I am laying down trying to relax.

I have several medical diagnosises. I have diabetes which is stable, high blood pressure which is stable, moderate degenerative disk disease and my pain is mostly controlled, but I do have to lay down for 20 minutes about every 2 hours, just to rest my back.. I am also bipolar, but take it very seriously and see my doctor regularly and have for 30 years. I take very good care of myself physically, emotionally, mentally and spiritually. I have had the same psychiatrist and separate family doctor for 15 years. I am on alot of medication, as I take something for everything, but I have been on my meds a long time and have never ever had a problem. I take Oxymorphone ER 20 mg bid, Oxymorphone IR 10 mg tid, Lamictal 150 mg bid, Zoloft 100 mg bid, Clonapin 3 mg qhs, Xanax ER 1 mg bid, Metformin, Diovan, Latuda 120mg qhs and Seroquel 200 mg. I was also on Saphris, 20 mg qhs. Latuda and Saphris are both antipsychotics, as you know, but Latuda is very similar to an antidepressant. The doctors think my problem is a side effect of withdrawal from a decrease in my dose of Latuda by 40 mgs, from 160mgs to 120mgs, because muscle contractions are noted to be a withdrawal side effect of antidepressants and Latuda, although an antipsychotic, is very similar to an antidepressant. But withdrawals of small doses, don't last 3 months. I don't agree with their diagnosis and I think they are just stumpted. My PCP is going to do more tests, but I want your opinion. I'm not a doctor, I am a nurse and I am the one who has been taking these medications and I know my body, so I do have a little bit of experience and knowledge. I am going to tell you what the doctor and I did. I had taken Saphris and Latuda for about 2 years, until this last April, when I started going into a depression. I started reducing the Saphris in April, with the hope of activating my brain. Unfortunately, my depression kept worsening, so we kept reducing the Saphris. By August 1st, I had discontinued the Saphris and was only on the Latuda 160 mg qhs. So a slow taper of 5 months for the Saphris without a problem, but my depression was still worsening. On August 13th, I decreased the Latuda to 120mg, a 40 mg reduction. On August 17th, I complained of having electrical shocks/twitches/contractions throughout my body. I decreased the Latuda to 80 mg. Two weeks later, on September 1st, I had a full recovery of my depression, but complainded that the electrical shocks/twitches/contractions were worse, so we increased the dose back to 120 mgs. Suposedly, I said the twitches got better, but I just remember a week, where I strangely had a few nights without any, then it returned to how it still is now. So, all of September, October, and November on 120 mg of Latuda, with twitches starting after a 40 mg dose decrease in mid August and a supposed worsening with an additional 40 mg decrease for 2 weeks. On October 1st, I started 200 mg of Seroquel and there was still no change in severity. The added antipsychotic should have compensated for the decrease in Latuda of only 40 mg, but even after almost 2 months it hasn't. On November 9th, a little over a week ago, I increased my Latuda back to 160 mgs and have kept taking the Seroquel and there has still been no change in severety. My doctors are still saying this is due to a withdrawal side effect and I don't see how it is possible to take 3 months to withdrawl from a 40 mg decrease of antipsychotic,, 2 months of which, I have compensated for the dose reduction with an alternate antipsychotic and now I still have them and I'm on the same dose I was for more than a week.

Are there any possibilities you can think of other than withdrawal. I even had an ordained minister/demonologist friend of mine tell me it could be God, changing my mind, thus the scripture reading, " be transformed by the renewing of your mind". I know a little far fetched, but the full body experience was truly supernatural feeling. Anyway, I look forward to hearing from you
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (39 hours later)
Brief Answer:
It seems withdrawal but I am not convinced

Detailed Answer:
Dear XXXXXXX
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

Although I would have agreed on initial diagnosis of withdrawal side effect of latuda but continuation over three months is never possible for withdrawal effects. I like to clarify here that withdrawal effects tends to last less than one month and revert back to normalcy when dose is added back. In your case despite increase of dose of latuda the twitches are continuing and I think we need to think over other options.

In my view the first possibility is mild tardive dyskinesia. This is first possibility as you are taking the antipsychosyics for long time and it is just a long term side effect of various antipsychotics. It is possible that it first appeared when you lowered the dose of looted and persisting over time despite best efforts.


The second possibility is anxiety component. I am not sure on this part but I think we need to keep this as differential diagnosis. For confirmation I think increasing the dose of Xanax should be sufficient to say whether it is anxiety or something else.

The third possibility is muscle disorder. I think doing nerve test is warranted rather than calling it just withdrawal effect of latuda.

I hope this helps you.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (5 hours later)
Thank you so much for your reply. It definitely gives me a lot more to look at. Can you think of why I might only have the twitches while I am in bed and relaxed vs when I am up and awake. When I went down for that short time to 80 mg, my I reported back in august that they got worse. I tried to compensate the decrease with Seroquel but it did not improve the twitching. I would assume I need to come off the Latuda, but how will I do that without significant discomfort. Do I risk them never going away. Am I at risk of other muscles contracting, like my heart, lungs, eyes, etc? You said it seemed mild to you, but when I'm in bed, like I was just a little ago, I see where they happen a lot more than I stated, it does not seem mild to me. Thank you again for your feedback.
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (1 hour later)
Brief Answer:
This is something unusual

Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.

The presence of twitches only while resting is unusual and that puzzles me to think for more options. It is possible that once the muscle tone is decreased (rest, lying down) they have uncontrolled twitches.

Regarding mild I said because many of individuals have severe diskinesia and not able to function properly. In your case you are still able to function when you are upright that makes me to call it off mild degree. I understand that it is not mild for you as it is causing severe distress but I labeled thinking the possible more severe forms among others.

It will be premature to say whether they will stay permanent but I think chances are very low.

I hope this helps you further.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (3 hours later)
Have you ever seen a paranormal cause for something like this, as I have been working with professionals on a situation of significant activity in my home.

Is there a way you could send out a mass question to the dr's
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (9 minutes later)
Brief Answer:
I have not seen any paranormal activity

Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.

I am sorry to inform you that I am yet to see any paranormal activity by this date and little convinced with the idea of paranormal. I think this goes beyond medical knowledge and not possible for me to experience the paranormal activity.

In regard to your next question please contact healthcare magic website management as they are the right people to advice you.

I hope this answers you.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Ashok Kumar Choudhary

Psychiatrist

Practicing since :2000

Answered : 3355 Questions

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Suggest Treatment For Withdrawal Symptoms Of Latuda

Brief Answer: It seems withdrawal but I am not convinced Detailed Answer: Dear XXXXXXX Thanks for using Healthcaremagic. I read your query and understand your concerns. Although I would have agreed on initial diagnosis of withdrawal side effect of latuda but continuation over three months is never possible for withdrawal effects. I like to clarify here that withdrawal effects tends to last less than one month and revert back to normalcy when dose is added back. In your case despite increase of dose of latuda the twitches are continuing and I think we need to think over other options. In my view the first possibility is mild tardive dyskinesia. This is first possibility as you are taking the antipsychosyics for long time and it is just a long term side effect of various antipsychotics. It is possible that it first appeared when you lowered the dose of looted and persisting over time despite best efforts. The second possibility is anxiety component. I am not sure on this part but I think we need to keep this as differential diagnosis. For confirmation I think increasing the dose of Xanax should be sufficient to say whether it is anxiety or something else. The third possibility is muscle disorder. I think doing nerve test is warranted rather than calling it just withdrawal effect of latuda. I hope this helps you. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for my future patients. In future if you wish to contact me directly, you can use the below mentioned link: http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386 Thanks and regards.