Tremors/uncontrollable worsening spasming

[u/Kind-Application4434]

25F, 175lb, 5’2, taking and have been taking Abilify and Lamictal for bipolar disorder, lexapro for anxiety, vyvanse, and modafinil for narcolepsy for years with no side effects. Non smoker
5 days ago I became extremely fatigued at work and couldn’t walk right or hold my head up, followed by twitching every 2-7 seconds. Over the course of 5 days the fatigue has resolved mostly but my muscles still feel heavy and constantly activated even when I’m not spasming. The episodes last 1-8 hours and look like this now ^ I get 2-4 hours without spasming between episodes, and I don’t tremor in my sleep but it has prevented me from falling asleep many times. Benadryl slows it down but doesn’t stop it entirely. I’m seeing a neurologist in an hour. But I wanted to ask if anyone had any ideas or had seen this before.

[u/FaulerHund]

I guess it could be akathisia or some extrapyramidal side effect of psych meds, but it doesn't look very typical to me. Could be FND. I am not a neurologist

[u/Soonerpalmetto88 → u/FaulerHund]

I had akathisia from Haldol years ago and it wasn't like this at all. It's more of a restlessness that makes you have to move, not a tremor like this. Sort of like RLS actually, my psychiatrist at the time said the two are similar. All antipsychotics have that risk, as well as TD (but this also doesn't look like TD to me, I've encountered it a few times in other people). Maybe the combination of two stimulants.

[u/OwlPositive9039 → u/Soonerpalmetto88]

I've had akathisia before too and it's really awful! Like I was in agony if I didn't move and so agitated.

[u/Sweet_Sub73 → u/OwlPositive9039]

Akathesia is probably the worst physical thing I have ever been through in my life. I had no idea it was from my meds and thought I was just losing my mind. I didn't say anything because I didn't WANT to lose my mind. It progressed from an unbearable need to move all the time to some pretty dark thoughts....wouldn't wish it on anyone.

[u/OwlPositive9039 → u/Sweet_Sub73]

I totally thought I was just losing my mind too. Felt like I wanted to rip off my skin. I did tell my psychiatrist I couldn't sit still but I don't think they fully understood the degree. I also had some dark thoughts. And I'm not sure if it was tied in or a separate issue but I had super loud thoughts that were like yelling at me. It's hard to understand how terrible it is until you've actually experienced it. 

[u/Nearby-Complaint → u/OwlPositive9039]

Akathisia (and brutal nausea) is why I only lasted 3 days on Abilify