[Jimbee (OP)]

I don't know if any of you are aware of the medication side effect of akathisia. It sounds so harmless, a simple side effect. And it certainly isn't deadly. But it can be quite painful.

My father had a nervous breakdown in 1996 and 1997 after my mother's death. But he was obviously already bipolar, and had been hospitalized as a young adult too. And that is when we found out quite a bit about the mental health system (esp. in Michigan, where we live).

Akathisia is a very common side effect associated with antipsychotic neuroleptics. It is often not associated with the the new class of atypical antipsychotics. And it can be quite painful.

Now no one is saying we should do away with psychiatric drugs or treatment. No one should take them who doesn't need them. But for those who need them, they can be a lifesaver.

And even doctors who work in the better mental health settings tend to be impatient with patients who complain about akathisia. We had good insurance, so we were always in the best places. But I can only imagine what it must be like for a mental patient dealing with akathisia in jail, or even worse prison, where I would imagine they'd be much less sympathetic.

As I said, no one is saying to do away with antipsychotic or antidepressant drugs. But dealing with akathisia can actually be quite simple. There are many drugs to eliminate or at least lessen this side effect, Cogentin is often used. Or something as simple as taking the medication at bedtime might be enough, because you can apparently sleep the side effect off.

My father was initially put on Haldol, the first drug of choice back then. But it is notorious for the side effect of akathisia. And he really didn't need, because as it turned out another medicine was more effective anyways.

I don't know how much people who advocate for prisoner or mental health rights are aware of akathisia. But if they aren't aware of it, they definitely should be.

[paul cotter]

Antipsychotic medications can have dreadful side effects and those who need them have my sympathy. Cogentin is an anticholinergic and it's principal use is to counteract some of the movement problems associated with antipsychotics, ie pseudoparkinsonism . I find it hard to imagine it being of help with akathisia-then again i'm not a medic and could be wrong. Haldol is also notorious for producing tardive dyskinesia, another horror.

[evan_au]

I've been listening to a podcast series from Flash Forward, called Vanguard Estates, a mythical home for people with aging, cognitive impairment and dementia. They use this theme to "look at some of the real science, policy, economics, law and ethics (of) living with dementia".
- They comment on the overuse of anti-psychotics in aged care, and a Royal Commission in Australia that reported on their misuse (even though we don't have any local Royals)
- They suggest that to get around the reporting on anti-psychotics, some psychiatrists are now prescribing high-dose anti-histimines, which have a sedative effect, but also other side-effects

An interesting series - here is one episode from the series (around 5 in the series)
https://podcasts.apple.com/us/podcast/vanguard-estates-living-with-dementia/id994349813?i=1000585332275

[paul cotter]

Caring for people with cognitive deficit and/or dementia is difficult and demands a lot of resources. Much easier to apply the "chemical cosh", however abhorrent this practice is.