Thats what akathisia is ren. You get it essentially now and then, sorta randomly?
Sorry to hear that *hugs* its fucking awful. I didn't know mirtazepine was an alpha2 adrenoreceptor antagonist (alpha2 is whats called an autoreceptor, autoreceptors act as negative feedback switches basically, when levels of a neurotransmitter become too high, they start activating the relevant autoreceptor, assuming their is one for that neurotransmitter system, and it essentially tells the brain 'too much floating around here, stamp on the breaks') Which is why in this case, an adrenergic antagonist actually increases the level of (nor)adrenergic neurotransmitter release. An example of one for NA would be yohimbine, sometimes taken as a sexual stimulant for some bizarre reason. I was wrongfully locked up (no, not drug charges), and of course, didn't have the resources pharmacologically speaking, or internet connection/copy of the BNF that I'd have access to otherwise to find out that mirtazepine, aside from being a crazy potent antihistamine (actually, IIRC, it is THE most powerful sedating type antihistaminergic agent used clinically, the binding affinity/IC:50 is absolutely fucking nuts) its also an alpha2 adrenoreceptor antagonist. If I'd have known that I would never have taken it, and could have predicted the awful reaction to it before it ever had a chance to happen
.
Sure as hell didn't help me sleep, didn't make me hungry either, just triggered an extremely severe episode of akathisia, and caused severe myoclonic episodes, twitching, shaking, muscle fasciculations and anxiety straight from the foulest reeking pit in all of Tartarus. It was so bad I would cheerfully have offed myself to stop it had I the means to do it.
The DA antagonists are nasty, potentially highly dangerous drugs, and I see them rx'd for some reasons that IMO they should NEVER be given out for, such as by docs for sleep who are too tight to write a script for benzos, never happened to me, never will either; as I would simply flat out refuse to have anything to do with them. And sometimes even heard of them being given to TODDLER age kids, for fucks sake. Which is bloody rediculous. Some of the side effects can be permanent, tardive dyskinesia for instance, or tardive akathisia even. I can't imagine living with the latter. I'd definitely off myself if I was stuck with it, and permanently. Or in the case of neuroleptic malignant syndrome, potentially even lethal. IIRC haldol can also form an MPTP-like metabolite that is like MPTP, selectively destructive towards dopamine neurons in the substantia nigra, Which is the part of the brain using dopaminergic neurons to control/allow movement, resulting in very, very severe, chemically-induced parkinson's if enough are damaged or destroyed.
IMO benztropine should be dished out with any script for the antipsychotics, so patients do not have to wait to see their doc to get hold of some if the side effects do happen.
Its a damn shame how ineffective drugs for schizophrenia currently on the market can be. Glutamatergic agents are currently being researched though which should be a lot less all-round noxious.
