Took Risperidal, Lorazepam And Benztropine. Unable To Stand Still After Sitting For Long. Is It Side Effect?

Posted on Thu, 31 Oct 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 31 Oct 2013 Answered on

Thu, 5 Dec 2013 Last reviewed on

Question : I take medication I took risperidal,lorazepam,and benztropine.... and when I'm out somewhere I can't stand still by sitting in a chair.... I have to get up and move around.... what is this?... how could I enjoy myself is there any treatment or cure or anything to stop this.....

Answered by Dr. Praveen (6 days later)

Brief Answer: This is a side effect of risperidal Detailed Answer: Hi, This is one of the commonest side effects of Risperidal and is called as Akathesia. Akathesia is inner restlessness, which means inability to remain motionless & literally means inability to sit. It’s a subjective feeling. Treatment includes stoppage/lowering the dose or changing to another low potency neuroleptic. If this does not work medications like beta-blockers, anticholinergics and sedatives are supplemented. Since you are already on Lorazepam and benzatropine, which are sedative and anticholinergic respectively, I suggest to discuss with your doctor about your problem since it might probably require a dose titration/change of the drug. Hope this helps. Keep me posted if any queries relating & kindly rate my feedback.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Praveen (53 minutes later)

ok well we had switched to abilify,trihexyphenidyl,and xanax.... Im doing and feeling better but I still have akathesia... what type of medications I may take to treat/cure this?

Answered by Dr. Praveen (4 hours later)

Brief Answer: Akathesia cannot be cured or nullified completely Detailed Answer: Hi. Drugs like olanzapine, quetiapine, risperidone & ziprasidone are second generation antipsychotics(SGA's). However SGAs are not alike in their propensity to provoke akathisia. Risperidone, ziprasidone and aripiprazole possess a higher risk than olanzapine, whereas quetiapine and clozapine present the lowest risk, although explicit comparative evaluation is lacking. Remarkably high rate of akathisia(about 15–25%) was reported in patients treated with the partial dopamine agonist aripiprazole(Abilify) which lead the manufacturer to refer as one of the most frequent side effect. Thus this is inherent side effect of antipsychotics and cannot be completely abolished. Non-specific anxiolytic and sedative effects of benzodiazepines(alprazolam/lorazepam) alone or in combination with propranolol may be beneficial in some patients. Trihexyphenydyl might be better than benzatropine. Discuss with your doctor for further treatment. Hope this helps.Take care. Keep us posted if you have any further queries.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Praveen (3 hours later)

so what would you recommend for I do for my akathesia?.....any medications at all?... or just ill have to deal with it....?

Answered by Dr. Praveen (6 hours later)

Brief Answer: You can try propranolol Detailed Answer: Hi. There are 2 things to be balanced. One is the condition (schizophrenia etc) for which you are being treated & the other is the side effect profile. Appropriate titration of the dose is always subjective - dose which gives a good symptom relief and a favorable side effect profile. You need to closely work with your treating doctor to find the most suitable dose of medication. You may also discuss with your doctor if he could prescribe one of the SGA's with least (manageable) akathesia and should you try propranolol. Hope I have answered your query. Let me know if you need clarification. Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Praveen (11 hours later)

Ook so propanlol?.. would be the best thing for treating akathisia?... I'll consult it with my doctor.. its just a restless feeling like I can't stay still and wait...I'm trying to get back into college.. but can't cause can't stay still in class... I take abilify,trihexyphenidyl,and xanax.... So adding on propanolo would work with the combinations?

Answered by Dr. Praveen (17 hours later)

Brief Answer: Propranolol might work Detailed Answer: Hi.Propranolol might give relief from akathesia.Though it cannot be assured.Discuss with your doctor if you can use it.Small dose might help you.Also discuss and find out if there any other optioms especially for your problem.Thanks for writing on XXXXXXX

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Praveen (13 hours later)

will there be any real bad side effects from the medication from propanlol?

Answered by Dr. Praveen (5 hours later)

Brief Answer: Low doses are relatively safe Detailed Answer: Hi. Low doses of propranolol are relatively safe and is used for treatment of performance anxiety, migraine and ameliorate side effects of antipsychotics etc apart from cardiovascular use.Low doses don't hamper the metabolic levels of fat/glucose.It can still be tried under medical supervision only. Thanks for writing.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Praveen (29 minutes later)

ok just so it can get the fidgety out of me and keep me calmer.... I sometimes don't like going out places, far places from home cause I have no patience I become fidgety a lot...

Answered by Dr. Praveen (38 minutes later)

Brief Answer: Yes Detailed Answer: Hi. Yes it will be a good choice. Worth trying. Hopefully you should get well soon.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Praveen (5 hours later)

what you recommend for a person with paranoia schizophrenia/with Anxiety/panic disorder?..... I feel if I go far places I will have an anxiety attack so I try to mainly stay Home.... how could I expand and get out of my comfort zone?

Answered by Dr. Praveen (2 hours later)

Brief Answer: A Psychiatrist is a better person Detailed Answer: Hi. I feel this is upto the specialist opinion.First these have to be diagnosed by a psychiatrist based on the symptoms you are having and then need to be treated appropriately.I suggest to this his advice. Hope I have answered your query.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Praveen (14 hours later)

if the doctor was to up the dose why would he/she do that?...

Answered by Dr. Praveen (36 minutes later)

Brief Answer: Response might be subjective Detailed Answer: Hi. Doctor would try using different medications(even when used upto the maximum dose) because response might be subjective(in a few cases based on their clinical experience although not quoted in any of available literature on that molecule).More over when high doses of the medication is prescribed the side effects increase and result in loss of compliance. Hope I have answered your query.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Praveen (40 minutes later)

yea cause I wanted to go to school to become some sought of doctor but I am having plenty of setbacks Idk if that's what I may want to do anymore... just deciding if my illness would allow me to go back to college....

Answered by Dr. Praveen (5 hours later)

Brief Answer: Your profession is independent of your illness Detailed Answer: Hi. Donot worry.You are not ill.Its just a balance/right combination of the medicines that you have to use so that it might help focus on your studies and continue with your personal/professional goals.If you feel that you have to be a doctor(if not a surgeon) you can as well do that.Hope this condition is not a shortcoming at all. I hope this helps.I suggest you to discuss with your doctor and not to get upset with these preoccupations.All the best.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Praveen (4 hours later)

ok cool.... well hopefully i can get back into college soon.... I had to stop due to the combination before the Meds I'm on now so I have to be patient.... thanks I don't know if I may have anymore questions... its hard to really talk to my doctor in the area I'm in....

Answered by Dr. Praveen (2 hours later)

Brief Answer: You can do it and study well Detailed Answer: Hi. You can take up the profession of your choice.There is no binding at all.Keep in touch with your doctor although its difficult because he alone can assess your existing symptoms and provide a need based treatment to utmost possible extent depending on your requirements.I hope you will perform well both professionally and personally.All the best.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Praveen (53 minutes later)

well ill see how this all goes.... I just want to be able to gain a better quality of my life.... and know what direction i am heading... cause I hate trying new medications...

Answered by Dr. Praveen (10 hours later)

Brief Answer: Donot lose hope Detailed Answer: Hi. You will fare well.But donot hesitate to try new medications because they might give expected benefits and that is when it helps handling all of your activities to a satisfactory level and that is how your quality of life improves.Do have faith and believe that you will be the best and you really deserve it.Wishing you all the best once again.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Praveen (16 minutes later)

some Meds aren't good for people that's why I hesitate to take them..... I want to Excel on life I just don't want this to hold me back... o one thing are people allowed to take other supplements with medication?.... such as vitamins and stuff..

Answered by Dr. Praveen (7 hours later)

Brief Answer: Vitamins is fine Detailed Answer: Hi. Vitamins are fine if they are taken according to the required dietary allowance (RDA) but if you are planning to take herbal medicine or any other medicine in similar lines, they might interact especially with drugs used for treatment of psychiatric/neurological conditions. I suggest to cross check with your doctor before you use if you are having any such doubts. Thanks for writing to me.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Praveen (34 minutes later)

so herbal supplements may have a bad effect?...

Answered by Dr. Praveen (3 hours later)

Brief Answer: They might possibly have Detailed Answer: Hi. Most of the herbal supplements might possibly have drug interactions.As a word of caution its better to avoid (of check if any) before using them.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Praveen (24 minutes later)

well how about basically dietary supplement that is more of a brain supplement made 100% natural ingredients... just take it to keep me focus throughout my day...

Answered by Dr. Praveen (13 minutes later)

Brief Answer: Upload the composition Detailed Answer: Hi. If its a protein supplement then it might not interact.Upload the composition so that I can be able to help you.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Praveen (29 minutes later)

I really can't do that I am on a phone device.... but all I can say is that its just a dietary supplement with vitamins and some herbs in it.... to help increase focus... from a manufacture place the product is name eureka brain supplement.... but I'm not taking it I'm just considering maybe using it.... after I get the right combination on my medication.....

Answered by Dr. Praveen (22 hours later)

Brief Answer: It contains Ginkgo Biloba Detailed Answer: Hi. It contains Ginkgo biloba which is medicinal herb as you said.Its interaction with the antipsychotics have to be checked before use.Rest of them - choline barbitrate, B12, l-arginine, phenylalanine and glutathione donot have interaction.Hope this answers your query.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Praveen (19 hours later)

ok... so the product must be safe to take?....

Answered by Dr. Praveen (1 hour later)

Brief Answer: Ginkgo biloba is only concern Detailed Answer: Interaction with Ginkgo biloba has to be ruled out.Otherwise safe.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Praveen (2 hours later)

ok well ill just look more into other products.... I just need throughout the day something to get me through....

Answered by Dr. Praveen (1 hour later)

Brief Answer: Sure. Detailed Answer: Hi. I shall help you if there are any drug interaction else you can check online on a interaction checker on medscape. Its a nice tool.Keep us posted for further queries.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Praveen (16 minutes later)

are there any good brain supplements that can give a person a help in focus,and concentration?... I'm not looking for any other medication.... just a all natural product.... that works....

Answered by Dr. Praveen (11 minutes later)

Brief Answer: I am not sure Detailed Answer: Hi. I am not sure.You may share any of those which are available in your country.I shall help you check whether they are fine.Most of might not give definitive results as what they promise. Thanks for writing.

Above answer was peer-reviewed by : Dr. Yogesh D