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Akathisia ?

Akathisia ?

I have been struggling with my DS15 son's behavior dealing with anger, over emotional tantrums, and irritability. Sometimes it would be so out of hand, I had thought I needed to call the police or have him admitted to a hospital.  He was recently dx with ADHD a year ago and found that Vyvance had made a significant difference for him academically however, we still experienced sporatic tantrums which his doctor added Abilify.  This seemed to make part of the day great while the other part extremely tense for those living with him.  He claimed Abilify works and calmed him down.  After 4 months on Abilify, I took him off of it completely and his doc started Tennex.  He says Tennex calms him down, differently, so he was willing to try it.  Things retuned to be more managable at home for everyone.

This weekend, he had come home from a sleepover that made me very suspicious of the activities of drug use. (I have him on a tight schedule so I know he does not use illegal drugs the past year except for this incident).  His behavior was a rollar coaster.  One minute he is arguing to win and he hates everyone and the next minute he is cleaning the house.  He was unable to sit still.  Constant chastising then cleaning again.  I hadn't seen this behavior since the time he was on Abilify.    

Then, something made me think about the time he was 2 and had general anesthesia.  I'm not sure what they gave him before surgery, however, he turned into an uncontrollable monster rolling all over the floor, unable to sit still, growling, and seemed to have a distant look in his eyes.  The nurse at the time told us to give him time and I'm pretty sure they gave him another dosage before he went into surgery.

Is this Akathisia?  Would Abilify cause a mild type of Akathisia?  Are there illegal drugs that would cause this effect also?
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Yes Abilify can cause akathesia (as well as tardive dyskinesia and the variant tardive akathesia which are permanent but for those who need antipsychotics it is rare enough to be neccessary of course, google "patient education tardive dyskinesia" as the site itself states "some of these medications may be medically neccessary). As for illegal drugs, depends. Some highly dangerous illegal drugs like amphetamines can cause tardive dyskinesia and certainly akathesia but ask him in a non contronfrontational way what drugs he tried and have him go to rehab. If he had akathesia set off as a child by one medication have him see a neurologist who is a movement disorders specialist to make sure he isn't suspectable to that side effect. As for Tenex it is helpful on ADHD, works as a mood stabilizer and also helps on akathesia and tardive dyskinesia. I took it before for the second two purposes but as it is short acting was transfered to the Clonidine patch but Tenex is quite good as well.
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