My heart is with everyone affected by the devastating wildfires in California. It’s impossible to overlook the pain and uncertainty many are experiencing right now. If you or someone you care about has been impacted, please know my thoughts are with you.

In times like these, supporting each other matters more than ever. While I can’t change the larger circumstances, I can continue sending useful insights that make navigating mental health just a little easier for you and your clients.

And if you’re interested in donating, THIS ARTICLE lists lots of local and national organizations that can help.

​
But this California story is from 2023…

As we taxied to our gate in Sacramento, I stared at my google voice app’s glowing red notification dot.

Uh oh.

I’m like 6hrs into my weekend away to wine country and I already had a message from a patient. Someone I already worry about.

Dr. B, I feel really bad. I can’t sit still and I feel so restless and uncomfortable. Like my skin is crawling. Please help! What’s wrong with me??

Oh, I know, I know! I’ve totally got this.

It still wasn’t good, but it was actually something I could treat right then.

Because I knew she was experiencing akathisia, a sneaky side effect that sometimes goes unidentified and causes tons of discomfort.

Plus, I had the added bonus of knowing that she had just started risperidone (an antipsychotic) before she was discharged from the hospital a few days before.

A quick call to consent her for some Cogentin (benztropine) and she was on her way to feeling better.

So that’s what this week’s short 6min video is on: the sometimes subtle, but always uncomfortable, side effect of akathisia.​

But if you just wanna skim the highlights, here you go:

What it is:​
Imagine feeling like you’re crawling out of your skin—akathisia causes intense inner restlessness and a constant need to move, often caused by certain psychiatric medications.

What it’s from:​
​Akathisia often comes from medications like antipsychotics or some antidepressants which can cause problems with dopamine pathways in the brain.

What to do about it:​
Learn how to recognize akathisia, differentiate it from anxiety, and collaborate with prescribers who may decrease, change, or add medication to ease this really uncomfortable side effect.

This is such an important side effect to be aware of because it's easy to think it's just worsening anxiety and focus on that, missing what's really going on!

Akathisia is usually super distressing to experience, but is pretty easy for a prescriber to address when it comes up (although it can still take over 24hrs to start feeling better).

I feel confident knowing you’ve got your clients’ backs with this sneaky side effect, Reader! And it only takes a few extra questions to be sure akathisia is what they're dealing with.

Your clients and their prescribers will thank you!

We can’t always prevent the tough stuff, but we can learn how to make it better.

Whether you’re facing challenges like the wildfires or just navigating the day-to-day in your practice, remember that small insights can lead to big impacts.

Cheers to healthy brains,

Dr. B

Jessica Beachkofsky, MD

Your friendly online psychiatrist!

P.S. Here’s the article with a bunch of ways to donate to help victims of the California wildfires.

P.P.S. Here’s the akathisia video describing this subtle (yet terrible) side effect