I'm trying to pinpoint where the cascade of insanity began and I'm not quite sure.  These are the events leading up to my hermitage and akathisia:

1. Went to pdoc looking for help because the topiramate was not cutting it.
2. Pdoc puts me on 600 mg lithium concurrent with topiramate, and plans to titrate off the topiramate.
3. Crazy descends.  We blame the mixture of the topiramate and lithium, as topiramate can increase lithium levels in the blood.