Posted by MTee on January 20, 2005, at 11:32:47
In reply to Re: Risperdal Bupropion for Depression Anxiety, posted by King Vultan on January 19, 2005, at 8:19:03
Thanks for your reply. I wish you the best with Geodon, which my doctor and I are also considering if the Risperdal is not effective. Not sure, but I think Risperdal may have been first resort because of lower likelihood of weight. Would love to hear how you are doing as you attain therapeutic levels.
How has the parnate served you? MAOs are my next resort after the APs.
I am not sure my doctor is aware of the amplification of which you speak. I will mention it. Notwithstanding, I am at a low dose and I dont think I am suffering any major side effects other than sleep issues, which are likely unrelated as this has been one of my ongoing issues.
Best of luck,
Todd> One problem I see with your combo is that Wellbutrin is a CYP-450 2D6 inhibitor and will amplify the effects of the Risperdal beyond what one would generally expect at any particular dosage. Risperdal is not a particularly dangerous drug, but it does have more adverse effects at higher dosages than do the other atypicals. The situation is actually much more complicated than that, and I hesitate to really get into it in any detail, but basically, using Wellbutrin with Risperdal will also tend to change the ratio between Risperdal and its main active metabolite (9-OH-risperidone). IMO, this may actually be a good thing, but your doctor needs to be on the ball and aware of all these factors, and the dosage really should be kept on the low side, at least at the beginning.
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> I take Parnate and am currently augmenting it with Risperdal at 0.375 mg/day. In my case, there is probably no enzyme interaction between the two drugs, or at least none of any significance, and I guess I am coming to the conclusion that my pdoc was correct in his original thought that Geodon/ziprasidone would be a better choice for someone like me. I had asked about trying an atypical AP mainly because I had found a paper that talked up Risperdal, which does have some very good properties, at least in theory, but I am coming to realize that this is one of those cases where I know just enough to be dangerous, and I am fortunate to be working with a good doctor who humors me to some extent but who also prevents me from getting into too much trouble. I seem to be experiencing some negative effects even at this dosage, mainly subtle cognitive issues, such as increased absentmindedness, slight confusion, and decreased attention to detail. I had planned on going up to 0.5 mg/day but am now probably more likely to go back to 0.25 mg/day, which I felt was an extremely beneficial dosage without a lot of negatives. I likely will be discussing Geodon with him at my next appointment.
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> Todd
poster:MTee
thread:444059
URL: http://www.dr-bob.org/babble/20050119/msgs/444673.html