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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Katefan0 on February 15, 2005, at 17:57:05
Hi everybody, my SO has periodic hypochondriac anxiety (maybe hypochondriasis?) ... she's been on Effexor and Prozac and that has helped in general terms (meaning, less time between episodes). But she still does get them from time to time... and once she gets them, it's hard for her to stop obsessing about whether her chest pain means she's having a heart attack, or headache = brain tumor, etc.
She went to her psychiatrist today and he recommended staying on Prozac, dropping the Effexor and going on risperdal. So I have been looking around at risperdal today and some of the side effects seem so scary.
Here are a few questions...
1, has anybody actually used this for anxiety disorders, and has it been effective?
2, what is the dosage at which tardive dyskemia becomes concerning?
Any other thoughts appreciated...
Kate.
Posted by Phillipa on February 15, 2005, at 18:03:37
In reply to Risperdal for anxiety?, posted by Katefan0 on February 15, 2005, at 17:57:05
I tried seroquel while in the hospital. From my experience, I will never take an AP for anxiety. Not when there are so many other effective meds out there. Yes, I read the side effects also. Fondly, Phillipa
Posted by Katefan0 on February 15, 2005, at 18:10:53
In reply to Re: Risperdal for anxiety? » Katefan0, posted by Phillipa on February 15, 2005, at 18:03:37
Thank you for your message... at this point we are just gathering all the info we possibly can. She has tried Zoloft (which worked but is now ineffective), Prozac and Effexor obviously (which together have so far worked the best, but still not completely), and Paxil which she had an allergic reaction to. What would be the next step?
Her psychiatrist is neither very comprehensive nor conscientious, his next recommendation was to up her Prozac dose (she is already taking the max recommended for humans) and this risperdal. She said she asked him about side effects and the only thing he said is that sometimes you can have tremors (!) I haven't seen what dosage yet as I haven't gone home today to talk about it. Anyway, so we will have to take the treatment into our own hands and I am looking for any infromation I can get to arm myself with. What would you suggest next to try? I have seen some things about Toframil that seem to indicate they are good for hypochondriasis/anxiety..... but I have so little experience with this stuff, I feel like I'm drowning in a big sea.
> I tried seroquel while in the hospital. From my experience, I will never take an AP for anxiety. Not when there are so many other effective meds out there. Yes, I read the side effects also. Fondly, Phillipa
Posted by banga on February 16, 2005, at 1:03:03
In reply to Re: Risperdal for anxiety?, posted by Katefan0 on February 15, 2005, at 18:10:53
I was given risperdal when at the hospital, to augment Lexapro. It definitely got rid of anxiety and obsessive ruminations for me. I was leery of using an AP for anxiety, but for me it does the trick, quickly. I have used geodon and abilify for this purpose too. Within two days on my mood chart you see both my depression and anxiety go down. For me, it is a quick fix, I hope to not take them long term. I do get some mild side effects with them, and they make me feel sort of foggy brained. I am still exploring other options for anxiety--possibly Luvox, a less popular SSRI. In the meantime I stay on a very low dose of Abilify.
A good drug for obsessive ruminations in my mind is Anafranil. It is an older tricyclic, but I for one like them better than average than SSRIs. The only side effect I had was some weight gain (but nothing like I had with Paxil); the one side effects some have complained of is that for people with somewhat low blood pressure, it can make you dizzy. I would be on it if it hadn't stopped working....
Good luck.
Posted by Katefan0 on February 16, 2005, at 9:35:13
In reply to Re: Risperdal for anxiety?, posted by banga on February 16, 2005, at 1:03:03
Banga,
Thank you, too, for your answer. Do you take risperdal every day or only as-needed? She has ativan that she takes for days when she is feeling particularly "jittery" but she does not need it much. She's gotten to the point where she doesn't have these hypochondriac episodes too often, but once she does it's hard for her to get back to an even keel, sometimes weeks or a month... does that make sense? Once she has it in her head that her chest pain = heart attack, she can hardly shake it even when the doctor told her she just has acid reflux. Then she'll take the ativan, and it's mildly helpful but doesn't get rid of the obsessive thoughts of being afraid of dying.
Well her doc Rx'ed her 1mg daily of risperdal. That seems like a pretty low dose although definitely not the lowest (I have seen as low as .25mg or .50 mg/day). Probably she would not have problems with it at that low a dose...
Although I have seen stuff online that says that certain kinds of symptoms exhibited under SSRI's are indicative of the potential for problems under risperdal -- called extra-pyramidal side effects... and she has some of them just from SSRI's, but I think they're very common ones (mildly shaking hands, restless legs espcially at night).
Anyway, we talked about it last night and I showed her all the information about risperdal especially the stuff about tardive dyskinesia and she was not at all interested in taking it.
So now I'm looking for suggestions for what else has worked for people, because I'm sure she is going to have to suggest something else to her psychiatrist.
Thanks again for listening, and for all the suggestions...
Kate.
> I was given risperdal when at the hospital, to augment Lexapro. It definitely got rid of anxiety and obsessive ruminations for me. I was leery of using an AP for anxiety, but for me it does the trick, quickly. I have used geodon and abilify for this purpose too. Within two days on my mood chart you see both my depression and anxiety go down. For me, it is a quick fix, I hope to not take them long term. I do get some mild side effects with them, and they make me feel sort of foggy brained. I am still exploring other options for anxiety--possibly Luvox, a less popular SSRI. In the meantime I stay on a very low dose of Abilify.
>
> A good drug for obsessive ruminations in my mind is Anafranil. It is an older tricyclic, but I for one like them better than average than SSRIs. The only side effect I had was some weight gain (but nothing like I had with Paxil); the one side effects some have complained of is that for people with somewhat low blood pressure, it can make you dizzy. I would be on it if it hadn't stopped working....
> Good luck.
Posted by banga on February 17, 2005, at 4:47:53
In reply to Re: Risperdal for anxiety?, posted by Katefan0 on February 16, 2005, at 9:35:13
Actually I am not taking risperdal right now, I am taking a different atypical antipsychotic for this, Abilify, at a very low dose. I certainly am not one to talk someone into taking a medication, especially an antipsychotic that, when taken in larger doses, can cause problems...but just to let you know many people take them in small doses do not get such serious side effects. Just to keep in mind down the road.
One possibility that comes to mind is a tricyclic antidepressant called clomipramine, which also is indicated for OCD. As any drug it can have side effects; some people gain weight on them.
Oddly enough, I just realized that pdocs seem quicker to prescribe an antipsychotic than a tricyclic antidepressant!? which many consider to be "old," and that SSRIs are way better and "cleaner"...not my experience at all. i feel more balanced on them thsn SSRIs and don't have sxs like restless legs. I don't have OCD, but anxious obsessive ruminations, and clomipramine helped. I am on another tricyclic as clomipramine doesn't work as well anymore...
People who know me on this board know I favor tricyclics, so certainly get other info and opinions.
This is the end of the thread.
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