![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by dayle on March 28, 2006, at 15:18:33
I'm looking for any research, information or people's experiences about the use of risperidone to treat amphetamine-induced psychosis. Anything about duration of treatment, its appropriateness for what is, often, a short-term problem, long term effects of this drug etc. My daughter was prescribed it 2 months ago after an ice binge, & has just had her dose increased, despite there being no evidence of further psychotic episodes.
I'd be grateful if anyone can point me in the direction of where to get more information.
Cheers,
Dayle
Posted by med_empowered on March 28, 2006, at 16:13:12
In reply to risperidone as speed psychosis treatment, posted by dayle on March 28, 2006, at 15:18:33
hey! Amphetamine psychosis treatment can be kind of complicated. Some people only need acute treatment. Some people, for whatever reasons, will have longer episodes and need longer treatment of some sort. And then there are people who have underlying problems (bipolar, depression, schizophrenia) that could necessitate treatment with some sort of psychiatric drug for a while.
BUT..in your daughter's case, this is a little confusing. I think there's some research on using antipsychotics to prevent stimulant use relapse--the idea being that it blocks the euphoria from stimulants. Thing is..it also causes lots of problems, and its easy enough to stop taking an antipsychotic. Her doc may suspect bipolar or something but...even then, the thing to do would be to switch her over to something else, like an antidepressant for depression or a mood stabilizer for bipolar. Unless she's showing ongoing psychotic symptoms, there's really no reason to keep her on an antipyschotic, especially at ever-increasing doses.
My advice would be to get her a new doctor, and get her off the antipsychotic, gradually.
Good luck!
Posted by scatterbrained on March 28, 2006, at 16:34:06
In reply to risperidone as speed psychosis treatment, posted by dayle on March 28, 2006, at 15:18:33
did the doctor give an explaination for increasing the dose of risperidone? I think asking the doctor why he increased the dose despite no increase in your daughter's psychosis is a reasonable first step.
Posted by dayle on March 28, 2006, at 18:26:08
In reply to Re: risperidone as speed psychosis treatment » dayle, posted by scatterbrained on March 28, 2006, at 16:34:06
> did the doctor give an explaination for increasing the dose of risperidone? I think asking the doctor why he increased the dose despite no increase in your daughter's psychosis is a reasonable first step.
still trying to get an answer on that one - difficulty is we are in different cities & access to the doctor has been difficult (within the public health system). we are looking at getting her in to see a doctor in private practice as soon as we can.
thank you so much to you and to med_empowered for your responses - they are really helpful and give me confidence in questioning the medical professionals.
Cheers,
Dayle
Posted by notfred on March 28, 2006, at 19:37:41
In reply to risperidone as speed psychosis treatment, posted by dayle on March 28, 2006, at 15:18:33
It generally takes 6 months to fully recover from abusing speed & longer for hard core long time users; I don't see 2 months on risperidone as a long time in this context. Psychosis needs to be treated aggressively and completely to go into remission. Risperidone and all other drugs of this class have significant side effects, but used for a short course any side effects should stop after the med is stopped. For psychosis caused by speed abuse APs are very effective; provided the speed abuse stops the person has little chance of having another psychotic episode. Essentially they are cured of this psychosis provided that do not have a diagnosis of another mental illness with psychotic features.
I can only speak generally as everyone is different so I hope you are able to communicate with the doctor; sorry you are having trouble with this.
Posted by med_empowered on March 28, 2006, at 20:24:22
In reply to Re: risperidone as speed psychosis treatment, posted by notfred on March 28, 2006, at 19:37:41
I think the problem here is that "amphetamine psychosis" is usually pretty short lived. The person has a freak-out for a while, then might have lingering paranoia and anxiety issues, and then usually goes down more or less to baseline. Since lots of docs use antipsychotics "off-label" these days, maybe the doc is medicating for paranoia/agitation (since using an antipsychotic would avoid use of a benzodiazepine). Anyway...the problem is that long-term AP treatment has all kinds of side effects, even with the new drugs, and it costs a good bit of $$$ that could be spent on other better, more well-tolerated therapies that won't turn you into a zombie.
My guess is that this young woman probably needs some help with anxiety, mood, and sleeping, possibly also with lingering low-grade paranoia or something. APs are just going to make her shut up; they're not a long-term solution.
I think its great that you're advocating for you daughter here. Psychiatric help can be immensely helpful but for some reason mental patients have to deal with a lot more sh!t then other kinds of patients. I mean, if you break your leg a doc just fixes it and goes about their business. If you have a mood disorder or drug problem, a lot of times docs feel like they can do **whatever** and you should deal with it because, well you're (crazy, drug-addicted, strange, whatever). Its simply ridiculous. In my own experiences with shrinks, I've learned sometimes you have to stop thinking "oh, they're a doctor..do what the doctor says" and start thinking "this is MY life and MY treatment".
Posted by utopizen on March 29, 2006, at 18:05:18
In reply to Re: risperidone as speed psychosis treatment » dayle, posted by scatterbrained on March 28, 2006, at 16:34:06
What M.D.'s are trained to do for admitting amphetamine psychosis patients in the hospital:
-Prescribe Valium (for agitation)
-Prescribe Risperdal (to help them "come down" and to curb their amphetamine psychosis
-These are like, for day one of hospital treatment.
Generally, most cases, the patient might need some more Valium for their agitation and psychosis (yes, Valium/Klonopin/Xanax are prescribed and effective for psychotics) and some Risperdal maybe for good measure, day 2 or 3.
I've read a case study where a kid on Adderall (exceptional and rare case) at 10mg needed monitoring and had psychosis for 3 days straight.
But that's very very very rare. And that's 3 days.
So, no. Have her see a social worker, and a psychiatrist willing to be honest with her diagnosis.
Amphetamine psychosis does not last longer than the half-life of amphetamine, which is out of everyone's system within 24-72 hours.
If you ask me, the only basis or rationale for this doctor to use that diagnosis is if he wants to pretend your daughter is continiously administering methamphetamine daily while taking Risperdal.
Quack quack quack. Have your daughter see a social worker, and a doctor specializing in drug abuse treatment.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.