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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by SLS on December 2, 2000, at 22:35:15
For anyone who is using Risperdal (risperidone) strictly as an antidepressant or as an augmentor to antidepressants:
What dosage of Risperdal are you taking, and how has it helped you?What side effects have you experienced? Did they get better over time?
Any input is greatly appreciated.
Sincerely,
Scott
Posted by shellie on December 3, 2000, at 11:22:12
In reply to Risperdal (risperidone) for depression? Anyone?, posted by SLS on December 2, 2000, at 22:35:15
>Risperdal: what EXACTLY did you experience. Describe it in as much detail as possible. How much did you take? Even 1mg could have been too much. Risperdal usually doesn't produce much weight gain. You might also take a look at Seroquel.<
> When you say that you couldn't speak, is it because you literally could not form words and vocalize them no matter how hard you tried, or did you just feel mute and have difficulty getting words out fluently and without clear pronunciation?
>Hey Scott-I was reminded by this post that I neglected to answer questions presented to me re risperdal in a previous post.
I do not remember the dosage I started with for my one day trial. I know my pdoc starts me very low and I always cut that in half.
What I felt was that my limbs each weighed a ton. Maybe this is what they describe as stiffness; I would describe it more as heaviness. And I could talk; I just had trouble forming words and was slurring my speech. I called the pdoc on call (it was a saturday), she told me she could precribe something the side effects to go away, or they would just go away themselves in a day. I opted not to add cogentin or whatever. My regular pdoc did not encourage me to continue taking risperdal.
I also took seroquel for one night. It kept me up the entire night. It was not given to me as an adjunct--just on it's own (my pdoc thought my thinking wasn't making sense); I felt out of it in the morning, angry as hell at my pdoc for going in a direction that we hadn't agreed on and at this point went for the consultation with the new pdoc who suggested serzone. btw, my therapist didn't agree that my thinking was at all flawed, just that I was very speedy and talking very very quickly, and not finishing words or sentences. Now I am back with the original pdoc, she would still like me to try anti-psychotics, but went along with pindolol to supplement nardil.
Now my strategy is to look back at lamictal and make a plan for cutting side effects before I even start to take it. And I need to do a search on selegilene, and ask her next week what she thinks about adding that to nardil. I believe I asked her before and she was concerned about hypotensive effects. In any case, I cannot afford to risk side effects of any new medications until my christmas work is done.
Did you decide to go with risperdal?
shellie
Posted by judy1 on December 3, 2000, at 18:52:01
In reply to Risperdal (risperidone) for depression? Anyone?, posted by SLS on December 2, 2000, at 22:35:15
Dear Scott,
I can't remember if you have unipolar or bipolar depression? Risperdal has been a fairly good AD for me, I find it very energizing and if I go too high with dosage will get manic. (Apparently this isn't uncommon in bipolar disorder). As an AD- the dose was 0.5mg bid, as an anti-psychotic 2mg bid. Hope you find it beneficial- j.
Posted by natg on December 4, 2000, at 23:51:37
In reply to Risperdal (risperidone) for depression? Anyone?, posted by SLS on December 2, 2000, at 22:35:15
> For anyone who is using Risperdal (risperidone) strictly as an antidepressant or as an augmentor to antidepressants:
>
>
> What dosage of Risperdal are you taking, and how has it helped you?
>
> What side effects have you experienced? Did they get better over time?
>
>
> Any input is greatly appreciated.
>
>
> Sincerely,
> ScottHi Scott:
As I have mentioned in an earlier post Risperdal was the best thing that happened to me.I started taking it again despite the galactorrhea.
I have found freedom from depression and for the first time ever have felt OK about myself.
No anxiety, no suicidal thought, no obsessive thoughts, no paranoia, no free- floating anxiety.I've taken anywhere from .5 mgs to 2 mgs. The trick for me has been to find the right dosage.
I currently take Adrafanil and Neurontin.
Best Wishes and I pray this helps you.
Posted by natg on December 10, 2000, at 16:46:41
In reply to Risperdal (risperidone) for depression? Anyone?, posted by SLS on December 2, 2000, at 22:35:15
> For anyone who is using Risperdal (risperidone) strictly as an antidepressant or as an augmentor to antidepressants:
>
>
> What dosage of Risperdal are you taking, and how has it helped you?
>
> What side effects have you experienced? Did they get better over time?
>
>
> Any input is greatly appreciated.
>
>
> Sincerely,
> ScottHi Scott:
Just wondering how your Risperdal trial is going? From what I read, you have taken Zyprexa as well. How did you like Zyprexa? Is it comparable to Risperdal? And what other meds. were you taking concurrently.Your input and time would be greatly appreciated.
I hope this finds you in good health.
Nat
Posted by R.Anne on December 10, 2000, at 19:35:20
In reply to Risperdal (risperidone) for depression? Anyone?, posted by SLS on December 2, 2000, at 22:35:15
> For anyone who is using Risperdal (risperidone) strictly as an antidepressant or as an augmentor to antidepressants:
>
>
> What dosage of Risperdal are you taking, and how has it helped you?
>
> What side effects have you experienced? Did they get better over time?
>
>
> Any input is greatly appreciated.
>
>
> Sincerely,
> Scott
############
Hi. I used risperdal for some of the symptoms of depression and when I quit taking it I sunk very low on and off. Adding .25 helped with the symptoms of depression. I needed more, though, for the other symptoms I experience not related to depression.I have gone off risperdal because I felt it was adversely effecting my hormones, etc. Now I started on Seroquel and was prescribed between 25 mg. and 50. I immediately took 50 mg. (recommended as optimal for the symptom of hypervigilence) and have been now for about 12 days. I feel too sluggish and, for me, this dose may be too high. I'm going to give it a little more time, though, before I decide to go down to 25 mg. Besides all that it seems to be similar to risperdal and helps some of the effects of depression that my antidepressants (paxil, effexor) don't. I've heard that many people are responding to lower doses. These doses are especially good for the elderly and those with kidney and liver conditions, too.
Posted by SLS on December 10, 2000, at 21:43:33
In reply to Re: Risperdal (risperidone) for depression? Anyone?, posted by R.Anne on December 10, 2000, at 19:35:20
Hi R. Anne (Roseanne?)
> Hi. I used risperdal for some of the symptoms of depression and when I quit taking it I sunk very low on and off. Adding .25 helped with the symptoms of depression. I needed more, though, for the other symptoms I experience not related to depression.> I have gone off risperdal because I felt it was adversely effecting my hormones, etc.
What hormones are affected and how do you know? Is this reluctance to use Risperdal based on theoreticals or is it the experience of your doctor that hormonal changes always occur? At what dosage of Risperdal does your doctor feel prolactin levels are increased? I would like to know myself. Finally, what is included in "etc."?
If you are talking about increased prolactin, there are drugs that will reduce it. Parlodel (bromocriptine) is the drug of choice. Sometimes, Parlodel even acts as an antidepressant. Not knowing what your condition entails, you and your doctor would have to evaluate how Parlodel might affect your non-depressive symptoms. If Risperdal is of such help to you, it might be worth treating the hormonal side effects. It shouldn't be too tough.
Of the newer atypical neuroleptic antipsychotics, Risperdal is the one most capable of increasing levels of prolactin. I am not sure at what dosages this becomes evident, but it is very possible that you would not see an increase until you go above 2.0mg. I'll need to look into this. Cam W. should be able to offer you some valuable input here. Of the SSRIs, Paxil appears to be the one most capable of increasing levels of prolactin. Perhaps the two together are responsible for any hormonal changes you have seen.
> Now I started on Seroquel and was prescribed between 25 mg. and 50. I immediately took 50 mg. (recommended as optimal for the symptom of hypervigilence) and have been now for about 12 days. I feel too sluggish and, for me, this dose may be too high. I'm going to give it a little more time, though, before I decide to go down to 25 mg. Besides all that it seems to be similar to risperdal and helps some of the effects of depression that my antidepressants (paxil, effexor) don't. I've heard that many people are responding to lower doses. These doses are especially good for the elderly and those with kidney and liver conditions, too.
It sounds very optimistic that Seroquel is treating your symptoms so well. Perhaps, as you say, reducing the dosage will help with the sedation. I wish you the best.
BTW, what is "hypervigilence", and how is it treated?
Thanks.
- Scott
Posted by SLS on December 10, 2000, at 22:04:30
In reply to To Scott, posted by natg on December 10, 2000, at 16:46:41
Hi Nat.
> Just wondering how your Risperdal trial is going? From what I read, you have taken Zyprexa as well. How did you like Zyprexa? Is it comparable to Risperdal? And what other meds. were you taking concurrently.
After a tease of an initial response, I have pretty much lost the antidepressant effect at 1.0mg. My doctor has given me some latitude in allowing me to increase it to 2.0mg. I might do this as of tomorrow.
I am currently taking Lamictal 300mg, Parnate 80mg, desipramine 300mg, and Risperdal. My current diagnosis is an unusual presentation of bipolar disorder in which depression is chronic and unremitting. I have experienced mixed-state manias only in association with medications involving MAOIs.
I also responded initially to Zyprexa at a dosage of 2.5mg, but then had the response deteriorate. Raising the dosage to 5.0mg did not seem to help. For me, Zyprexa produced some brain-fog at the higher dosage. I discontinued Zyprexa for two days before starting Risperdal. I experienced a substantial antidepressant effect the day after my first 0.50mg dose of Risperdal. I can't help to wonder if there may have been some synergy between the first dose of Risperdal and any residual Zyprexa in the brain. Zyprexa has an average half-life of about 35 hours. Do you know if these two drugs can be taken together? Also, I began to feel better upon my initial reduction in dosage of Zyprexa. Is less more effective? Maybe not. Sometimes, a dosage change, either up or down, can lead to a transient improvement. This happens to me, particularly with MAO-inhibitors.
> Your input and time would be greatly appreciated.
I hope some of this was helpful. Please post again if I didn't answer your questions fully or if you have any more. No biggie. :-)
> I hope this finds you in good health.
It doesn't, but my day has been made brighter by your sentiments.
Sincerely,
Scott
Posted by R.Anne on December 10, 2000, at 22:58:51
In reply to Re: Risperdal (risperidone) for depression? Anyone? » R.Anne, posted by SLS on December 10, 2000, at 21:43:33
> Hi R. Anne (Roseanne?)
>
>
> > Hi. I used risperdal for some of the symptoms of depression and when I quit taking it I sunk very low on and off. Adding .25 helped with the symptoms of depression. I needed more, though, for the other symptoms I experience not related to depression.
>
> > I have gone off risperdal because I felt it was adversely effecting my hormones, etc.
>
> What hormones are affected and how do you know? Is this reluctance to use Risperdal based on theoreticals or is it the experience of your doctor that hormonal changes always occur? At what dosage of Risperdal does your doctor feel prolactin levels are increased? I would like to know myself. Finally, what is included in "etc."?
>
> If you are talking about increased prolactin, there are drugs that will reduce it. Parlodel (bromocriptine) is the drug of choice. Sometimes, Parlodel even acts as an antidepressant. Not knowing what your condition entails, you and your doctor would have to evaluate how Parlodel might affect your non-depressive symptoms. If Risperdal is of such help to you, it might be worth treating the hormonal side effects. It shouldn't be too tough.
>
> Of the newer atypical neuroleptic antipsychotics, Risperdal is the one most capable of increasing levels of prolactin. I am not sure at what dosages this becomes evident, but it is very possible that you would not see an increase until you go above 2.0mg. I'll need to look into this. Cam W. should be able to offer you some valuable input here. Of the SSRIs, Paxil appears to be the one most capable of increasing levels of prolactin. Perhaps the two together are responsible for any hormonal changes you have seen.
>
> > Now I started on Seroquel and was prescribed between 25 mg. and 50. I immediately took 50 mg. (recommended as optimal for the symptom of hypervigilence) and have been now for about 12 days. I feel too sluggish and, for me, this dose may be too high. I'm going to give it a little more time, though, before I decide to go down to 25 mg. Besides all that it seems to be similar to risperdal and helps some of the effects of depression that my antidepressants (paxil, effexor) don't. I've heard that many people are responding to lower doses. These doses are especially good for the elderly and those with kidney and liver conditions, too.
>
> It sounds very optimistic that Seroquel is treating your symptoms so well. Perhaps, as you say, reducing the dosage will help with the sedation. I wish you the best.
>
> BTW, what is "hypervigilence", and how is it treated?
>
> Thanks.
>
>
> - ScottHi Scott,
Hypervigilence is being in a constant state of alertless often with adrenelin pumping, nerves jumping-being extremely on guard and I find it can cross into a bit of paranoia-real paranoia. Hypervigilence is being able to hear a pin drop when you sleep and having nightmares, too. My doctor treated it with risperdal and now seroquel. One hormone that risperdal effected was Prolactin and even at .50 mg. There was breast cancer in my family and I've heard that if you have it in your family or have had it yourself it may be better to avoid increases in Prolactin(there is a hypothesis that it may cause breast cancer). I think it also effected my m.cycle as it seemed to never end-this has also been reported as a side effect. The ETC meant that along with those particular hormonal changes I had psychological changes that were defeating the purpose of the drug. Wanting to eat a lot (I think from hormonal changes) and m.cycle "moods" often. I haven't had the prolactin induced leakage that I had while on .50 and .75. and 1 mg. of risperdal. I think my hormonal situation is improving now. We will see-it may still be too early to tell. Thanks for your feedback! ;-)
r.anne
Posted by natg on December 11, 2000, at 3:52:24
In reply to Re: To Scott » natg, posted by SLS on December 10, 2000, at 22:04:30
> Hi Nat.
>
> > Just wondering how your Risperdal trial is going? From what I read, you have taken Zyprexa as well. How did you like Zyprexa? Is it comparable to Risperdal? And what other meds. were you taking concurrently.
>
> After a tease of an initial response, I have pretty much lost the antidepressant effect at 1.0mg. My doctor has given me some latitude in allowing me to increase it to 2.0mg. I might do this as of tomorrow.
>
> I am currently taking Lamictal 300mg, Parnate 80mg, desipramine 300mg, and Risperdal. My current diagnosis is an unusual presentation of bipolar disorder in which depression is chronic and unremitting. I have experienced mixed-state manias only in association with medications involving MAOIs.
>
> I also responded initially to Zyprexa at a dosage of 2.5mg, but then had the response deteriorate. Raising the dosage to 5.0mg did not seem to help. For me, Zyprexa produced some brain-fog at the higher dosage. I discontinued Zyprexa for two days before starting Risperdal. I experienced a substantial antidepressant effect the day after my first 0.50mg dose of Risperdal. I can't help to wonder if there may have been some synergy between the first dose of Risperdal and any residual Zyprexa in the brain. Zyprexa has an average half-life of about 35 hours. Do you know if these two drugs can be taken together? Also, I began to feel better upon my initial reduction in dosage of Zyprexa. Is less more effective? Maybe not. Sometimes, a dosage change, either up or down, can lead to a transient improvement. This happens to me, particularly with MAO-inhibitors.
>
> > Your input and time would be greatly appreciated.
>
> I hope some of this was helpful. Please post again if I didn't answer your questions fully or if you have any more. No biggie. :-)
>
> > I hope this finds you in good health.
>
> It doesn't, but my day has been made brighter by your sentiments.
>
>
> Sincerely,
> ScottHi Scott:
I'm in the same boat as you. 1 mg worked wonders and now the AD affect is gone. What to do? I increased to 2 mg today. We'll what happens.Sorry I have no answers for you, I wish I did.
Finding the right dosage is quite tricky and mind- boggling to me.One last question, did you gain weight on Zyprexa?
I experienced more sedation on Zyprexa. I think I would probably give Zyprexa a try again if it were not for the horrible weight gain. I say this because I had no galactorrhea while I was on Zyprexa.I'm rambling, thanks for listening!
Best of Luck, it will get better : )
Please let us know how you are doing.Nat
Posted by SLS on December 13, 2000, at 21:59:45
In reply to Re: To Scott, again, posted by natg on December 11, 2000, at 3:52:24
> Hi Scott:
> I'm in the same boat as you. 1 mg worked wonders and now the AD affect is gone.That stinks.
How soon after you began Risperdal did it begin working? For how long did the improvement last?
> What to do?
1. Give it more time at 1.0mg. If we are both fortunate, this initial "blip" is an indicator that a positive response will return after a longer period of time.
2. Increase the dosage to 2.0mg and give it two weeks. I don't think that there is a therapeutic window for Risperdal (a situation in which it is possible to lose a response if the dosage is raised beyond a certain point). For this reason, I think it makes sense to raise the dosage if you can tolerate it. I'm just not sure that going above 2.0mg will provide any greater chance of responding. I'll need to look into this further.
> I increased to 2 mg today.
I just said that.
> We'll see what happens.
I've got my eyes crossed.
Please let me know how things go at 2.0mg. I am still hanging out at 1.0mg for now, but will be quick to move up if things don't break soon. I'll keep you informed.
> Sorry I have no answers for you, I wish I did.
Then just what in the heck am I doing talking to you for? :-)
> Finding the right dosage is quite tricky and mind- boggling to me.
To follow your progress through your drug trials will give me plenty of answers. You make one fine guinea pig.
> One last question, did you gain weight on Zyprexa?
Yes. The two times I have been on Zyprexa, I have gained weight. It definitely increased my appetite. It probably slows the body's metabolism as well. Double-whammy.
> I experienced more sedation on Zyprexa. I think I would probably give Zyprexa a try again if it were not for the horrible weight gain. I say this because I had no galactorrhea while I was on Zyprexa.
I got the impression that weight gain was not as obvious at 2.5mg. People definitely respond to this low a dosage when used for depression. At 5.0mg, I could see a trend towards needing a longer belt. I received some initial benefit at 2.5mg, so, hopefully, you will respond at a dosage of Zyprexa that produces a minimal and manageable tendency towards weight gain. It can't hurt to perform a short trial - 2 weeks maximum. You would then be in a better position to "weigh" the advantages versus the disadvantages of continued Zyprexa therapy.
> I'm rambling, thanks for listening!
Ditto.
> Best of Luck, it will get better : )
> Please let us know how you are doing.Ditto. Ditto.
- Scott
Posted by Natd on January 1, 2001, at 11:46:09
In reply to Re: To Scott, again » natg, posted by SLS on December 13, 2000, at 21:59:45
> > Hi Scott:
> > I'm in the same boat as you. 1 mg worked wonders and now the AD affect is gone.
>
> That stinks.
>
> How soon after you began Risperdal did it begin working? For how long did the improvement last?
>
> > What to do?
>
> 1. Give it more time at 1.0mg. If we are both fortunate, this initial "blip" is an indicator that a positive response will return after a longer period of time.
>
> 2. Increase the dosage to 2.0mg and give it two weeks. I don't think that there is a therapeutic window for Risperdal (a situation in which it is possible to lose a response if the dosage is raised beyond a certain point). For this reason, I think it makes sense to raise the dosage if you can tolerate it. I'm just not sure that going above 2.0mg will provide any greater chance of responding. I'll need to look into this further.
>
> > I increased to 2 mg today.
>
> I just said that.
>
> > We'll see what happens.
>
> I've got my eyes crossed.
>
> Please let me know how things go at 2.0mg. I am still hanging out at 1.0mg for now, but will be quick to move up if things don't break soon. I'll keep you informed.
>
> > Sorry I have no answers for you, I wish I did.
>
> Then just what in the heck am I doing talking to you for? :-)
>
> > Finding the right dosage is quite tricky and mind- boggling to me.
>
> To follow your progress through your drug trials will give me plenty of answers. You make one fine guinea pig.
>
> > One last question, did you gain weight on Zyprexa?
>
> Yes. The two times I have been on Zyprexa, I have gained weight. It definitely increased my appetite. It probably slows the body's metabolism as well. Double-whammy.
>
> > I experienced more sedation on Zyprexa. I think I would probably give Zyprexa a try again if it were not for the horrible weight gain. I say this because I had no galactorrhea while I was on Zyprexa.
>
> I got the impression that weight gain was not as obvious at 2.5mg. People definitely respond to this low a dosage when used for depression. At 5.0mg, I could see a trend towards needing a longer belt. I received some initial benefit at 2.5mg, so, hopefully, you will respond at a dosage of Zyprexa that produces a minimal and manageable tendency towards weight gain. It can't hurt to perform a short trial - 2 weeks maximum. You would then be in a better position to "weigh" the advantages versus the disadvantages of continued Zyprexa therapy.
>
> > I'm rambling, thanks for listening!
>
> Ditto.
>
> > Best of Luck, it will get better : )
> > Please let us know how you are doing.
>
> Ditto. Ditto.
>
>
> - ScottHi Scott:
How's the Risperdal trial going?
Just wanted to touch base with you and see how you are doing.
I've been on 2 mg and I've added Mirapex to my it, I feel pretty good, too. WOW! I can't believe I said this!To answer your question, I got relief immediately with Risperdal. Sounds too good to be true?
After 2 months on it, the initial response faded and I got seriously depressed. My Doctor was lousy and he still does not want me on Risperdal.
He wants me to ditch it ( because of the Galactorrhea) but I won't. Maybe, down the road but not now.
He did mention that the Galactorrhea and irregular menses. were a side- effect and all that would be back to normal when I go off it.I haven't felt this good in years, if ever, I refuse to plunge in the dark dungeon when for the first time ever something is working for me.
Make sense?Am- I rambling again?
Happy New- Year and best of health to you,
Nat
Posted by SLS on January 1, 2001, at 20:11:12
In reply to Re: To Scott, again, posted by Natd on January 1, 2001, at 11:46:09
Dear Nat,
You are making sense. You are not rambling. You are definitely cute.
Thanks for your concern.
I have increased my dosage of Risperdal to 2.0mg. I felt better for having increased it, but I seem to have once again experienced a plateauing and diminishing returns.
I had never thought of adding Mirapex. I'll bring it up with my doctor when I see him in a couple of weeks. Was this your idea? I guess I am still confused as to the extent to which the innovative treatments I see on Psycho-Babble are the result of one's doctor's treatment method or the suggestions of their patients. Do you treat yourself? (Not to be construed as pejorative). At this point, I don't want to assume control over my treatment with my new doctor. I need to give him a chance. However, I am not convinced that he will conceive of the type of strategies such as adding Mirapex to Risperdal.
I definitely need to change at least two of my medications. I want to switch from Parnate to Nardil and from desipramine to nortriptyline. I am even considering adding a small amount of Zyprexa to the Risperdal on a hunch. My hunches are usually wrong, but I am afraid to leave any stone unturned.
Have you tried Zyprexa? Sorry, but I forget a lot of things. It is much less likely to produce galactorrhea and dysmenorrhea. Weight-gain can be a big problem with it, though. Perhaps amisulpride would fill the role of Risperdal if Risperdal becomes intolerable. I know that were I in your position, I wouldn't want to mess with a good thing. If you deem it necessary, you might attempt a switch-over to Zyprexa or one of the other neuroleptics after your remission "digs" in deep. Maybe in six months. By that time, ziprasidone (Zeldox) might be available. It looks like a Zyprexa without weight gain, plus, it possesses pindolol-like effects that would potentiate its serotonergic effects. It sounds exciting. Of course, what looks good on paper doesn't always work out in real life. We'll see.
For now, keep feeling good. :-)
Sincerely,
Scott
Posted by natg on January 10, 2001, at 12:20:17
In reply to Re: To Scott, again » Natd, posted by SLS on January 1, 2001, at 20:11:12
Dear Scott:
To answer your question, yes, it was my idea to add Mirapex to my drug treatment. My Doctor was not 100% happy about it, and truthfully I cannot understand why considering I feel so much better.
He was against Risperdal as well.
I do not like him very much but he is the only shrink intown who is accepting new patients, so what do you do?I have an excellent Psychiatrist but he is in France ( I lived there for many years before moving to the US) and I call him for advice and suggestions. He has been very supportive.
I think French Doctors are a lot more flexible-- just my opinion.Yes, I may try zyprexa down the road or the newer version. Weight gain on Zyprexa is too anxiety- producing for me. I am a recovering anorexic/ bulimic which explains my fear of meds. that will produce weight gain.
I hope this finds you well.
Good Luck to you,Nat
This is the end of the thread.
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