![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 28. Go back in thread:
Posted by JahL on January 4, 2001, at 8:42:47
In reply to Re: anergia, posted by Cam W. on January 4, 2001, at 6:47:46
>Sorry, good health does not come in a pill. You have to help it along with a balance diet and regular exercise.
Sorry Cam but if it were that simple this site wouldn't exist. Anergia is a symptom of depression and as such should be treatable by 'anti-depressive' medications.
I agree that regular exercise/good eating promotes well-being but my 5 days a week training of 2 yrs ago has not prevented me becoming so demotivated as not to be able to get out of bed.
I've read a no. of Elizabeth's posts (since opiates interest me) & I believe her complaint goes beyond a general lack of 'good health'.
I too would be interested to hear of anyone successfully treating extreme apathy/anergia.
Rgds,
Jah.
Posted by Cam W. on January 4, 2001, at 12:33:38
In reply to Re: anergia » Cam W., posted by JahL on January 4, 2001, at 8:42:47
Jah - Sorry, I didn't mean for it to sound that diet and exercise as a cure, but as an augmenting agent to meds like antidepressants and antipsychotics. A good diet and exercise WILL give one more energy and a sense of wellbeing.
Opiates do cause dependence and subsequent addiction in most people who take them to enduce euphoria and well being. I recommend reading an article in Neuropsychopharmacology (Feb, 2001) issue, entitled Drug Addiction, Dysregulation of Reward, and Allostasis by George Koob and Michel Le Moal. It can be read at:
http://www.elsevier.nl/gej-ng/10/33/33/37/25/22/article.pdf
Thanks Jah; too often I don't proofread what I write. - Cam
Posted by JahL on January 4, 2001, at 14:14:36
In reply to Re: anergia, posted by Cam W. on January 4, 2001, at 12:33:38
> Jah - Sorry, I didn't mean for it to sound that diet and exercise as a cure, but as an augmenting agent to meds like antidepressants and antipsychotics. A good diet and exercise WILL give one more energy and a sense of wellbeing.
>
> Opiates do cause dependence and subsequent addiction in most people who take them to enduce euphoria and well being. I recommend reading an article in Neuropsychopharmacology (Feb, 2001) issue, entitled Drug Addiction, Dysregulation of Reward, and Allostasis by George Koob and Michel Le Moal. It can be read at:
>
> http://www.elsevier.nl/gej-ng/10/33/33/37/25/22/article.pdf
>
> Thanks Jah; too often I don't proofread what I write. - CamNo worries, mate. I like to see exercise & healthy eating as providing the foundation upon which meds can more efficiently work.
You're right to highlight the importance of it; it never ceases to amaze me the liberties people-mentally unwell or otherwise-take with their bodies.
I can still vividly remember the immense sense of well-being & vitality I would get after 2 hrs on the weights. Shame it's too much effort now.
Jah.
Posted by SLS on January 4, 2001, at 20:52:41
In reply to Re: anergia » Cam W., posted by JahL on January 4, 2001, at 14:14:36
> I can still vividly remember the immense sense of well-being & vitality I would get after 2 hrs on the weights. Shame it's too much effort now.Sadly, ditto.
- Scott
Posted by Adam on January 5, 2001, at 1:33:16
In reply to anergia, posted by Elizabeth on January 3, 2001, at 23:32:41
I know your're no fan of CBT, but I will offer this fwiw. I have also experienced, despite a robust response to selegiline, a reduction, if anything, in my levels of motivation. I am in the process of addressing this, via therapy as opposed to drugs. The reason I am doing so is, quite simply, I'm not satisfied. I don't feel I'm living to my potential. I'm the happiest I've ever been, but I really don't feel like doing much but hanging out with friends, reading books on quantum mechanics, listening to NPR, and surfing the net (worst of all). I really don't feel like doing much of the day-to-day maintainance stuff, and if it weren't for the company I keep, my living space would be a hovel. And I'd be fine with it. This isn't really like me, or the old me, miserable, but often getting a remarkable amount of stuff done, all things considered.
Sound familiar? I'm wondering if this is a common personality shift in MAOI responders.
Anyway, here's the basic gist of the therapy: Motivation is a chicken-and-egg thing. You (the non-specific "you") say to yourself "I'm not motivated, I'm not doing anything," and, sure enough, it's true. This continues so long as you're waiting to be motivated to get anything done. The remedy: Don't wait. Do whatever it is you need to do anyway, even if it feels like a Sisyfusian ordeal. Start the day with a "stuff I need to do" list. Make it realistic. Do what's on the list. Even if you'd rather be dragged naked across carpet tacks and dipped in isopropanol, do it. Even if you feel like you're doing a crappy job, finish the task as best you can. At the end of the day, go over the list, the things you've checked off, and write down how you feel about it.
My experience: I feel better about myself. I worry I'm dependant on a therapist's approval rather than some internal impetus, but I can't deny I'm encouraged by what I feel, and hope this can become habitual. I know, it's painfully obvious where I'm going with this, but the reward of seeing my list completed and getting some positive feedback does seem to be motivating me to stick with it, and that's a good thing.
It looks dippy, I know. It can sound like the cheapest form of platitudinous self-help baloney, etc., etc., and does little for the existentialist to feed their intellect, but I'm rather convinced, mu-receptors or no, that this approach has its merits.
Best of luck, whatever you do.
> Anybody have any success treating anergia? Even when my mood is fine, I have little motivation or drive. The only successful treatment I've found is mu opioid agonists. Has anybody else used opioids for this, and if so, were you able to maintain a constant dose?
Posted by Noa on January 5, 2001, at 10:06:35
In reply to Re: anergia, posted by Adam on January 5, 2001, at 1:33:16
Stimulants helped some, for somnolence and energy to do things..
Adding CPAP to treat my sleep apnea helped Tremendously, but more for the actual somnolence than for the motivation to get up and out and do things.
Adding thyroid hormones (sufficient doses) to treat my hypothyroid helped Magnificently for both extreme fatigue and weakness, as well as for motivation, energy, etc. The improvement has increased gradually, with some ups and downs along the way, but overall movement upward, over the past 9 months.
I just recently arrived at the point where I have the energy and motivation to start exercising. It is still new (about 2 weeks) but I am finding that exercising is definitely adding more benefit in terms of energy and motivation. However, it is a catch 22. I could not have started and kept up with exercise at all until I reached a certain level of improvement. I hope I will be able to maintain my enjoyment of the exercise, and that is not just some sort of honeymoon period or enjoyment of the novelty of it. But, I do find that on days I exercise, I am able to muster motivation to get things done without each thing becoming a big deal. I just do a task and it doesn't take much time, as opposed to seeing the task as part of a mound of tasks that seems insurmountable, etc. etc.
Posted by Noa on January 5, 2001, at 10:20:35
In reply to Re: anergia, posted by SLS on January 4, 2001, at 20:52:41
I am finding I love using the weight devices. I am not pushing myself to do too much, just enough to start feeling where each of these muscle groups are, to get acquainted with ones I never "met" before, and reacquainted with the ones I haven't paid attention to in a long long time.
I enjoy this part of the routine so much. It is my "reward" for completing the cardio part of the routine, which I also enjoy, but still takes a fair amount of "psyching".
It strikes me that your thinking about weight sessions 2 hours long may create a barrier to getting back into it at all. To return to this after a long hiatus, you wouldn't expect yourself to do 2 hours of weights, would you?
I keep having to remind myself that ANYTHING I do, in terms of exercise, is a huge improvement over my usual---ie doing none at all. I do feel the pull to "be better at this", go faster, workout longer, etc., but I am working hard to talk back to that voice to tell myself that baby steps is not only ok, it is absolutely necessary if I am to really make exercise a part of my life for the long run.
And, yes, I also feel wonderful after exercising. On days I don't exercise (and I have been averaging 3 times per week), my muscles cry out to me as though thirsty for the movement. It is amazing, because I dreaded starting exercise so much!!! Now I am beginning to notice the difference between how I feel after spacing out in front of my computer games (scrabble, solitaire, etc.) and how I feel after getting up and moving.
I feel my body loving the exercise, and I feel so good afterward, it seems like instant injection of the best antidepressant. Who knew that my body had this internal pharmacy just waiting to be accessed?
Posted by SLS on January 5, 2001, at 14:29:07
In reply to Re: anergia, posted by Adam on January 5, 2001, at 1:33:16
> It looks dippy, I know. It can sound like the cheapest form of platitudinous self-help baloney, etc., etc., and does little for the existentialist to feed their intellect, but I'm rather convinced, mu-receptors or no, that this approach has its merits.
Dear Adam,I don't know what the hell you are talking about here, except that I tried some of your boloney today. It enabled me to take care of some paperwork that I have been putting off since September. Thanks for the tip and the transient motivation.
Sincerely,
ScottOh yeah, CBT is for real. BIG TIME. I would be surprised if the person you were replying to would think otherwise - not sure, though. I think it is a matter of choosing the right therapy for the right person for the properly evaluated problem.
I don't know why so many perspectives need be black or white, up or down, in or out. Although I truly believe that such is useful in a Socratic dialogue to hopefully arrive closer to the truth, I'm not sure that polar thinking is productive with regard to mental illness. I know the words I listed in a post along a different thread make me look even more pretentious than I really am, but they are four of my favorites - even Lake Webster.
2.5 cents.
http://www.dr-bob.org/babble/20001231/msgs/50920.html
(the end)
In a conversation I had with William Z. Potter, he indicated to me that he thought the inhibition of MAO-B was actually counterproductive when treating major depression and bipolar disorder. I believe him. BIG TIME.(sorry)
Posted by Orin3 on January 5, 2001, at 21:57:29
In reply to anergia, posted by Elizabeth on January 3, 2001, at 23:32:41
> Low dose gabapentin has worked well for me. Bright light therapy and regular exercise also help greatly.
Posted by anita on January 5, 2001, at 23:32:31
In reply to anergia, posted by Elizabeth on January 3, 2001, at 23:32:41
Hi Elizabeth,
Sorry to hear the Parnate is causing that apathy curse. As you might remember, loss of motivation, apathy, and lack of interest in life are extreme problems for me. I've been taking low-dose risperidone (1mg/day) for a few months now, and while the effect is quite subtle, I have noticed improvement in these areas, along with an improvement in my general depression. When I tried Zyprexa a long time ago briefly, I also noticed that I was "getting things done" more than usual.
So, maybe low-dose risperidone or zyprexa (but alas the weight gain) might help you. Or, maybe the Remeron will also help, given that it has 5HT2A antagonism as well. I really think I've improved depression-wise in the last year with Zoloft (plus my usual lamictal) and then with risperidone, and given that we are both treatment-resistant but responded to Nardil, maybe my combo might be worth a try for you if Remeron doesn't pan out?
Just wanting to help :-),
anitaP.S. Only 3-lb. weight gain with risperidone so far...
> Anybody have any success treating anergia? Even when my mood is fine, I have little motivation or drive. The only successful treatment I've found is mu opioid agonists. Has anybody else used opioids for this, and if so, were you able to maintain a constant dose?
Posted by Dwight on January 7, 2001, at 23:01:27
In reply to Anergia help -- for Elizabeth, posted by anita on January 5, 2001, at 23:32:31
I've been taking .5mg resperidone for sleep. Do you take less than that? Doesn't it make you sleepy?
> Hi Elizabeth,
>
> Sorry to hear the Parnate is causing that apathy curse. As you might remember, loss of motivation, apathy, and lack of interest in life are extreme problems for me. I've been taking low-dose risperidone (1mg/day) for a few months now, and while the effect is quite subtle, I have noticed improvement in these areas, along with an improvement in my general depression. When I tried Zyprexa a long time ago briefly, I also noticed that I was "getting things done" more than usual.
>
> So, maybe low-dose risperidone or zyprexa (but alas the weight gain) might help you. Or, maybe the Remeron will also help, given that it has 5HT2A antagonism as well. I really think I've improved depression-wise in the last year with Zoloft (plus my usual lamictal) and then with risperidone, and given that we are both treatment-resistant but responded to Nardil, maybe my combo might be worth a try for you if Remeron doesn't pan out?
>
> Just wanting to help :-),
> anita
>
> P.S. Only 3-lb. weight gain with risperidone so far...
>
>
>
> > Anybody have any success treating anergia? Even when my mood is fine, I have little motivation or drive. The only successful treatment I've found is mu opioid agonists. Has anybody else used opioids for this, and if so, were you able to maintain a constant dose?
Posted by natg on January 8, 2001, at 0:44:25
In reply to Re: anergia » Adam, posted by SLS on January 5, 2001, at 14:29:07
Hi,
Thanks for everybody's posts, I learned a lot.
I, too, suffer from anergia but I must admit it is getting better for me.
Medication has helped the most but I've had to discipline myself to get out of bed every morning and do a few things that I know would ultimately help me. It's been rough and I've had days when I could not get out of bed. No matter how much, I wanted to function, I couldn't for a long time. I try to do at least 5 " responsible" things each day. It has become as important as taking my meds. I know I feel less depressed at the end of the day.
Risperdal and Mirapex have been a life- saver for me.Best of health to all,
Nat
Posted by SLS on January 8, 2001, at 7:38:46
In reply to Re: what do you consider low dose Resperidone?, posted by Dwight on January 7, 2001, at 23:01:27
Dear Dwight,
> > So, maybe low-dose risperidone or zyprexa (but alas the weight gain) might help you. Or, maybe the Remeron will also help, given that it has 5HT2A antagonism as well. I really think I've improved depression-wise in the last year with Zoloft (plus my usual lamictal) and then with risperidone, and given that we are both treatment-resistant but responded to Nardil, maybe my combo might be worth a try for you if Remeron doesn't pan out?
> I've been taking .5mg resperidone for sleep. Do you take less than that? Doesn't it make you sleepy?
> > I've been taking low-dose risperidone (1mg/day) for a few months now, and while the effect is quite subtle, I have noticed improvement in these areas, along with an improvement in my general depression. When I tried Zyprexa a long time ago briefly, I also noticed that I was "getting things done" more than usual.
So far, the optimum dosage of Risperdal to augment my antidepressants seems to be 1.0mg. 0.5mg was definitely too little. Increasing Risperdal to 2.0mg did not add to its antidepressant effect and only served to bring on some unwanted cognitive effects. It affected my memory and made me feel strangely distant from things. I take my 1.0mg at night before bed.
For the first few week, Risperdal did cause some sedation and sleepiness, but it disappeared completely with two weeks. It does not help me sleep.
- Scott
Posted by Ant-Rock on January 10, 2001, at 10:49:35
In reply to Re: anergia, posted by natg on January 8, 2001, at 0:44:25
> Hi,
> Thanks for everybody's posts, I learned a lot.
> I, too, suffer from anergia but I must admit it is getting better for me.
> Medication has helped the most but I've had to discipline myself to get out of bed every morning and do a few things that I know would ultimately help me. It's been rough and I've had days when I could not get out of bed. No matter how much, I wanted to function, I couldn't for a long time. I try to do at least 5 " responsible" things each day. It has become as important as taking my meds. I know I feel less depressed at the end of the day.
> Risperdal and Mirapex have been a life- saver for me.
>
> Best of health to all,
> NatHey Nat,
would you mind letting me know what dose Mirapex you are using?
Thanks in advance.
Anthony
Posted by natg on January 10, 2001, at 12:06:16
In reply to Re: anergia » natg, posted by Ant-Rock on January 10, 2001, at 10:49:35
> > Anthony:
I take 1.4 mg of Mirapex per day (2 .7 tabs)Are you considering taking it?
It's helped me a lot.Best of health to you,
Nat
>
> Hey Nat,
> would you mind letting me know what dose Mirapex you are using?
> Thanks in advance.
> Anthony
Posted by JahL on January 10, 2001, at 12:22:04
In reply to Re: anergia » Ant-Rock, posted by natg on January 10, 2001, at 12:06:16
> I take 1.4 mg of Mirapex per day (2 .7 tabs)> It's helped me a lot.
> Nat
Hi Nat.
I tried about 0.5mg of Mirapex a while back & while it worked quickly, it only helped a little; not enough, I thought, to warrant continuing.
Could you tell me how long it was before you felt significant benefit (& @ what dose)?
Also, does it help at all with cognitive dysfunction (if at all you have this)/anhedonia?
Any side-effects to speak of?
Thanx,
Jah.
Posted by natg on January 10, 2001, at 13:14:01
In reply to Re: anergia » natg, posted by JahL on January 10, 2001, at 12:22:04
>
>Hi Jah,
I started taking Mirapex 5 weeks ago because of Risperdal poop- out. I can't tell you when I started to feel better but it was pretty rapid. I started at a very low dose and it made me extremely sleepy initially.
At 1.4 mg a day I feel like a new person. I have increase energy and the desire to do things which I have not experienced in years! I almost feel " normal", if you know what I mean.
I used to have social phobia where I never left my house UNLESS it was a necessity now I actually like going out.I went without it for a week and fell back into depression-- big time.
I'm embarassed to admit this but I'm not too sure what cognitive dysfunction?
Yes, Mirapex has helped with anhedonia.
It did make me initially nauseous, other than that no side- effects.
This is just my experience hope it helps.
Nat
>
> Hi Nat.
>
> I tried about 0.5mg of Mirapex a while back & while it worked quickly, it only helped a little; not enough, I thought, to warrant continuing.
>
> Could you tell me how long it was before you felt significant benefit (& @ what dose)?
>
> Also, does it help at all with cognitive dysfunction (if at all you have this)/anhedonia?
>
> Any side-effects to speak of?
>
> Thanx,
> Jah.
Posted by JahL on January 10, 2001, at 16:30:19
In reply to Re: anergia » JahL, posted by natg on January 10, 2001, at 13:14:01
Thanx 4 the prompt reply.
> At 1.4 mg a day I feel like a new person. I have increase energy and the desire to do things which I have not experienced in years! I almost feel " normal", if you know what I mean.
Good on ya.
> I used to have social phobia where I never left my house UNLESS it was a necessity now I actually like going out.
That's interesting. I too have social phobia (which partly responds to antipsychotics)
.
> I went without it for a week and fell back into depression-- big time.
>
> I'm embarassed to admit this but I'm not too sure what cognitive dysfunction?Posh term for foggyheadedness. (personally; difficulty processing info/concentrating etc.)
> Yes, Mirapex has helped with anhedonia.
> It did make me initially nauseous, other than that no side- effects.
> This is just my experience hope it helps.It does. Thanx.
Just a thought. Since the risperdone pooped out on you, might the Mirapex be doing all the 'work'? (ie. is the risperdone redundant?)Jah.
Posted by natg on January 10, 2001, at 18:34:44
In reply to Re: anergia » natg, posted by JahL on January 10, 2001, at 16:30:19
Dear Jah,
You raise an intersting point about the Risperdal being redundant, I was also wondering the same thing.
I think I'll try to go off it for a week and see what happens.No, I have no problems concentrating. In fact, my concentration has greatly improved!
Good luck
Posted by Dwight on January 10, 2001, at 20:23:46
In reply to Re: what do you consider low dose Resperidone?, posted by SLS on January 8, 2001, at 7:38:46
Scott,
you said you take 1mg of resperidone at bed time. I'm taking .5mg at bedtime along with 50mg trazadone and a little temazepam. I have taken the resperidone earlier in the evening alone and it does seem to make me a little sleepy. I'm also taking paxil and adderal in the day. I have a couple of questions for you. I was under the impression that the resperidal doesn't stay in your system that long; it would be out of your system by the time you wake up. But are you saying that it has some sort of antidepressant effect during the day. Also somebody said something about combining it with a stimulant; if I took it during the day with adderal wouldn't the two just negate each other? I'm seriously in need of something for anergia and lack of motivation and would be willing to try the resperidone during the day if there's a chance it might help. What would happen if I took 1mg along with the adderal? What is the dose of resperidal they use for schizophrenia? much higher? Thanks, Dwight> Dear Dwight,
>
> > > So, maybe low-dose risperidone or zyprexa (but alas the weight gain) might help you. Or, maybe the Remeron will also help, given that it has 5HT2A antagonism as well. I really think I've improved depression-wise in the last year with Zoloft (plus my usual lamictal) and then with risperidone, and given that we are both treatment-resistant but responded to Nardil, maybe my combo might be worth a try for you if Remeron doesn't pan out?
>
> > I've been taking .5mg resperidone for sleep. Do you take less than that? Doesn't it make you sleepy?
>
> > > I've been taking low-dose risperidone (1mg/day) for a few months now, and while the effect is quite subtle, I have noticed improvement in these areas, along with an improvement in my general depression. When I tried Zyprexa a long time ago briefly, I also noticed that I was "getting things done" more than usual.
>
> So far, the optimum dosage of Risperdal to augment my antidepressants seems to be 1.0mg. 0.5mg was definitely too little. Increasing Risperdal to 2.0mg did not add to its antidepressant effect and only served to bring on some unwanted cognitive effects. It affected my memory and made me feel strangely distant from things. I take my 1.0mg at night before bed.
>
> For the first few week, Risperdal did cause some sedation and sleepiness, but it disappeared completely with two weeks. It does not help me sleep.
>
>
> - Scott
Posted by r.anne on January 11, 2001, at 23:55:06
In reply to Re: anergia, posted by SLS on January 4, 2001, at 20:52:41
>
> > I can still vividly remember the immense sense of well-being & vitality I would get after 2 hrs on the weights. Shame it's too much effort now.
>
> Sadly, ditto.
>
>
> - Scott*****
Another ditto but I don't seem to care too much to change it right now. Maybe later, maybe sooner.
Posted by SLS on January 13, 2001, at 21:32:12
In reply to Re: SCOTT Resperidone?, posted by Dwight on January 10, 2001, at 20:23:46
Hi Dwight.
> Scott,
> you said you take 1mg of resperidone at bed time. I'm taking .5mg at bedtime along with 50mg trazadone and a little temazepam. I have taken the resperidone earlier in the evening alone and it does seem to make me a little sleepy. I'm also taking paxil and adderal in the day. I have a couple of questions for you. I was under the impression that the resperidal doesn't stay in your system that long; it would be out of your system by the time you wake up.No. The half-life of risperidone is about 20 - 24 hours. This is long enough to allow for once-daily dosing for dosages up to 2.0mg. I don't know at what point twice a day dosing becomes necessary. If you take all of your risperidone at night, you will certainly have enough in your body to exert its full effects until the following night's dosing.
> But are you saying that it has some sort of antidepressant effect during the day.
In some people, risperidone can produce a potent antidepressant effect when combined with other drugs. I don't know how effective it is for depression when used alone. Such an antidepressant effect remains constant throughout the day and night. That is the goal.
> Also somebody said something about combining it with a stimulant; if I took it during the day with adderal wouldn't the two just negate each other?
I can't remember reading of anyone taking both at the same time, but it seems perfectly safe to me. As far as the two negating each other, I think it depends on what disorder is being treated. For instance, to give Adderal to someone who is suffering from schizophrenia, or perhaps mania, the Adderal might make their psychotic symptoms worse. When used for depression, such a combination might be exactly what is needed.
> I'm seriously in need of something for anergia and lack of motivation and would be willing to try the resperidone during the day if there's a chance it might help.
It seems that the effective dosage of risperidone for depression lies in the range of 0.5mg - 2.0mg. My doctor has raised my dosage from 1.0mg to 2.0mg. I think I'm starting to feel better.
I would advise taking it before bed. As I described above, it stays in your system all day long.
> What would happen if I took 1mg along with the adderal?
I don't know. Does your doctor have any experience with this combination? I would also recommend looking into the addition of Mirapex (pramipexole) to Risperdal (risperidone).
> What is the dose of resperidal they use for schizophrenia? much higher? Thanks, Dwight
It is higher. 4mg - 8mg
Risperdal has not been officially sanctioned by the FDA for the treatment of depression and other mood disorders, it is used "off label" successfully for these things. When reading through the drug company's package insert for Risperdal, you will not find an indication for its use in depression. For information regarding the use of Risperdal (risperidone) in schizophrenia, check out the following URL:
http://www.mentalhealth.com/drug/p30-r05.html
I hope I have helped answer your questions.
- Scott
Posted by judy1 on January 15, 2001, at 21:31:44
In reply to Re: SCOTT Resperidone?, posted by SLS on January 13, 2001, at 21:32:12
Hi Scott,
I'm glad you are having success with risperdal- and I find it really interesting that it sedates you. I'm also taking 2mg/day- but in the AM, I find it a very energizing drug. But then if I took adderal I would and have gotten manic. Why do I react in such an opposite way? Thanks, Judy
Posted by SLS on January 16, 2001, at 9:03:08
In reply to Re: SCOTT Resperidone? » SLS, posted by judy1 on January 15, 2001, at 21:31:44
Dear Judy,
Thanks.
> I'm glad you are having success with risperdal
:-) Yeah, it' pretty cool. The improvement is mild at best, but significant because there is any steady improvement at all. Even if I am on the exactly right medications, my doctor reinforced the long period of time, 6 months or more, before I would truly feel well. He said that this is a function of the severity of my depression and the number of years my brain has been operating that way. Slow and gradual. Actually, I can be quite patient when I believe that I am on the right stuff at the right dosages.
I had no problem travelling to NYC on Saturday, and was feeling well enough and confident enough to enter a cafe in an unfamiliar neighborhood alone to wait for someone. I initiated spontaneously conversations with some of the patrons while I waited. It was an experience that I actually ENJOYED. (I almost forgot how to spell that word).
>- and I find it really interesting that it sedates you. I'm also taking 2mg/day- but in the AM, I find it a very energizing drug. But then if I took adderal I would and have gotten manic.
Thanks for writing this. I may try to split up my doses of Risperdal as morning/evening given your reaction to it. Perhaps it is the Risperal (risperidol) that has worsened my insomnia recently. I vaguely recall reading a few other posts where the authors described a similar energizing effect. I may try taking it all in the morning as do you.
> Why do I react in such an opposite way?
I think I have already beaten this word to death, but this is a manifestation of our "heterogeneity". We are all different in one way or another. A population is comprised of individuals with diverse characteristics and hidden traits.
Although these individuals might be almost exactly the same, it may be the relatively small differences between them that lead to the type of opposing effects that are seen between any two individuals taking the same drug. It is the goal of biomedical science to identify and understand the minute details that explain these individual biological differences.
I know you will be disappointed to hear this, Judy, but as unique as you surely are, I doubt you are unique regarding your reaction to Risperdal. At the moment, I am not in one of my explain-the-world-with-a-theory moods, so I'll have to set aside some time before I would offer any guesses for why Risperdal is sedating for some and energizing to others. I think Ativan has dulled my mind. I don't like that.
It sounds paradoxical, but some antipsychotic neuroleptics have demonstrated a potential to induce mania. Zyprexa (olanzapine) is one of them. I think I have seen this with Risperdal and Clozaril (clozapine) also, but my memory is vague on this. Zyprexa is one of the best drugs to control acute severe mania. Yet, it can infrequently cause mania as well. These observations help to demonstrate how different are our individual biologies and underscores the importance of treating them under the premise that they are. I think one of the most frustrating things that can occur is when a patient complains about a certain side effect that the doctor deems as being impossible simply because it is not listed in the PDR or package insert.
Thanks again, Judy. You may have saved me a real complication. I have just started taking Ativan (lorazepam) for sleep because my sleep has been disturbed enough to leave me sleep-deprived on a daily basis. Obviously, I would rather be without it. I'll let you know how things go as I try to change my dosing schedule.
I am sure that I must have asked you this stuff before, so please forgive my withered hippocampus. For what reasons are you taking Risperdal? In what ways does it help you? How did you come to use 2.0mg? What other drugs are you taking?
THANKS!
Sincerely,
Scott
Posted by judy1 on January 16, 2001, at 15:36:02
In reply to Re: SCOTT Resperidone?, posted by SLS on January 16, 2001, at 9:03:08
Hi Scott,
I'm so glad you enjoyed your trip to NYC, it's one of my favorite places. My pdoc told me about half his patients on risperdal find it energizing, so hopefully you'll be able to overcome your insomnia by splitting the dose. I really like the withered hippocampus explanation, do you mind if I borrow it? I'm on lamictal, klonopin and risperdal and HEAVY therapy- but I hardly expect you to remember my drugs since they change all the time. I am on 2mg risperdal because my pdoc is convinced it stabilizes me- when I have psychotic symptoms (auditory hallucinations) I'm on 2mg bid and it really helps. Take care- Judy
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