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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Dinah on October 7, 2004, at 7:47:19
I've been taking Risperdal far more often lately than usual. Usually I take one or two every month or two. But I've been very agitated lately and I find Risperdal works well as a more potent tranquilizer when Klonopin doesn't cut it, so I've been taking it frequently for the past three weeks.
Last night I woke up to find myself biting the very very tip of my tongue. It hurt, but I couldn't wake up enough to stop biting. I couldn't wake up enough to wake up my husband for help. I couldn't move. I'm not sure how long it was, or what happened to end it. But when I woke up this morning, the very very tip of my tongue was sore and numb, and if I looked very closely, you could see two (one far more pronounced than the other) approximately tooth edge sized spots where the taste buds are cut.
I experienced sleep paralysis on Neurontin. It didn't feel exactly the same, but I'm guessing that's what this was, and I'm wondering if it's something I should mention to my pdoc.
I am in absolute terror of losing the Risperdal. He pulled me off the Neurontin immediately when I reported the sleep paralysis. If I lose the Risperdal, I'm not quite sure how I'm going to get through what is shaping up to be a very difficult period in my life, and is appearing to get even more difficult.
Posted by Ritch on October 7, 2004, at 10:31:05
In reply to Could it be the Risperdal?, posted by Dinah on October 7, 2004, at 7:47:19
> I've been taking Risperdal far more often lately than usual. Usually I take one or two every month or two. But I've been very agitated lately and I find Risperdal works well as a more potent tranquilizer when Klonopin doesn't cut it, so I've been taking it frequently for the past three weeks.
>
> Last night I woke up to find myself biting the very very tip of my tongue. It hurt, but I couldn't wake up enough to stop biting. I couldn't wake up enough to wake up my husband for help. I couldn't move. I'm not sure how long it was, or what happened to end it. But when I woke up this morning, the very very tip of my tongue was sore and numb, and if I looked very closely, you could see two (one far more pronounced than the other) approximately tooth edge sized spots where the taste buds are cut.
>
> I experienced sleep paralysis on Neurontin. It didn't feel exactly the same, but I'm guessing that's what this was, and I'm wondering if it's something I should mention to my pdoc.
>
> I am in absolute terror of losing the Risperdal. He pulled me off the Neurontin immediately when I reported the sleep paralysis. If I lose the Risperdal, I'm not quite sure how I'm going to get through what is shaping up to be a very difficult period in my life, and is appearing to get even more difficult.Hi Dinah, haven't talked to you in quite a while. I think you mentioned something about tongue biting with respect to Risperdal before. It sounds like it is probably the culprit, but if it is helping a lot and "the very difficult period" isn't a too lengthy thing, maybe it would be better to add something just before you go to sleep that might stop it. What about an anticholinergic like 25mg of Benadryl at bedtime? I've found it reduces the restlessness I get from SSRI meds. It's good for EPS symptoms-maybe the tongue thing will dissappear? --hope this helps--
Posted by tabitha on October 7, 2004, at 13:13:15
In reply to Re: Could it be the Risperdal? » Dinah, posted by Ritch on October 7, 2004, at 10:31:05
I get sleep paralysis a lot, from meds, or from no meds. I never thought it was a health concern-- just unpleasant, so I'm surprised to hear a doc would take you off a med because of it. If you're worried about hurting your tongue, maybe get one of those dental bite guards that prevent tooth grinding. Mine covers the front teeth completely-- it would certainly minimize the damage of any tongue biting.
Posted by Sad Panda on October 7, 2004, at 13:49:15
In reply to Could it be the Risperdal?, posted by Dinah on October 7, 2004, at 7:47:19
Hi Dinah,
It maybe Risperdal, how much do you take?
Have you ever tried any TCA antidepressants? Some of them provide anxiety relief the same way the Risperdal does (5-HT2A Antagonism).
Cheers,
Paul.
Posted by zeugma on October 7, 2004, at 14:28:22
In reply to Could it be the Risperdal?, posted by Dinah on October 7, 2004, at 7:47:19
hi Dinah,
you know sleep paralysis is a symptom of narcolepsy. It is actually a manifestation of cataplexy- intrusion of REM atonia into a period not appropriate to it. Stimulants combat the fatigue and sleepiness narcoleptics constantly feel, but for the other synproms of the 'narcoleptic tetrad'- cataplexy, and hynogogic hallucinations- AD's such as imipramine or desipramine are called for. It appears to be NE reuptake inhibition that is the specific property associated with anti-cataleptic medications, others than Xyrem, whose method of action is not familiar to me. I found that Klonopin, because it blocks slow-wave sleep, induce cataleptic symptoms. I would think that Risperdal, because it blocks DA receptors, would aggravate cataplexy too because it would contribute to the loss of monoaminergic tome. Neurontin as a GABA enhancer would also cause the excitatory monoamines which hold REM in check (primarily norepinephrine, but also serotonin, although I do not understand the current practice, as canvassed by looking through narcolepsy forums, of prescribing SSRI's to narcoleptic patients. They control the cataplexy to some extent, but are less effective than noradrenergic meds in controlling the symptoms.).
The dilemma you face, as I understand it, is that TCA's increase your anxiety. I am no MD, but I would think that Klonopin is better from a side-effect standpoint than Risperdal, as it does not induce movement disorders (which I believe narcoleptics are particularly vulnerable to, due to the weakness of the aminergic systems). Other than that- sleep hygiene, getting adequate sleep every night. I had a hypnagogic hallucination last night, due to getting too little sleep this week, and it has upset my entire system, digestive included (left work early due to IBS flareup). I doubt any of this has been helpful but I'm feeling terrible thanks to narcolepsy complications as well and need to vent.
[end note: grammar and spelling mistakes left unedited because I'm feeling awful.]final question: do you notice that in the day following an attack of sleep paralysis, nothing feels 'right'? I am all jangled.
-z
Posted by linkadge on October 8, 2004, at 18:42:13
In reply to Re: Could it be the Risperdal? » Dinah, posted by zeugma on October 7, 2004, at 14:28:22
Posted by zeugma on October 8, 2004, at 20:36:40
In reply to what is sleep paralysis (nm), posted by linkadge on October 8, 2004, at 18:42:13
sleep paralysis is where you are awake but unable to move. often is it accompanied by vivid dream imagery or sensations. it is considered a dissociative state because two states normally exclusive (dreaming and waking consciousness) are simultaneously present.
-z
Posted by Dinah on October 9, 2004, at 9:02:00
In reply to Re: Could it be the Risperdal? » Dinah, posted by zeugma on October 7, 2004, at 14:28:22
Thank you for that. It ties the whole thing together. Why I experienced it on Neurontin, and now Risperdal, and how it probably isn't just the meds, but an interplay between how the meds work with some inborn propensities. It also explains why my sleep doctor thought my sleep paralysis was a sign of narcolepsy even though it only occurred on a medication.
It's hard to say how I felt the day after, since the day after was pretty screwed up.
It hasn't happened since, but I think I'm trying to solve the problem by not sleeping. (rueful smile)
Posted by Dinah on October 9, 2004, at 9:04:10
In reply to Re: Could it be the Risperdal? » Dinah, posted by Ritch on October 7, 2004, at 10:31:05
Not unless it happens a lot. The benefits outweigh the downside right now.
Thanks for being there when I was worried about a new weird side effect.
Posted by linkadge on October 9, 2004, at 17:45:39
In reply to Yeah, I think I won't let it bother me, posted by Dinah on October 9, 2004, at 9:04:10
I had this on zopiclone. It was perhaps one of the scarriest things I have had happen to me.
Linkadge
This is the end of the thread.
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