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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 linkadge on November 17, 2005, at 18:55:03
Mother is taking lithium 900 and risperdal 2mg.
Her mood is mainly depressed, and she has some bad nausia which is causing significant impairment.
My question is weather the risperdal might be causing the depression or the nausia.
Linkadge
Posted by Emily Elizabeth on November 17, 2005, at 19:17:34
In reply to mother is not doing well - lith risp side effects?, posted by linkadge on November 17, 2005, at 18:55:03
I don't know very much abt risp, but I have had lots of nausea from Li. It is actually a pretty unique type of nausea--one that is pretty hard to describe. Sick to my stomach and and lots of tummy growling and rumbling. My pdoc actually mentioned that such unusual tummy trouble is not uncommon w/ Li. In good news, my nausea went away a week or two after I started it. (It comes back if I increase the dose, but then goes away again).
Best,
EE
Posted by Phillipa on November 17, 2005, at 22:42:54
In reply to Re: mother is not doing well - lith risp side effects? » linkadge, posted by Emily Elizabeth on November 17, 2005, at 19:17:34
Link, what happened to her trying an older antipsychotic like the stelazine? Fondly, Phillipa
Posted by med_empowered on November 18, 2005, at 0:30:41
In reply to Re: mother is not doing well - lith risp side effects?, posted by Phillipa on November 17, 2005, at 22:42:54
Risperdal is more old-school style than the other atypicals so..I imagine that you'd have more of a problem with possibly pushing bipolar into depression, which was pretty common with the old meds. I know she's been stable on lithium forever, but have you considered a different mood-stabilizer? Depakote or Tegretol/Trileptal might be able to do the trick with fewer problems (especially if you opt for Trileptal). You could also add Lamictal for depression. It also seems like a low-dose, mildly sedating atypical might be helfpul...like Zyprexa+metformin (to prevent metabolic problems). Risperdal is kind of rough, so you could probably reduce the EPS/TD risk by switching to a "cleaner" atypical. Good luck!
Posted by linkadge on November 18, 2005, at 10:38:11
In reply to Re: mother is not doing well - lith risp side effe, posted by med_empowered on November 18, 2005, at 0:30:41
She was on depakote for a while with ok results. Tegretol was a disaster, she said it just made her depressed period (she tried to kill herself on tegretol so they swiched her back to lithium).
Coming of lithium is not an option. I think maybe going back on depakote might be an idea, and then dropping the risperdal.
Linkadge
Posted by ed_uk on November 18, 2005, at 15:55:49
In reply to mother is not doing well - lith risp side effects?, posted by linkadge on November 17, 2005, at 18:55:03
Hi Link
Am I right in thinking that your mother was doing ok on Mellaril? Certainly better than she is at the moment?
Ed
Posted by linkadge on November 18, 2005, at 17:52:12
In reply to Re: mother is not doing well - lith risp side effects? » linkadge, posted by ed_uk on November 18, 2005, at 15:55:49
Yes she was doing better on the mellaril.
Linkadge
Posted by ed_uk on November 19, 2005, at 8:27:38
In reply to Re: mother is not doing well - lith risp side effects?, posted by linkadge on November 18, 2005, at 17:52:12
Link,
AFAIK, your mom was on Mellaril for many years. The abrupt withdrawal of Mellaril was disasterous for her. Mellaril's withdrawal symptoms can be particularly bad. On top of that, she will have lost any benefit that Mellaril was providing.
IMHO, your mom would do best on one of the older sedating antipsychotics - something similar to Mellaril. Chlorpromazine (Largactil) would be the logical first choice. Many patients in the UK who were formerly taking thioridazine (Mellaril) were switched to chlorpromazine when Mellaril was withdrawn. Your mom could get a prescription for the 25mg chlorpromazine tablets.
Perhaps you could suggest to your mom's pdoc that she might do better on something similar to Mellaril - she was much more stable on Mellaril.
Drugs most similar to Mellaril.......
Chlorpromazine (Largactil)
Periciazine (Neuleptil)
Levomepromazine (Nozinan)Largactil would be the logical first choice. It is considerably more familiar to most pdocs than the other two drugs.
Kind regards
Ed
PS. Some 'brands' of generic thioridazine may still be available in Canada.......
Posted by linkadge on November 19, 2005, at 8:58:00
In reply to Re: mother is not doing well - lith risp side effects? » linkadge, posted by ed_uk on November 19, 2005, at 8:27:38
We wanted to try an older one, but it was the hospital that put her on a newer one, regular doctor is hesitant to change anything.
Linkadge
Posted by ed_uk on November 19, 2005, at 9:08:25
In reply to Re: mother is not doing well - lith risp side effects?, posted by linkadge on November 19, 2005, at 8:58:00
Link,
Why not ask her pdoc to switch her medication when she next has an appointment?
Ed
This is the end of the thread.
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