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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by twinch on August 10, 2007, at 18:35:44
Im currently taking 4 mg of Risperdal. I have been on this dosage for 6 months for my bipolar. I still have mental fogs. My thoughts are mixed up. I can't get my words out straight (saying something before I think about it). It does help tremendously with my violent thoughts and violent images. Could I be on too high of a dosage which is causing the mental fog and mixed thoughts? Should I try another antipsychotic? I have tried seroquel but couldn't handle the side effects. I also tried geodon and was lethargic. Is abilify any good?
Thanks :)
Posted by med_empowered on August 10, 2007, at 22:15:42
In reply to Riserdal Dosage, posted by twinch on August 10, 2007, at 18:35:44
OK, here's the thing: antipsychotics aren't really good for your brain. They block D2 receptors (and the "atypicals," like risperdal, also block some serotonin) which can help calm you down but...long-term, its not going to do your intellect any good.
The good thing is that with bipolar, you can usually avoid (and should avoid, if at all possible) long-term antipsychotic use. Its like this: bipolar treatment centers on a mood-stabilizer which *can* be an antipsychotic, but could also be something safer, like lithium, depakote, trileptal, tegretol, lamictal (a combo of any of the above...). This helps control mania, and the dosage can be lowered after a manic episode to keep everything even without making you stupid.
When problems pop up (depression, anxiety, hypomania/mania, agitation, insomnia, whatever) other meds can be added. So, you might be on 1200mgs/trileptal and start feeling manic: THEN your doc could add in Risperdal, calm you down, and then taper off the antipsychotic. See what I'm saying?
Personally, I'd ditch the antipsychotic and see about a more standard mood stabilizer long-term. If you start having psychosis or something, you can add in an antipsychotic for a little while and then when it simmers down you can get off of it but..there's no reason if you're bipolar to rely on an antipsychotic, when you can use other drugs w/o the risk of tardive dyskinesia.Good luck.
Posted by infectedmushrooms on August 11, 2007, at 0:59:56
In reply to Re: Riserdal Dosage, posted by med_empowered on August 10, 2007, at 22:15:42
risperdal srews up hormones also so I caution you with that drug...I am still struggling with hormonal side effects a year and a half off the drug and I took it for 3 months...Everyone is different of course...I also took it with ssris which made it worse probably...I would personally consider a more safer alternative that doesn't so heavily target the pituitory and D2 receptors...It seems any atypical is safer than risperdal as risperdal is unsafer than even older typical psychotics like haldol which is in the exact same famility and is an isotope derivitive of risperdal that is not even as powerful as risperdal.....risperdal just makes you a zombie so you can't think at all and the long term effects even a few months imo can be devastating...It makes you lactate as well which is disgusting..I would suggest you talk to your doctor about a different drug...go to askapatient see the reviews and see how its not such a wonder drug...IMO ask around not just mine opinion risperdal is one of the unsafest drugs on the market today..The label also says 6 weeks is the suggested max time one should be on it if im not mistaken although that is grossly ignored....I would suggest any drug med_empowered suggested as they are much safer to the brain in comparison and the effects won't wear off as quick b/c of less damage being done and you should have good results.....especially the dose you are taking seems kind of high if you are bipolar...I would even suggest some benzos as well if you haven't gone that route either...Also make sure you get blood work done while on and off the drug and tell your doctor if you have any sexual dysfunction b/c risperdal has the potential to cause pituitory tumors and devastating hormonal side effects in some people sometimes after quitting the drug that take who knows how long to go away...Discuss these things with your doctor and if you go off the drug make sure the taper is always slowly and under the supervision of a medical professional.
Posted by Phillipa on August 11, 2007, at 11:59:44
In reply to Re: Riserdal Dosage, posted by med_empowered on August 10, 2007, at 22:15:42
Med thanks for explaining the disease so well I think I finally got it on the antipsychotics. Again thanks. Love Phillipa
Posted by nellie7 on August 11, 2007, at 14:11:01
In reply to Re: Riserdal Dosage, posted by infectedmushrooms on August 11, 2007, at 0:59:56
Hi Infectedmushrooms,
The side effects you describe sound really bad. May I ask what kind of hormonal problems you suffer from and what dose you were on?
TIA,
Nellie.
Posted by twinch on August 11, 2007, at 16:48:12
In reply to Re: Riserdal Dosage, posted by med_empowered on August 10, 2007, at 22:15:42
I tried coming off the risperdal at one point in time, but my mania sypmtoms came right back (violent thoughts and images). I have heard that lithium is supposedly the most potent mood stabilizer. How could a benzo help with the mania? Do they have the same effects that antipsychotics do?
Thanks :)
Posted by infectedmushrooms on August 11, 2007, at 18:26:06
In reply to Re: Riserdal Dosage » infectedmushrooms, posted by nellie7 on August 11, 2007, at 14:11:01
> Hi Infectedmushrooms,
>
> The side effects you describe sound really bad. May I ask what kind of hormonal problems you suffer from and what dose you were on?
>
> TIA,
> Nellie.I was on risperdal probably for about 3 months total at about 1mg for a couple weeks to 2mg to maybe up to 4mg or 6mg max...I took this concurrenly with zoloft 200mg and for a few days I couldn't get out of bed the physical pain and anxiety was so bad so I took it with wellbutrin as well...I know risperdal was the main culprit not to say the impact the other drugs I took concurrently with it didn't have a synnergic effect....Currenly my testosterone is that of a 90 year old man about 300 free bioavailable and someone my age should be 800-1200 any given time of day which I am sure I had before... and my prolactin hovers around high...I don't have a baseline to compare what it was before the drugs...Lets just say these drugs can do a job on your hormones...I believe i have drug induced secondary hypogonadism due to the drug...I never get waking erections anymore in fact I get zero erections when before I couldn't control them i was so horny... and now I am 22 and its going to be a long road ahead of me to recover...I'd like to meet someone that was on risperdal for a 3 months or more at 3-4mg for several months and got their baseline sex drive back upond discontinuation...I don't think it is possible for it to happen with some sort of regenesis and alteration of neurotranmitters....If the dose was .25-.5 the effects of the drug are completely different as the affinity towards d2 receptors is not apparent...And i have read could increase testosterone...So it is more of a dose dependent thing for this to have occured i believe...I am currently talking with a top psychiatrist at University of Penn about this issue who has connections at penn labratories and actually what I said to him was confirmed and plausible with researchers he contacted with...I think l-glutathione stores in the brain play the biggest role in recovery from this....
Posted by Jay_Bravest_Face on August 11, 2007, at 19:15:14
In reply to Re: Riserdal Dosage )) med empowered, posted by twinch on August 11, 2007, at 16:48:12
> I tried coming off the risperdal at one point in time, but my mania sypmtoms came right back (violent thoughts and images). I have heard that lithium is supposedly the most potent mood stabilizer. How could a benzo help with the mania? Do they have the same effects that antipsychotics do?
>
> Thanks :)I think your Risperdal dose is fine if it is working for you. Just ask your doctor to test your 'prolactin' level occasionally, as Risperdal can increase this. Another option (but you have to weigh the benefits/consequences) is to take a slightly smaller dose of Risperdal with a small dose of another antipsychotic.(Could be a typical or an atypical. If atypical, (i.e. Zyprexa) keep an eye on your blood sugar). Risperdal does have a good, safe track record. I cannot tolerate the usual 'mood-stabilizers' (i.e. depakote/Epival, Lamictal) A benzo could very well help as an 'add-on' too, but not as a single coverage med.
Best,
Jay
:)
Posted by med_empowered on August 12, 2007, at 10:29:58
In reply to Re: Risperdal Dosage » twinch, posted by Jay_Bravest_Face on August 11, 2007, at 19:15:14
if mania is the problem, then focus on an anti-manic agent; Lithium is a classic. YOu can combine it with other drugs; the lamictal+lithium combo, for instance, is apparently pure gold for some people, so it might be worth a shot.
Benzos help control agitation and anxiety and (usually) reduce hostility, kind of like a low-dose antipsychotic. In bipolar disorder, they can be used long-term or periodicially, as needed, to control problems that pop up (anxiety, insomnia, etc.).
Antipsychotics pretty much suck...they can give you tardive dyskinesia, tardive akathisia, impair concentration, so on and so forth...my advice would be to avoid them, b/c long term use could harm you.
Posted by nellie7 on August 12, 2007, at 12:40:22
In reply to Re: Riserdal Dosage, posted by infectedmushrooms on August 11, 2007, at 18:26:06
Sorry you are suffering such side effects. I hope your condition will improve with time.
Take care,
Nellie.
Posted by infectedmushrooms on August 14, 2007, at 16:57:11
In reply to Re: Riserdal Dosage » infectedmushrooms, posted by nellie7 on August 12, 2007, at 12:40:22
I have no doubt it will thanx....I am planning on getting back my sex drive 100% to what it was when I lost it at 21 anything less is unacceptable to me....Trial and error attitude adjustments and a few other things I need to work on should get me there...
> Sorry you are suffering such side effects. I hope your condition will improve with time.
>
> Take care,
> Nellie.
This is the end of the thread.
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