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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by schleprock on August 11, 2012, at 14:04:06
After my .5 mgs of Risperidone pooped-out after working wonderfully for 2 weeks on my depression and anxiety, it's time for it to go. I've tried increasing it to .75 two nights in a row I just feel worse. Since I won't be able to speak to my pdoc until monday, I need some "unofficial" advice on how to taper-off. I've been on it aprox. 3 weeks total. First four days .25 mg, .50 mgs after that, .75 mgs (actually, slightly less due to how I cut it.) weds-thurs night, then brought it back down to .50 friday night. Thinking of just going to .25 tonight and see how it goes from there.
I think I may have had a similar experience when trying Lithium, as in the medication going from working to becoming something of a poison. It's a long story, but I had to quit that cold turkey.
I'm wondering if there's a good chance that my chronic symptoms may be related to a dopamine defficiency, since it seems both meds have a negative effect on that of some sort.
God, I feel awful...
Posted by SLS on August 11, 2012, at 15:04:56
In reply to Done with Risperidone, please help., posted by schleprock on August 11, 2012, at 14:04:06
> Thinking of just going to .25 tonight and see how it goes from there.
This is perfectly reasonable and demonstrates prudence. Since I am sometimes imprudent, I discontinued risperidone 1.0 mg/day abruptly (cold-turkey) without adverse effect.
> I'm wondering if there's a good chance that my chronic symptoms may be related to a dopamine defficiency, since it seems both meds have a negative effect on that of some sort.
This is also perfectly reasonable. Have you thought to try Lamictal? It is likely that Lamictal is pro-dopaminergic. Abilify is also a drug that I would consider as an alternative. Actually, both of these drugs might work to increase dopaminergic activity via different mechanisms. Combining them might produce an improvement in depression and anxiety. It is important to consider, though, that the temporary startup side effects of taking Abilify might include anxiety and insomnia. If you can get through the first week, you should be okay.
> God, I feel awful...
:-(
- Scott
Posted by schleprock on August 11, 2012, at 15:49:51
In reply to Re: Done with Risperidone, please help. » schleprock, posted by SLS on August 11, 2012, at 15:04:56
> > Thinking of just going to .25 tonight and see how it goes from there.
>
> This is perfectly reasonable and demonstrates prudence. Since I am sometimes imprudent, I discontinued risperidone 1.0 mg/day abruptly (cold-turkey) without adverse effect.
>
> > I'm wondering if there's a good chance that my chronic symptoms may be related to a dopamine defficiency, since it seems both meds have a negative effect on that of some sort.
>
> This is also perfectly reasonable. Have you thought to try Lamictal? It is likely that Lamictal is pro-dopaminergic. Abilify is also a drug that I would consider as an alternative. Actually, both of these drugs might work to increase dopaminergic activity via different mechanisms. Combining them might produce an improvement in depression and anxiety. It is important to consider, though, that the temporary startup side effects of taking Abilify might include anxiety and insomnia. If you can get through the first week, you should be okay.
>
> > God, I feel awful...
>
> :-(
>
>
> - ScottThanks for the response. I'm currently upping my clonazepam to 1.5 mg day, so maybe that might help with abilify if I go that way. How long were you on the 1mg of Risperidol before you quit, if I may ask.
Posted by SLS on August 11, 2012, at 16:21:41
In reply to Re: Done with Risperidone, please help., posted by schleprock on August 11, 2012, at 15:49:51
> How long were you on the 1mg of Risperidol before you quit, if I may ask.
No more than two or three weeks.
- Scott
Posted by phidippus on August 11, 2012, at 18:33:45
In reply to Done with Risperidone, please help., posted by schleprock on August 11, 2012, at 14:04:06
You can just stop the Risperidone. No need to taper.
Dopamine deficiency would lead to Parkinsons.
What meds are you on?
Eric
Posted by schleprock on August 11, 2012, at 18:58:55
In reply to Re: Done with Risperidone, please help. » schleprock, posted by phidippus on August 11, 2012, at 18:33:45
> You can just stop the Risperidone. No need to taper.
>
> Dopamine deficiency would lead to Parkinsons.
>
> What meds are you on?
>
> EricCurrently on 150 mg of Nortriptyline and 1.5 mg of clonazepam (just added .5 mg). I mention dopamine due to decreased libido over the past years or so. My (pre-risperidone) testosterone levels checked out, and I have reasons to doubt it's due to the meds. I'm also looking a dopamine because I think I've had a similar experience with lithium a while back, which apparently also blocks dopamine.
Keep in mind I've only recently started considering dopamine as a factor in my present condition.
Posted by phidippus on August 11, 2012, at 19:52:09
In reply to Re: Done with Risperidone, please help., posted by schleprock on August 11, 2012, at 18:58:55
Nortriptyline will effect your libido and one of the pharmacological means of treating this is by taking a medication that enhances dopamine. Wellbutrin is a popular choice to treat decreased libido.
Abilify helped me with my libido-it ances dopamine.
Eric
Posted by SLS on August 11, 2012, at 20:13:05
In reply to Re: Done with Risperidone, please help. » schleprock, posted by phidippus on August 11, 2012, at 18:33:45
> Dopamine deficiency would lead to Parkinsons.
Wouldn't that depend on the location of the "deficiency"?
- Scott
Posted by novelagent on August 11, 2012, at 22:52:07
In reply to Done with Risperidone, please help., posted by schleprock on August 11, 2012, at 14:04:06
If you feel like you've been hit by a truck, that's from changing the dosage or not taking it within the same hour each day. After 4 days, that feeling subsides. The best way to avoid feeling that way is fo take Invega Sustenna injections, which you can't forget so much because it's once a month.
Or try Latuda. I've tried Latuda-- it's not cognitively blunting at all. You'll feel quite lucid on it. But again, it takes 4 days of taking it at exactly the same time of day each day before you feel normal... use cell phone alarms to remind yourself when to take it.
> After my .5 mgs of Risperidone pooped-out after working wonderfully for 2 weeks on my depression and anxiety, it's time for it to go. I've tried increasing it to .75 two nights in a row I just feel worse. Since I won't be able to speak to my pdoc until monday, I need some "unofficial" advice on how to taper-off. I've been on it aprox. 3 weeks total. First four days .25 mg, .50 mgs after that, .75 mgs (actually, slightly less due to how I cut it.) weds-thurs night, then brought it back down to .50 friday night. Thinking of just going to .25 tonight and see how it goes from there.
>
> I think I may have had a similar experience when trying Lithium, as in the medication going from working to becoming something of a poison. It's a long story, but I had to quit that cold turkey.
>
> I'm wondering if there's a good chance that my chronic symptoms may be related to a dopamine defficiency, since it seems both meds have a negative effect on that of some sort.
>
> God, I feel awful...
Posted by SLS on August 12, 2012, at 7:36:39
In reply to Re: Done with Risperidone, please help. » schleprock, posted by novelagent on August 11, 2012, at 22:52:07
> Or try Latuda. I've tried Latuda-- it's not cognitively blunting at all. You'll feel quite lucid on it.
People can be very different in their reactions to the same drug. For me, Latuda produced a great deal of cognitive blunting and brain fog. It left me feeling "zombified". Perhaps not surprisingly, I suffered the same reaction to its sister drug, Geodon. These two drugs produced greater cognitive impairments than any of the other APs I have tried.
Damned drugs.
- Scott
Posted by schleprock on August 12, 2012, at 10:52:50
In reply to Re: Done with Risperidone, please help. » schleprock, posted by phidippus on August 11, 2012, at 19:52:09
> Nortriptyline will effect your libido and one of the pharmacological means of treating this is by taking a medication that enhances dopamine. Wellbutrin is a popular choice to treat decreased libido.
>
> Abilify helped me with my libido-it ances dopamine.
>
> EricThe thing is my first 17 or so years on Nortriptyline never affected my libido. From about July 2009 to about July 2011 I was also taking clonazepam and atenolol following an episode with Lithium; that's when the decrease began. For the following eight months I was back on straight Nortriptyline, I expected some increase in libido but it never happened (I think it felt even lower this phase than before), though I felt psychologically well otherwise.
I'm thinking my spontanious relapse back into anxiety\depression (since about april) may have some connection with the libido loss. Perhaps both sharing the same cause. Total symptoms I'm currently experiencing seem consistant with both low testosterone (though I've just had that checked.) and low dopamine.
Posted by schleprock on August 12, 2012, at 11:05:20
In reply to Re: Done with Risperidone, please help., posted by schleprock on August 12, 2012, at 10:52:50
I'd also like to mention that during my time off of clonazepam and atenolol I drank alcohol on occasion (after 2 years of sobriety due to the extra meds) but it seemed to have much less of an effect on me than before, even that very first drink. I wonder if this indicates any deficiency in dopamine production.
Posted by phidippus on August 12, 2012, at 22:16:03
In reply to Re: Done with Risperidone, please help., posted by schleprock on August 12, 2012, at 11:05:20
Why so concerned with dopamine deficiency?
Eric
Posted by phidippus on August 12, 2012, at 22:20:01
In reply to Re: Done with Risperidone, please help., posted by schleprock on August 12, 2012, at 10:52:50
I still don't understand how you've decided low dopamine is what's affecting you.
Eric
Posted by phidippus on August 13, 2012, at 12:26:21
In reply to Re: Done with Risperidone, please help., posted by SLS on August 11, 2012, at 20:13:05
The motor symptoms of Parkinson's disease result from insufficient formation and activity of dopamine produced in certain neurons within parts of the midbrain
Eric
This is the end of the thread.
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