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Re: Really fatigued by risperidone and paroxetine Jaxter99

Posted by SLS on August 9, 2023, at 8:54:36

In reply to Really fatigued by risperidone and paroxetine, posted by Jaxter99 on August 6, 2023, at 19:54:59

Both risperidone and paroxetine tend to be sedating or fatiguing. However, 10 people can react to the same drug in 10 different ways.

Regarding paroxetine, I think it is the SSRI most likely to poop-out. For me, risperidone was one of the most sedating of the antipsychotics.

I have seen reports over the years that imipramine (Tofranil), a tricyclic antidepressant (TCA), was effective for agoraphobia (with panic attacks).

https://pubmed.ncbi.nlm.nih.gov/?term=agoraphobia+panic+attacks+imipramine

However, my guess is that clomipramine (Anafrinil) might be even better, as it is thought to be the most effective drug for OCD. Clomipramine is potent as a reuptake inhibitor of both norepinephrine and serotonin. It's sort of a combination of TCA and SSRI. Its side effects include those of a TCA and SSRI. Its anticholinergic side effects seemed rather strong to me, but certainly bearable. Compared to SSRIs, I think clomipramine is less likely to poop-out.

https://pubmed.ncbi.nlm.nih.gov/?term=agoraphobia+panic+attacks+clomipramine

There are some older studies that looked at using phenelzine (Nardil)O for agoraphobia.

https://pubmed.ncbi.nlm.nih.gov/?term=agoraphobia+panic+attacks+phenelzine


I did not enjoy being on either paroxetine or risperidone.

One last thing. Paroxetine is extremely difficult to discontinue for some people. Withdrawal symptoms can include the typical SSRI withdrawal effects. In addition, you might experience some cholinergic rebound, which makes it even harder. You will need to taper off of it gradually, but your doctor might elect to start imipramine or clomipramine as you near the end of your taper period. However, you cannot begin taking Nardil until two weeks after your last dose of paroxetine.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.

 

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