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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by lostforwards on October 24, 2004, at 11:28:47
I went on Lithium and Risperidal 2mg at night in the first hospital for 1 week, then seroquel 300mg for the 2nd week. I then left the hospital, quit the seroquel and stayed on lithium. I had extreme insomnia and would always wake up confused. I also had a dry mouth a lot of the time, including parkinsonian. Other than that I felt fine.
In the second hospital, while still experiencing those symptoms I was given a low sedative dose of phenothiazine to sleep at night and Risperidal IN THE MORNING. The dose was put up as high as 3mg. I'm thinking I could've just taken the risperdal at night.
I then developed difficulty breathing, eps in my fingers, and muscular rigidity. Plus I couldn't sleep well without the phenothiazine.
Now after quitting the meds, 3 weeks later, I'm still going through anhedonia and apathy. I'm also having difficulty sleeping, waking up every 2 or 3 hours with a dry mouth and rigidity.
Did taking the Risperdal in the morning along with the phenothiazine at night make any huge difference in the treatment?
Posted by Eljakeo25 on October 24, 2004, at 12:15:00
In reply to does this story sound strange, posted by lostforwards on October 24, 2004, at 11:28:47
I take 2mg Risperdal for controlling my impulsivity and anxiety related with it. I ALWAYS take risperdal at night. Your mood will be brighter during the day than if you would take it in the morning. Thats the best advice I could give you on the Risperdal.
Posted by jboud24 on October 24, 2004, at 16:00:19
In reply to does this story sound strange, posted by lostforwards on October 24, 2004, at 11:28:47
What are you asking here lostforwards? You have posted on the boards about your experience with risperdal, and several people have given you good advice. I will take one more stab at this to try and help you out.
Anti-psychs, especially risperdal and the phenothiazines, can cause the symptoms you have described. If you are still taking the risperdal, quitting it will more than likely get rid of the symptoms. It won't be pleasant to withdraw, but it's never pleasant to withdraw of off anything. Alternately, you could try to cut the dose back to .25-.5 mgs. 3mgs was a very high dose of risperdal IMHO, particularly if your body was not used to having a neuroleptic in it. Taking the med at night is a good idea. Lowering the total dose of neuroleptics would probably be your best bet at significantly reducing the symptoms of EPS and TD.
You should know that you MAY peranately have problems with EPS and TD the rest of your life, but you should also know that you most likely will not. Given time, reduction in dose, or both, all of your symptoms will probably go away. But if you really need help, you need to go and see a doctor. This may sound disagreeable, but a physician is the only person that can treat the problems that you are experiencing. They have worked with patients before with the same issues, and they can and will help you with yours. If you don't have a good psychiatrist to go to, then it would be in your best interest to find one. If you go to one and don't care for him, then you can go to another one.
I know it may seem like you cant get rid of these problems fast enough, but you need to take action on this, as difficulty breathing and extra-pyramidal symptoms are very serious.
I wish you good luck,
Justin
Posted by lostforwards on October 24, 2004, at 19:01:33
In reply to Re: does this story sound strange, posted by jboud24 on October 24, 2004, at 16:00:19
Most of the eps, besides the eyebrow twitch is going. Though I did an experiment by taking 0.5mg Risperidal once and had difficulty breathing again and my arms stopped swinging. That eventually went away in a day or two.
What I'm worried abous is that the anhedonia and apathy might last for a long time ( months to years ). I heard from someone else who'd been taking 3mg throught the day for 6 months that developed withdrawal symptoms a lot like mine after they quit. I don't believe they were negative symptoms of their illness either. In my case it couldn't be, I'm bipolar but don't have depressive phases.
Posted by jboud24 on October 24, 2004, at 19:34:37
In reply to long term(?) changes after use of AP, posted by lostforwards on October 24, 2004, at 19:01:33
Lostforwards,
My suggesstion would be to switch anti-psychotics from risperdal to seroquel and see if that helps. Seroquel will not induce those side-effects of EPS or TD or NMS in you. It is quite sedative though, and you may gain some weight, although not as bad as zyprexa would be.
Do you take a mood stabilizer for BP? If not consider depakote, gabitril, or lyrica(not available in US yet). They are the best IMHO.
A benzodiazepine would help reduce anxiety and cycling, perhaps Ativan or Librium would help in that respect. It would also lessen the anti-psychotic side-effects, although you would be highly unlikely to get any on Seroquel.
A dopamine agonist would likely help with the involuntary movements, and decrease the anhedonia. Consider Mirapex(pramipexole), Requip(ropinirole), and Permax(pergolide) for the DA agonists.
Finally, all of the meds I have listed are safe in combination. You could combine Seroquel, Mirapex, Ativan, and Depakote for example.
I hope you feel better soon,
Justin
Posted by lostforwards on October 24, 2004, at 20:24:38
In reply to Re: long term(?) changes after use of AP, posted by jboud24 on October 24, 2004, at 19:34:37
Thanks for your help. Though I used to get by on lithium alone, no anhedonia. I'd either be normal or hypomanic. I'd like to know if the AP has screwed me over by 'causing some long lasting change in my brain. I'm not keen on taking the dopamine agonists nor do I think my doctor would every prescribe them. I'm taking lamictal and lithium and lamictal is doing nothing for me. This is all after being on that dose of Risperidal the other doctor put me on.
This is the end of the thread.
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