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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 Deb200 on April 2, 2005, at 14:55:57
I am in a very agitated state..unable to focus, excessive worry, obsessive thoughts...my doc just put me on risperidone, 2 mg 2x per day. I also just started lithium for bipolar. He thinks lithium will negate the need for the risperidone once it kicks in. What is anyone's experience regarding risperidone for anxiety? And/or lithium...how long did one need to take it before it started having an effect...thanks
Posted by jay on April 5, 2005, at 18:14:40
In reply to risperidone and lithium, posted by Deb200 on April 2, 2005, at 14:55:57
> I am in a very agitated state..unable to focus, excessive worry, obsessive thoughts...my doc just put me on risperidone, 2 mg 2x per day. I also just started lithium for bipolar. He thinks lithium will negate the need for the risperidone once it kicks in. What is anyone's experience regarding risperidone for anxiety? And/or lithium...how long did one need to take it before it started having an effect...thanks
>Risperidone is a very good drug for mixed-states with bad anxiety. You may find the risperidone works better than the lithium, so make sure you keep track and tell your doctor.
Good luck..
Jay
Posted by Deb200 on April 6, 2005, at 13:05:06
In reply to Re: risperidone and lithium » Deb200, posted by jay on April 5, 2005, at 18:14:40
Thank you for replying.
Posted by barbaracat on April 6, 2005, at 13:25:51
In reply to risperidone and lithium, posted by Deb200 on April 2, 2005, at 14:55:57
Dear Deb,
I too have agitated depression and obsessive worry that was finally diagnosed as bipolar mixed states disorder. Lithium has made a tremendous difference in my life. After over 20 years on every imaginable antidepressant, suffering miserably and getting worse, I can truly say that, although not perfect, my life is now measured Before Lithium and After Lithium. The ONLY down side is that it's my my hypothyroidism worse, but as long as I keep on top of my thyroid meds, it's fine. It can also put on weight (this is also true of the antipsychotics which are even worse weight gainers) but it's given me an incentive to move my butt more.I've also been on Zyprexa and Seroquel, both with and without lithium and did NOT like them. We're all different and some find that these antipsychotics work like a charm for the agitated hell. For me, I felt dopey and more depressed. I since found out I don't do well on meds that have a strong anti-histamine component, like the antipsychotics do. Instead of agitated and depressed, I feel dulled and depressed.
So I'm a very enthusiastic fan of Lithium, although I'm not a typical user of it. I take it in a very small dose - 600mg - which works just fine. But I have to dig my heals in and refuse to raise that dose based on the 'therapeutic window'. You will most likely be pressured by your doc to have blood tests and reach a therapeutic level, but this level is not appropriate for everyone and too much can cause severe problems.
Lithium also has neuroprotective properties and helps grow new dendrite connections, actually heals instead of suppressing. Lithium augments serotonin and will boost whatever med you're currently on. So, even if you need to stay on risperadol, lithium will make the ride smoother and you'll require less of your other meds.
If it were me, I'd start with 450mg extended release and see how it goes before slowly raising it. This small amount is enough for some people and there's really no hurry to push it too fast. The full effect takes about 3-4 weeks, but you will feel a calming and smoothing within 3 days, definitely in 1 week.
If you decide to try Lithium, I urge you to listen closely to your body and not allow the dose to be raised any higher than you know is enough. You may feel some tremors and nausea and tiredness and peeing alot the first week of every dose increase, but if this persists past the second week, it's too much. Too much too fast is what gives Lithium a bad rap and it's a shame cause for those who respond to it, it's a true miracle drug. Plus, it's cheaper than dirt cause it's a natural element. Good luck and keep me posted. - BarbaraCat
> I am in a very agitated state..unable to focus, excessive worry, obsessive thoughts...my doc just put me on risperidone, 2 mg 2x per day. I also just started lithium for bipolar. He thinks lithium will negate the need for the risperidone once it kicks in. What is anyone's experience regarding risperidone for anxiety? And/or lithium...how long did one need to take it before it started having an effect...thanks
>
Posted by Deb200 on April 7, 2005, at 14:24:02
In reply to Re: risperidone and lithium » Deb200, posted by barbaracat on April 6, 2005, at 13:25:51
> Dear Deb,
> I too have agitated depression and obsessive worry that was finally diagnosed as bipolar mixed states disorder. Lithium has made a tremendous difference in my life. After over 20 years on every imaginable antidepressant, suffering miserably and getting worse, I can truly say that, although not perfect, my life is now measured Before Lithium and After Lithium. The ONLY down side is that it's my my hypothyroidism worse, but as long as I keep on top of my thyroid meds, it's fine. It can also put on weight (this is also true of the antipsychotics which are even worse weight gainers) but it's given me an incentive to move my butt more.
>
> I've also been on Zyprexa and Seroquel, both with and without lithium and did NOT like them. We're all different and some find that these antipsychotics work like a charm for the agitated hell. For me, I felt dopey and more depressed. I since found out I don't do well on meds that have a strong anti-histamine component, like the antipsychotics do. Instead of agitated and depressed, I feel dulled and depressed.
>
> So I'm a very enthusiastic fan of Lithium, although I'm not a typical user of it. I take it in a very small dose - 600mg - which works just fine. But I have to dig my heals in and refuse to raise that dose based on the 'therapeutic window'. You will most likely be pressured by your doc to have blood tests and reach a therapeutic level, but this level is not appropriate for everyone and too much can cause severe problems.
>
> Lithium also has neuroprotective properties and helps grow new dendrite connections, actually heals instead of suppressing. Lithium augments serotonin and will boost whatever med you're currently on. So, even if you need to stay on risperadol, lithium will make the ride smoother and you'll require less of your other meds.
>
> If it were me, I'd start with 450mg extended release and see how it goes before slowly raising it. This small amount is enough for some people and there's really no hurry to push it too fast. The full effect takes about 3-4 weeks, but you will feel a calming and smoothing within 3 days, definitely in 1 week.
>
> If you decide to try Lithium, I urge you to listen closely to your body and not allow the dose to be raised any higher than you know is enough. You may feel some tremors and nausea and tiredness and peeing alot the first week of every dose increase, but if this persists past the second week, it's too much. Too much too fast is what gives Lithium a bad rap and it's a shame cause for those who respond to it, it's a true miracle drug. Plus, it's cheaper than dirt cause it's a natural element. Good luck and keep me posted. - BarbaraCat
>
>
>
> > I am in a very agitated state..unable to focus, excessive worry, obsessive thoughts...my doc just put me on risperidone, 2 mg 2x per day. I also just started lithium for bipolar. He thinks lithium will negate the need for the risperidone once it kicks in. What is anyone's experience regarding risperidone for anxiety? And/or lithium...how long did one need to take it before it started having an effect...thanks
> >
>
>I can't thank you enough for taking the time to write so much. He started me on lithium at 450 mg, twice a day (so 900 mg daily). I have been on it a week, was starting to feel a little better, but crashed and burned last night. Is this normal? Why would I feel a bit better, then slide back? I have been on it one week. The agitation was as bad as ever last night. I don't like taking the risperidal, it really makes me feel spaced out, and doesn't help too much w/ the anxiety. I feel such fear and total incompetence, it is more horrible than any depression. He has not mentioned blood tests yet, although I see him tomorrow.
Thank you again. It is comforting to hear that it worked for you. I am just confused as to why I have taken a turn for the worse....
Deb
Posted by barbaracat on April 8, 2005, at 10:35:22
In reply to Re: risperidone and lithium, posted by Deb200 on April 7, 2005, at 14:24:02
>>He started me on lithium at 450 mg, twice a day (so 900 mg daily). I have been on it a week, was starting to feel a little better, but crashed and burned last night. Is this normal?
**How do you mean 'crashed and burned'? What were you feeling? Is there a life event that's creating difficulties? Be thankful you were feeling some benefit from it. That's a good sign for being on it for so short a time. It may be your doc will need to adjust your med combo with an antidepressant. You might ask him for an anti-anxiety benzo.
I agree, risperidal stinks and is not my drug of choice so therefore, I don't take it. If I'm feeling agitated, I'll take a valium or Xanax anyday over an anti-psychotic.
Have you had your thyroid checked and other hormones? That's been a huge piece for me. Since my thyroid was adjusted and I'm on the right dose of bioidentical hormones, I feel physically better than in years.
It does seem to go in starts and fits so don't get too discouraged about backsliding. It takes some time to adjust things to be just right. Take heart that lithium seems to be kicking in. Perhaps you could discuss going off risperidal and taking something else for anxiety and agitation. There seems to be this thing lately with pdocs prescribing anti-psychotics. Some people do well on them. Sounds like you're like me - I feel WORSE on them. There are other things you could be taking. Keep me posted. - BarbaraCat
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