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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by becksFLA on September 14, 2008, at 22:25:12
I've read a few posts about Risperdal helping with anxiety a bit, but I think I've noticed my anxiety spiking a little bit since being on it a week ago or so. Is this possible?
Thanks
Posted by Phillipa on September 15, 2008, at 0:22:30
In reply to Risperdal CAUSING anxiety?, posted by becksFLA on September 14, 2008, at 22:25:12
Weren't you on a benzo before? Resperidol and anxiety? Need to google that. Phillipa
Posted by Phillipa on September 15, 2008, at 0:25:51
In reply to Re: Risperdal CAUSING anxiety? » becksFLA, posted by Phillipa on September 15, 2008, at 0:22:30
Quick search yeilded this. Phillipa but they continued benzos through the trial.
Adjunctive Risperidone in Generalized Anxiety Disorder: A Double-Blind, Placebo-Controlled Study
Olga Brawman-Mintzer, M.D.; Rebecca G. Knapp, Ph.D.; and Paul J. Nietert, Ph.D.--------------------------------------------------------------------------------
Objective: Although significant advances have been made in recent years in the treatment of generalized anxiety disorder (GAD), many patients remain symptomatic despite ongoing treatment, underscoring the need for adjunctive new treatments to help improve response.
Method: Forty patients with a primary diagnosis of DSM-IV GAD, who continued to experience GAD symptoms despite current anxiolytic treatment of at least 4 weeks' duration, as evidenced by Hamilton Rating Scale for Anxiety (HAM-A) total score >= 18 and Clinical Global Impressions-Severity of Illness scale score of moderate or greater, completed a 1-week screening phase and were then randomly assigned to 5 weeks of double-blind adjunctive treatment with placebo or risperidone at flexible doses of 0.5 to 1.5 mg/day. Patients continued to take their anxiolytics throughout the study. The study was conducted from June 2001 through March 2003.
Results: Adjunctive risperidone was associated with statistically significant improvements in core anxiety symptoms, as demonstrated by greater reductions in HAM-A total scores (p = .034) and HAM-A psychic anxiety factor scores (p = .047) compared with placebo. Although change scores on other outcome variables, including response rates, were higher in the risperidone group, differences did not achieve statistical significance.
Conclusion: Study findings suggest that risperidone at low doses may represent a useful tool in the management of symptomatic GAD patients.
Posted by yxibow on September 15, 2008, at 3:11:44
In reply to Re: Risperdal CAUSING anxiety?, posted by Phillipa on September 15, 2008, at 0:25:51
I assume you mean from this small double blind study that Risperdal was shown to improve anxiety?
As for the prior poster, are you sure it is anxiety and not akathisia, an EPS, a side effect that is the "creepy crawly" feeling of needing to move, personally I would say "straight into a brick wall"?If you've experienced akathisia before, then I'll assume you know what it feels like. It is definitely not anxiety.
Risperdal I think is pretty strong for GAD -- I would assume that lower potency APs would be used, but I suppose at that level the D2 occupancy level is lower so maybe that doesn't differ in comparisons.Its all an individual response thing really to APs and their intensity though I have a personal list of what would be descending orders, as I have posted before, and Risperdal is at the top.
-- best wishesJay
Posted by becksFLA on September 15, 2008, at 8:07:48
In reply to Re: Risperdal CAUSING anxiety? » Phillipa, posted by yxibow on September 15, 2008, at 3:11:44
Phillipa, yes I was on this a long time ago, but didn't notice the anxiety I'm feeling now. I am coming off klonopin still, but I'm sure it wasn't like this before the Risperdal.
Posted by Jeroen on September 15, 2008, at 12:15:22
In reply to Risperdal CAUSING anxiety?, posted by becksFLA on September 14, 2008, at 22:25:12
yes had terribe anxiety on this med
Posted by Justherself54 on September 15, 2008, at 15:25:40
In reply to Re: Risperdal CAUSING anxiety?, posted by Jeroen on September 15, 2008, at 12:15:22
I had anxiety and felt awful on it.
Posted by Phillipa on September 15, 2008, at 19:48:50
In reply to Re: Risperdal CAUSING anxiety?, posted by becksFLA on September 15, 2008, at 8:07:48
Becks why did you decide to quit the benzo? I'd get off the resperidol also. Love Phillipa
Posted by med_empowered on September 15, 2008, at 22:39:57
In reply to Risperdal CAUSING anxiety?, posted by becksFLA on September 14, 2008, at 22:25:12
I'm not really sure why docs keep pushing antipsychotics as "tranquilizers." I mean, it must have worked for someone, somewhere over the past 50+ years, but..there are better options.
Anyway: antipsychotics can (and often do) raise anxiety. They can do this by inducing akathisia (inner restlessness), which varies in severity from mild (at least to the observer) to severe (akathisia apparently drives some people to suicide/homicide).
Then there's the D2 blockade. I read a couple studies where they hypothesized that one reason schizophrenics seem so anxious is b/c of the antipsychotics inducing a hypodopaminergic state...the result can be an increase in anxiety and panic attacks, kind of like what you see in Parkinson's Disease (often the psychiatric symptoms of PD come on before the dyskinetic movements).
Are you feeling apathetic or dysphoric? There's also the "Neuroleptic-Induced Deficit Syndrome," a cluster of problems in mood, cognition, and overall functioning caused by the dopamine-blocking action of antipsychotics.
And finally..there's "Neuroleptic-Induced Dysphoria." This is a common (and commonly ignored) problem in which antipsychotics make people feel unhappy, with the degrees of unhappiness ranging from the relatively mild (apathetic, anxious, etc.) to the severe (depression leading to suicide).I had to take Risperdal for a while and it made my anxiety pretty awful. I'd recommend that you drop the Risperdal and avoid antipsychotics in the future.
Posted by Amigan on September 16, 2008, at 0:26:16
In reply to yup. it happens., posted by med_empowered on September 15, 2008, at 22:39:57
I agree with everything you said, but i wonder if Seroquel is an exception to this?
Posted by med_empowered on September 16, 2008, at 1:08:42
In reply to Re: yup. it happens. » med_empowered, posted by Amigan on September 16, 2008, at 0:26:16
I personally hated seroquel. It gave me akathisia, nightmares, and a terrible drug-induced depression. I've known other people who have had similar reactions, so I'm kind of inclined to think that while Seroquel might be less likely to cause problems than some other antipsychotics, a lot the current Seroquel-pushing that's going on can be chalked up to hardcore marketing, the low levels of observable EPS, and the increasing benzo-phobia of pdocs and general practitioners.
Posted by becksFLA on September 16, 2008, at 8:16:06
In reply to seroquel..., posted by med_empowered on September 16, 2008, at 1:08:42
Posted by Zyprexa on September 16, 2008, at 23:32:32
In reply to yup. it happens., posted by med_empowered on September 15, 2008, at 22:39:57
Zyprexa! Works very well.
Posted by yxibow on September 20, 2008, at 1:17:52
In reply to Re: Some AP's work for anxiety!, posted by Zyprexa on September 16, 2008, at 23:32:32
> Zyprexa! Works very well.
It does... and for some it doesnt.... as my "possible" tardive dystonia (stiffness in legs) has played out. But that's a very rare case -- I think in general Zyprexa and Seroquel have the least EPS for most -- not all people.
Posted by yxibow on September 20, 2008, at 1:29:19
In reply to seroquel..., posted by med_empowered on September 16, 2008, at 1:08:42
> I personally hated seroquel. It gave me akathisia, nightmares, and a terrible drug-induced depression. I've known other people who have had similar reactions, so I'm kind of inclined to think that while Seroquel might be less likely to cause problems than some other antipsychotics, a lot the current Seroquel-pushing that's going on can be chalked up to hardcore marketing, the low levels of observable EPS, and the increasing benzo-phobia of pdocs and general practitioners.
Everybody has a different reaction to atypicals (and typicals -- some typicals are fairly "mild" in EPS, although that is more rare if you study a set of patients, than atypicals). Risperdal at like 1mg caused awful nightmares; Geodon and Abilify both had big time akathisia. But I'm sensitive to akathisia in the descending order of potency of neuroleptics in general. Some people aren't.
No, I don't approve of random use of Seroquel just to not use a benzodiazepine...(I refused Zyprexa and Seroquel when they first came out in the late 90s, but that was when I was much younger, under different circumstances at college in a different town -- just really because I was scared of TD and also because I felt it was unnecessary).... but some anxiety disorders are really much stronger than a benzodiazepine, and something has to switch eventually to an SSRI, TCA, or some other agent because using a benzodiazepine indefinitely as I am unfortunately caught in....(as well as needing Seroquel, which I also don't like... but that's another story, there is use for it in my case to a fair extent)
.... can cause habituation and short term memory loss over the longhaul.
I hope that run-on sentence made some sense...
Sure, for the short (however that can be labeled) term, Klonopin can be very good for social phobia, etc -- but its unknown how long one can stay on one and still feel the "zing" (well actually I never originally felt any zing from Klonopin, it was way too subtle, rather than the PRN use of Xanax or Ativan here and there).-- Jay
Posted by alfbarks007 on January 10, 2014, at 12:29:56
In reply to Re: Risperdal CAUSING anxiety?, posted by becksFLA on September 15, 2008, at 8:07:48
> Phillipa, yes I was on this a long time ago, but didn't notice the anxiety I'm feeling now. I am coming off klonopin still, but I'm sure it wasn't like this before the Risperdal.
I came off klonopin before and it sent me to ER with what I thought was having a heart attack but turned out it was physical muscle pains from the return of the anxiety and the tension I had in my body, it was awful. I literally took a beta blocker to quell the anxiety or maybe a benzo could help you get off it. It was awful getting off it and I would not of made it without the aide of the beta blocker.
Posted by alfbarks007 on January 10, 2014, at 12:31:32
In reply to Re: Risperdal CAUSING anxiety?, posted by Jeroen on September 15, 2008, at 12:15:22
> yes had terribe anxiety on this med
at what dose was your anxiety level? did you stick it out or stop taking it? I'm going up to .5 and taking this FOR anxiety and hearing these things terrify me because I do not want more anxiety
Posted by alfbarks007 on January 10, 2014, at 12:36:55
In reply to yup. it happens., posted by med_empowered on September 15, 2008, at 22:39:57
> I'm sorry I keep asking people if these side effects were/are dose related? No one seems to ever include that info and it is really annoying when someone says they have these terrifying symptoms and maybe they are taking 4, 6 or more mgs and someone (me) is taking only up to a .1 and doesn't have to freak out like she does. Each post I read I want to flush this stuff but been seeing such good benefits with my moods/patience and even my thinking is much clearer but still waiting for some anxiety relief. I'm taking .50 now and I'm staying put for a few weeks before I dare to try to inch my way to the .1 mark.
Can you explain this though: When I increase the dose I get so happy and giddy and full of energy and i feel just so good! Not sure if this is a good thing or a bad thing but I do settle down again but I'm afraid of it because it is not like me..any thoughts?
I'm not really sure why docs keep pushing antipsychotics as "tranquilizers." I mean, it must have worked for someone, somewhere over the past 50+ years, but..there are better options.
>
> Anyway: antipsychotics can (and often do) raise anxiety. They can do this by inducing akathisia (inner restlessness), which varies in severity from mild (at least to the observer) to severe (akathisia apparently drives some people to suicide/homicide).
> Then there's the D2 blockade. I read a couple studies where they hypothesized that one reason schizophrenics seem so anxious is b/c of the antipsychotics inducing a hypodopaminergic state...the result can be an increase in anxiety and panic attacks, kind of like what you see in Parkinson's Disease (often the psychiatric symptoms of PD come on before the dyskinetic movements).
> Are you feeling apathetic or dysphoric? There's also the "Neuroleptic-Induced Deficit Syndrome," a cluster of problems in mood, cognition, and overall functioning caused by the dopamine-blocking action of antipsychotics.
> And finally..there's "Neuroleptic-Induced Dysphoria." This is a common (and commonly ignored) problem in which antipsychotics make people feel unhappy, with the degrees of unhappiness ranging from the relatively mild (apathetic, anxious, etc.) to the severe (depression leading to suicide).
>
> I had to take Risperdal for a while and it made my anxiety pretty awful. I'd recommend that you drop the Risperdal and avoid antipsychotics in the future.
>
>
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