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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Zana on June 1, 2009, at 9:07:10
I am discontinuing the 1mg of resperidone that I take at night because I have no idea why I am taking it. It was prescribed by a pdoc I am not seeing any more.
So, anybody have any experience with this? Any thing in particular that I should watch out for?
I am depressed, no thought disorder or mood instability.
I'm also taking:
seroquel 150mg
remeron 45mg
pristiq 50mg
provigil 200mg (100mg 2x daily)
klonopin 3mg (divided doses)
gabapentin 600mg (300mg 2x daily)Any thoughts will be apprechiated. I'd like to simpify things if I can and resperidone seems redundant with seroquel
Thanks in advance,
Zana
Posted by Zyprexa on June 1, 2009, at 9:53:45
In reply to Discontinuing Risperidone, posted by Zana on June 1, 2009, at 9:07:10
I never had any problems discontinuing risperidone. I just stoped it, cold turky. And went on zyprexa.
Posted by Phillipa on June 1, 2009, at 10:54:31
In reply to Re: Discontinuing Risperidone, posted by Zyprexa on June 1, 2009, at 9:53:45
Zana good question why the resperidone? Two atypicals agree sounds like overkill. Is the Pristiq working? Are you better. Missed seeing you. Love Phillipa
Posted by Zana on June 1, 2009, at 17:59:15
Could I feel crappy after missing one dose last night? Or is it all in my head?
Well, I know it's all in my head but you know what I mean...Zana
Posted by bleauberry on June 1, 2009, at 20:10:05
In reply to RE Discontinuing Resperidone, posted by Zana on June 1, 2009, at 17:59:15
> Could I feel crappy after missing one dose last night? Or is it all in my head?
> Well, I know it's all in my head but you know what I mean...
>
> Zana1mg, right? That is a high enough dose to cause problems stopping, no doubt about it. If you were switching to a different one like Zyprexa maybe, that would likely buffer or prevent any downfall. But to just stop it cold, yeah, you are gonna feel it. Keep in mind, .25mg is powerful to some people, .50mg is powerful, 1mg is unattainable by some people because it is too strong.
I would think it best to taper off it slowly. I don't know if it is tabs or capsules. Either way, it is not hard to customize those doses and step down in dose by maybe .10mg every 4 days or so.
Or just continue with the cold turkey and see how it goes. It might be some short-lived discomfort.
>I am depressed, no thought disorder or mood instability.
I'm also taking:
seroquel 150mg
remeron 45mg
pristiq 50mg
provigil 200mg (100mg 2x daily)
klonopin 3mg (divided doses)
gabapentin 600mg (300mg 2x daily)Any thoughts
Well, you already mentioned it was too many meds. I agree. Remeron is a good antidepressant in studies, but not so much in the real world. I think its improvement of sleep and anxiety accounts for a lot of its numerical goodness when looking at it statistically. For the core depression stuff, I don't think it is very good, and I know I am not alone in that opinion. That said, it is a miracle to a few people. Not you obviously. Maybe keep 7.5mg of it for sleep.
Seroquel. I don't know. I've just rarely seen anybody do real great with it. I think Zyprexa is a much better one in that family, by a long shot.
I would drop the Pristiq and go for the new fibromyalgia med Savella, which happens to be a longtime good antidepressant in 32 countries and the #1 antidepressant in Japan, and helped me when nothing else did including ECT failure. Or, combine a serotonin and a norepinephrine med, like Zoloft+Nortriptyline, Zoloft+Amitriptyline, Celexa+Desipramine, or something along those lines. Pristiq is pretty much just a pure play on serotonin with scant activity on anything else. Savella is designed with the same type of mechanism as Pristiq, except that Savella is much more balanced and unique, having almost equal action on serotonin and norepinephrine and some residual action on dopamine, throughout the entire dose range. It's a great med if you ask me. And its side effect profile is so much more attractive than Pristiq/Effexor. I suspect in 5 years it will be very popular here, as it already is in other countries.
Provigil looks like a keep, unless you don't sense any benefit from. If not, get rid of it. The less work your body has to do in grinding up all this stuff the better. If it is doing a lot of good, keep it. If not, bye bye.
Same with klonopin and gabapentin. Though they are in a cousin sort of way overlapping some functions. Keep whatever is doing significant good. If it isn't doing that, replace it with something else.
I hate it when doctors keep adding one thing on top of a failure on top of a failure and people end up with a long list of meds in their cocktail and they are still sick! I mean, geez. In my thinking, a med has to at least be doing some pretty darn good stuff, though not complete, to add something else to it to make it complete. If it is just doing a little bit, or maybe helping a tiny bit, forget it, move on to something else. Don't keep the losers. They just drag you down and prevent the good meds from shining. You never even know when you've got a good med because the bad ones are drowning it out.
You ask for thoughts, and those are mine, for whatever it is worth. I hope something in there is helpful.
Posted by floatingbridge on June 1, 2009, at 21:15:44
In reply to Re: RE Discontinuing Resperidone, posted by bleauberry on June 1, 2009, at 20:10:05
Hi Bleauberry,
I thought Pristiq was an snri? No?
Candace
Posted by Phillipa on June 1, 2009, at 21:38:49
In reply to Bleauberry Re: RE Discontinuing Resperidone, posted by floatingbridge on June 1, 2009, at 21:15:44
Pretty sure it is a quick google search will supply the answer. Love Phillipa
Posted by bleauberry on June 2, 2009, at 5:28:51
In reply to Bleauberry Re: RE Discontinuing Resperidone, posted by floatingbridge on June 1, 2009, at 21:15:44
> Hi Bleauberry,
>
> I thought Pristiq was an snri? No?
>
> Candace
Barely. Its impact on norepinephrine is very slight. Example:Ratio of serotonin to norepinephrine of 3 SNRIs:
Cymbalta 9:1
Milnacipran (Savella): 1:2.5
Effexor 30:1Through direct and indirect actions, Prozac actually increases norepinephrine and dopamine more than Pristiq does.
Posted by Zyprexa on June 2, 2009, at 11:47:04
In reply to RE Discontinuing Resperidone, posted by Zana on June 1, 2009, at 17:59:15
I feel incredably crapy if I miss just one dose of zyprexa. It usualy convinces me to take it a few hours later.
Posted by yxibow on June 6, 2009, at 14:27:22
In reply to Re: RE Discontinuing Resperidone, posted by Zyprexa on June 2, 2009, at 11:47:04
> I feel incredably crapy if I miss just one dose of zyprexa. It usualy convinces me to take it a few hours later.
Curious, since its half life is longer than Seroquel and its plasma life would cover that blip
-- Jay
Posted by Zyprexa on June 7, 2009, at 22:17:27
In reply to Re: RE Discontinuing Resperidone » Zyprexa, posted by yxibow on June 6, 2009, at 14:27:22
Its only got a 24 hour half life. I just need that dose to start the day and get to sleep.
This is the end of the thread.
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