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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 28. This is the beginning of the thread.
Posted by floatingbridge on August 7, 2011, at 13:09:21
Well, I am tolerating it well so far after being scared half to death about trying it.
My script is for .125mg to .25mg per night. Yesterday I had a whopper bout of dysphoria, (I suppose my worst mood complaint--at least the most painful and unnerving), and took an extra .25mg during the day by splitting it into 1/4's and dissolving under my tongue. It helped :-)
Downs so far are:
Dullness yesterday after I had taken the full extra .25mg. You know, kinda' staring at my supper plate like into space during dinner. But ate and conversed. Much prefered to a clenched stomach or curling up in my bed, crying or hating myself.
Also I fall asleep w/o ambien just fine at night, but wake up after two hours, then take the ambien. Oh well....
Who knows? If I really read the sx profile, I'll probably freak. If my response continues, I may be able to cut back on Xanax use a bit. (No rush to do many changes here, believe me.)
I need to discuss yesterday's extra usage with my pdoc and
come to an understanding of what and how this stuff works and get his consent and advisement.New rx
Emsam 9mg (all that means so far is a much less discreet
looking patch, like huge!)Xanax XR 1mg 2x day
Risperidone .125-.25 mg per night. (Maybe additional as needed?)
Ambien CR :-/
I still dream of monotherapy, but wanting to suffer less beats that desire right now. There is the idea held out by my shrink that if Emsam doesn't cut it, Nardil will come on board. That would, dear lord one hopes, reduce the Xanax usage. If risperidone does not provide enough mood control, there is lithium discussed next.
Posted by Dinah on August 7, 2011, at 14:23:50
In reply to My risperidone response, fourth day, posted by floatingbridge on August 7, 2011, at 13:09:21
Hmmm... I wonder if the Risperdal amplifies the Xanax. It's a nice small dose of Risperdal that shouldn't cause too much sedation.
Do you notice any increased clarity of mind on it? That's one of the things that really struck me. It moved me out of my obsessive loop.
Posted by morgan miller on August 7, 2011, at 16:07:03
In reply to My risperidone response, fourth day, posted by floatingbridge on August 7, 2011, at 13:09:21
FB, of course only time will tell if you start to feel much better on your current regimen.
Have you though about at least taking a trace mineral supplement like the NOW brand, which has 1 mg lithium per dose? Maybe you could take this a few times a day? You never know, it may be somewhat supportive. Most of us probably are not getting enough lithium through our water and diet. It is after all now believed by many to be an essential nutrient.
I'm surprise you guys didn't decide to just go for a low dose of lithium first. Afterall, you could have added a low dose of risperdal to it.
As opposed I am to the out of control polypharmacy that is taking place in current psychiatry, I don't think it's a big deal to be taking 2 or even 3 different meds, especially if one of them is a relatively low dose of lithium, which I don't really consider much of a drug. I guess I'm trying to say that maybe it would help if you were totally o.k. with taking 2, or even 3, different things, especially if you feel that much better. The reason why I cut it off at four is that at this point, most people are ending up on things like atypical antipsychotics and benzodiazepines, both of which I believe end up doing more harm than good in the long run. If it were 4 or 5 drugs that I saw as fairly benign and supportive in the long run, I wouldn't take such issue with all this polypharmacy bullocks.
I only wish you the very best FB : )
Morgan
Posted by morgan miller on August 7, 2011, at 16:08:40
In reply to My risperidone response, fourth day, posted by floatingbridge on August 7, 2011, at 13:09:21
Maybe when you start feeling better you can try a paleo-type diet? It really might help you feel and function even better, really. When you are ready, check out Mark's Daily Apple and Weston A Price Foundation. These websites will be very helpful in guiding you towards better nutrition.
Morgan
Posted by jono_in_adelaide on August 7, 2011, at 17:40:48
In reply to My risperidone response, fourth day, posted by floatingbridge on August 7, 2011, at 13:09:21
You will probably need to gradualy push the risperidone to 0.5-1mg at bedtime. Side effects are pretty much absebt at this doseage (except for the dulness you noticed, which passes off after a day or two)
Posted by emmanuel98 on August 7, 2011, at 18:41:01
In reply to Re: My risperidone response, fourth day, posted by jono_in_adelaide on August 7, 2011, at 17:40:48
Risperdal made me go from feeling panicked, depressed and suicidal to feeling fine within hours. I can't remember the dose I took. I loved it. But it made me gain a lot of weight, so I had to stop it. Not everyone gains weight on these drugs though, so good luck.
Posted by morgan miller on August 7, 2011, at 19:48:46
In reply to Re: My risperidone response, fourth day, posted by emmanuel98 on August 7, 2011, at 18:41:01
> Risperdal made me go from feeling panicked, depressed and suicidal to feeling fine within hours. I can't remember the dose I took. I loved it. But it made me gain a lot of weight, so I had to stop it. Not everyone gains weight on these drugs though, so good luck.
Paleo diet + exercise = minimalized weight gain-at least in theory
Posted by jono_in_adelaide on August 7, 2011, at 19:59:16
In reply to Re: My risperidone response, fourth day, posted by morgan miller on August 7, 2011, at 19:48:46
If you eat too much, you're gonna gain weight, whatever diet you're following.
Take in more calories than you burn = weight gain
I havent found Risperdal causing any weight gain, but I remember years ago taking dothiepin (Prothiaden) and I couldnt stop eating.... if i hadnt stopped the pills, I think I would have exploded
Posted by morgan miller on August 7, 2011, at 22:06:02
In reply to Re: My risperidone response, fourth day, posted by jono_in_adelaide on August 7, 2011, at 19:59:16
> If you eat too much, you're gonna gain weight, whatever diet you're following.
>
> Take in more calories than you burn = weight gainNot necessarily true, differnet foods have different impacts on the body. Grains, sugars, and other carb heavy foods will have more of a negative impact on insuling, which in turn will be more likely to cause an increase in fat.
Check out Mark's Daily Apple, books by Gaury Taubes, and Weston A. Price foundation.
Humans were not meant to consume the grains and and added sugar we've been consuming for thousands of years. And no, we have not adapted to it.
> I havent found Risperdal causing any weight gain, but I remember years ago taking dothiepin (Prothiaden) and I couldnt stop eating.... if i hadnt stopped the pills, I think I would have exploded.
Any drug that makes you want to eat non stop is the wrong drug to be on.
Posted by floatingbridge on August 7, 2011, at 22:31:22
In reply to Re: My risperidone response, fourth day » floatingbridge, posted by Dinah on August 7, 2011, at 14:23:50
> Hmmm... I wonder if the Risperdal amplifies the Xanax. It's a nice small dose of Risperdal that shouldn't cause too much sedation.
>It might do that. Thank you for the observation. I will ask this week.
> Do you notice any increased clarity of mind on it? That's one of the things that really struck me. It moved me out of
my obsessive loop.Clarity of mind. I'm not sure....I am not sure my thinking is organized the way it might be for, say more OCD thought. It's
more like, oh no, oh no.Guess that's a loop, huh? Just not very elaborate. Or insightful.
I am not sure how this will play out. Because the quietness
induced by the risperdone, which is very welcome, somehow does something that may not be good with depression.I will post if I find out anything insightful.
I hope you are feeling well today. Thanks for writing.
Posted by emmanuel98 on August 7, 2011, at 22:54:50
In reply to Re: My risperidone response, fourth day, posted by morgan miller on August 7, 2011, at 19:48:46
This is bull. I didn't consume more calories, but tended to diet on AAP's, since I felt well enough to cotrol my food intake (not that I gained when I was depressed. I tended not to eat and usually lost weight). Also i upped my exercise considerably, from laying in bed all day, to swimming a mile and walking 3-4 miles daily. I still gained 2-3 pounds per week. Most AAPs (risperadone, abilify, zyprexa, seroquel) worked like magic for me as anti-depressants, but caused out-of-control weight gain. My various trials of AAPs made me gain 50 pounds in a year. When I stopped them, I dieted and exercised once my depression was under control with parnate and lost 45 pounds.
Posted by floatingbridge on August 7, 2011, at 23:02:33
In reply to Re: My risperidone response, fourth day, posted by morgan miller on August 7, 2011, at 16:07:03
> FB, of course only time will tell if you start to feel much better on your current regimen.
>
> Have you though about at least taking a trace mineral supplement like the NOW brand, which has 1 mg lithium per dose? Maybe you could take this a few times a day? You never know, it may be somewhat supportive. Most of us probably are not getting enough lithium through our water and diet. It is after all now believed by many to be an essential nutrient.Now has a trace mineral supplement? That could be good. I give my animals trace supplements. I think it helped my young dog refrain from chewing everything up.
>
> I'm surprise you guys didn't decide to just go for a low dose
of lithium first. Afterall, you could have added a low dose of risperdal to it.It was my idea, not his. I brought up risperidone. He then laid out the two tracks in question, lithium or risperidone. His observations on lithium were very positive, but could take
months to show effect in a person presenting with my
symptoms and what I expressly asked him to treat, affective
instability with with marked mood reactivity, that is for me, regular bouts of dysphoria and anxiety. There is some evidence that risperidone (or other similar agents) could help
(not cure) these symptoms, ESP as an adjunct to therapy.I just wanted to try it, Morgan. It's been bad around here,
and I just can't tell anyone how painful my days are. On top of this I am in severe depression. Waiting months or a few weeks pushed my decision. I am certainly tolerating it whereas I did not seroquel nor abilify. I really don't know.
>Who's in love with polypharmacy? I'm not. Even my new doc isn't. The treatments of choice, when I read, for my symptoms are mood stabilizers like lamictal (or lithium) or the newer atypicals. Plus lots of effective therapy. I am trying what I can.
>
> I only wish you the very best FB : )
>I know you do, Morgan. Thanks.
fb
Posted by Phillipa on August 7, 2011, at 23:44:40
In reply to Re: My risperidone response, fourth day » morgan miller, posted by floatingbridge on August 7, 2011, at 23:02:33
FB and you know I do. Love Phillipa
Posted by Dinah on August 8, 2011, at 9:17:58
In reply to Re: My risperidone response, fourth day » morgan miller, posted by floatingbridge on August 7, 2011, at 23:02:33
Tolerating it is a good start. I hope it goes well for you. I think it's always wise to be careful when starting a new medication, but I don't think there's any reason to be more afraid of Risperdal.
I'm not familiar with Seroquel, though I've heard it is pretty sedating. I've always been scared of Abilify because it is "activating". I am terrified of anything with that descriptor. I don't think bad reactions with either of those will necessarily mean a bad reaction with Risperdal.
I have my fingers and toes crossed for you.
Posted by floatingbridge on August 8, 2011, at 9:34:37
In reply to Re: My risperidone response, fourth day » floatingbridge, posted by Dinah on August 8, 2011, at 9:17:58
Thanks Dinah. Abilify was activating. Odd. But felt terrible to me. These medications are really something. It is morning, and I notice that the long half life of the risperidone leaves a good feeling in it's wake. Calmer.
In answer to your question yesterday, yes, there is a mental clarity. I was confused last night because a. It was night and my fatigue and mood worsen, and b. I had just taken the risperidone for the night. It's best effects for me are a number of hours afterwards. Then there is, actually, an break in the looping as you put it.
Thanks for the crossed fingers and toes :-). We all need that for each other, don't we?
Posted by SLS on August 8, 2011, at 10:03:03
In reply to My risperidone response, fourth day, posted by floatingbridge on August 7, 2011, at 13:09:21
> I still dream of monotherapy,
Why?
Polypharmacy might be a desirable treatment modality if it means a reduction in the time necessary to reach remission without side effects.
One day, I hope drugs will be specific enough in their mechanisms of action such that "recipes" of drug admixtures for each individual can be tested for and implemented. This should increase one's chances of responding favorably to treatment with few, if any, side effects.
- Scott
Posted by SLS on August 8, 2011, at 10:09:07
In reply to Re: My risperidone response, fourth day, posted by emmanuel98 on August 7, 2011, at 22:54:50
> Most AAPs (risperadone, abilify, zyprexa, seroquel) worked like magic for me as anti-depressants, but caused out-of-control weight gain.
Geodon and Latuda are supposed to be the only AAPs that are truly weight neutral.
- Scott
Posted by morgan miller on August 8, 2011, at 11:31:33
In reply to Re: My risperidone response, fourth day » morgan miller, posted by floatingbridge on August 7, 2011, at 23:02:33
Hey I don't blame you for trying it and see nothing wrong with it. It's not like you have to take risperdal for the rest of your life. I used Zyprexa for similar reasons, but just wish I had gotten off it sooner.
Hope you feel better soon FB
Posted by floatingbridge on August 8, 2011, at 11:55:04
In reply to Re: My risperidone response, fourth day, posted by morgan miller on August 8, 2011, at 11:31:33
> Hey I don't blame you for trying it and see nothing wrong with it. It's not like you have to take risperdal for the rest of your life. I used Zyprexa for similar reasons, but just wish I had gotten off it sooner.
>
> Hope you feel better soon FBIt's o.k. Morgan, I 'blame' myself, and it is my own personal dream to have a mono therapy. Silly and irrational, yes, but I don't think most people on babble would have checked off the
box on that sheet given each baby at birth, "yes, sign me up for multiple afflictions, and be sure to include polypharmacy as my treatment." I don't remember signing that contract. But if there is the possibilty of help, I will take it and be grateful for what science has to offer to date. Like I said, my
new doc doesn't seem to be real pharma driven. Like why contemplate Nardil right out of the box for me when I don't think there are any reps for that formulation hitting the streets.Besides, he works at a small hospital. I think the reps, if and when they come, leave samples at the larger administrative office. He doesn't have samples in his office, and thank goodness, no pens or post-it pads etc. with medication names on them.
Posted by Roslynn on August 8, 2011, at 16:51:52
In reply to My risperidone response, fourth day, posted by floatingbridge on August 7, 2011, at 13:09:21
Hi FB,
I am hoping the best for you with this new combination of meds. I know it's scary taking new meds or changing your combo. Seems like the meds are having somewhat of an effect, though?
We're all rooting for you-
Roslynn
Posted by floatingbridge on August 8, 2011, at 19:29:18
In reply to Re: My risperidone response, fourth day, posted by morgan miller on August 8, 2011, at 11:31:33
> Hey I don't blame you for trying it and see nothing wrong with it. It's not like you have to take risperdal for the rest of your life. I used Zyprexa for similar reasons, but just wish I had gotten off it sooner.
>
> Hope you feel better soon FBMM
I'm curiuos, if you care to explain a little, why you wish you
had gone off sooner. You may have posted about this somewhere, but I don't recall.fb
Posted by sleepygirl2 on August 9, 2011, at 20:26:20
In reply to Question for Morgan » morgan miller, posted by floatingbridge on August 8, 2011, at 19:29:18
good luck :-)
Posted by floatingbridge on August 9, 2011, at 20:54:23
In reply to just wanted to say.... » floatingbridge, posted by sleepygirl2 on August 9, 2011, at 20:26:20
> good luck :-)
>Thanks sg. How are things your way?
I am noticing that I feel much more irritable at times :-/
I am realizing this now. I don't know if this will pass. I am not sure how long to give this. I finf information on trial time for schizophrenia is 4-6 weeks.
This couldn't give me more stomach distress could it?
I see the doc on Friday. But gosh, I get more irritable later in the day. Pooh. Maybe everyone does. But jeez, this descent is preciptitous (sp?).
That's the trouble with upping one med (emsam to 9mg) at the same time as adding a new one.
Waking up at 3:00am doesn't help either :-/
I'm not asking you, sg. Sorry.
I'm just so moody and quick to complain.
Posted by sleepygirl2 on August 9, 2011, at 21:04:26
In reply to I feel crankier? » sleepygirl2, posted by floatingbridge on August 9, 2011, at 20:54:23
> > good luck :-)
> >
>
> Thanks sg. How are things your way?I'm not so great, but nothing horrendous.
>
> I am noticing that I feel much more irritable at times :-/god, I hate irritability.
> I am realizing this now. I don't know if this will pass. I am not sure how long to give this. I finf information on trial time for schizophrenia is 4-6 weeks.
what's the doc say? does pdoc know about the irritability? sounds important
> This couldn't give me more stomach distress could it?I think you should call your doc if you think you can't wait.
> I see the doc on Friday. But gosh, I get more irritable later in the day. Pooh. Maybe everyone does. But jeez, this descent is preciptitous (sp?).
>
> That's the trouble with upping one med (emsam to 9mg) at the same time as adding a new one.ah, yes, then it's harder to tell too, what's what.
>
> Waking up at 3:00am doesn't help either :-/no, can't be good for the mood
>
> I'm not asking you, sg. Sorry.why?
> I'm just so moody and quick to complain.It's ok. I'm NEVER like that ;-)
>
>
>
>
>
>
Posted by floatingbridge on August 9, 2011, at 21:10:06
In reply to Re: I feel crankier? » floatingbridge, posted by sleepygirl2 on August 9, 2011, at 21:04:26
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