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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by busub on August 17, 2016, at 9:48:27
Hi all, I started a low dose of Risperdal about 6 days ago, 0.5mg/day to augment my antidepressant. I'm on paxil, so my pdoc wanted to keep my dose nice and low due to the med interactions between the two. At any rate, since starting my sleep has improved greatly as I was previously unable to sleep through the night. Last night I slept 8 hours straight!
However, I have been feeling kind of spaced out, and foggy headed. Also, it seems that at night I feel anxious, as if the med isn't working as well at night (I'm taking for treatment resistant depression/anxiety). My mood isn't terrible but I'm not necessarily happy if that makes sense. I also feel a little groggy in the mornings.
Is this a normal reaction? Will it pass? If so, when can I expect a return of my feelings/emotions? Also, will the grogginess dissipate?
Thanks all!
Posted by Christ_empowered on August 17, 2016, at 15:52:59
In reply to Risperdal... feeling weird, posted by busub on August 17, 2016, at 9:48:27
hi. .5mgs is a low dose of risperdal, but...its still a neuroleptic.
risperdal is the less "atypical" atypical. It tends to elevate prolactin, sometimes a whole lot. Weight gain, metabolic problems; higher rates of twitches, tremor, long term movement problems.
Having said that...low doses do help a lot of people with mood problems.
Your reactions to risperdal may or may not get better. Doctors will usually tell you to stick it out for however long and then see how it goes. Sometimes, they'll throw additional medication(s) your way for the adverse reactions.
Neuroleptics--aka major tranquilizers, aka antipsychotics--tend to flatten emotions. They often cause problems with concentration and sedation. Sometimes, they cause akathisia, which is a sense of inner restlessness. Akathisia can be mildly unpleasant, or it can drive violent behavior.
Sometimes other add on drugs can do what low dose atypicals do, without as many problems. Buspirone and remeron come to mind. I think they're both also cheaper than risperdal.
Neuroleptics do help some people with depression. That's been the case ever since Thorazine came out. Some people just can't tolerate them, even at low doses.
If risperidone helps, but the adverse effects are too much, you might consider a different neuroleptic. A lot of the newer ("atypical") ones are generic now, so cost is less of an issue. Sometimes the older ones help at low doses, too...and a lot of those are super cheap. At low doses, the older ones often get the job done with less weight gain, diabetes, etc.
I hope this helps.
Posted by busub on August 17, 2016, at 19:01:50
In reply to Re: Risperdal... feeling weird, posted by Christ_empowered on August 17, 2016, at 15:52:59
Thanks, I've tried many things already to include buspar and mirtazapine as augmentors without success. Same with some of the other atypicals such as ziprasidone, aripiprazole, quetiapine and asenapine. I got a allergic reaction to ziprasidone, while asenapine and quetiapine were much too sedating. I got a VERY robust response to aripiprazole, however I couldn't handle the amount of insomnia and constipation it caused. I'm hopeful that Risperdal is a good middle ground between sedation and activation with the same robust result.
It would be faster for me to list AD's that I haven't tried which are vilazodone, pristiq and a handful of TCA's and the MAOI's. I've also exhausted the majority of augmenting strategies: wellbutrin, remeron, T3, buspar, various AC's, lyrica and now the AAP's. Still have to try the typicals and olanzapine, which I'm keeping in my back pocket as a last resort due to the metabolic issues that can result.
Posted by linkadge on August 18, 2016, at 20:31:25
In reply to Re: Risperdal... feeling weird, posted by busub on August 17, 2016, at 19:01:50
Hey Busub,
I'll share a slightly more optimistic view.
Risperdal acts very strongly at the 5-ht2a receptors (much more than dopamine d2). Blockade of 5-ht2a receptors is what leads to the sleep improvement of Risperdal. By taking low doses, you can avoid / reduce dopaminergic side effects.
You may even find that it improves your sleep at less than 0.5mg.
How much paxil are you taking? You could try taking the Risperdal earlier in the evening to reduce daytime effects. Also, you may need to adjust your paxil dose (up or down).As a side note, I just did a post on the herb feverfew (it is typically used for migraines). It blocks 5-ht2a like Risperdal, and may give you a similar sleep improving effect with fewer side effects. May be worth a shot.
Either way, I think that you should adjust (to some extent) to Risperdal side effects.
Linkadge
This is the end of the thread.
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