[splitimage]

I met with my pdoc today to have a serious meds discussion, and we talked about my risperidone. I told him I had very mixed feelings about it, as it's one of the better meds for me, and I'm feeling really good now so I don't want to mess with a combo that's working. But at the same time, i don't like the side effects of risperidone, so I wondered if I'd been on it long enough that the positive effects might be sustainable at a lower dose and could I go down to 2 mg from 3 mg. He thought that was too big a decrease, so wrote me a script for 2.5 mg, which I'm to try and then see him again in 3 weeks.

He agreed with me that this was a good time to be making medication adjustments as I'm in a hospital 5 days a week for rehab and my mood is being monitored daily, so if there's any dip it will be noticed immediately.

One thing I did find odd is he asked if I'd ever considered olanzapine or seroquel. I told him I wouldn't touch olanzapine due to the weight gain profile, and I'd never go on seroquel because everybody I know who is on it, says it turns them into a zombie. He thought that was weird, because risperidone is apparently a lot stronger anti-psychotic, but it's always worked well for me in the past.

So I'm a bit nervous, but looking forward to trying the lower dose.

--splitimage

[Jerrypharmstudent]

HI splitimage

What side effects of the Risperdal are you having that you do not like? Restlessness? etc? Sounds like your doc is a good doc. Decreasing it to 2.5 sounds manageable especially since you are being seen inpatient 5 days/week. Even tho Risperdal dosages seem to be slight because they are "only" a milligram apart, consider them equal to moving from 50mg to 100mg of Zoloft - a pretty big jump.

Az for olanzapine (Zyprexa) and Seroquel - I'm not sure about them being "stronger" antipsychotics or even "better." If Risperdal is what is working for you stay with it. If you are having restlessness or tremors, etc., ask your doc about Cogentin or Primidone. Risperdal, Seroquel and Zyprexa are all pretty equal in their efficacy. All three have weight gain as a side effects - with Seroquel and Zyprexa more so because of their affinity to histamine receptors.

Hang in there and keep us informed!

Jerry

[splitimage]

Hi Jerry,

I've been lucky - I haven't gained weight with the risperidone, but it does leave me with a slight hand tremor, although I'm not 100% sure it's the risperidone as it might just be my combo of meds (I'm on quite a few). But it's not bad enough to justify going on Cogentin.

The main side effect I don't like, is the flattenned affect - even my friends comment on it, and I know it affects me socially and professionally. I got my new driver's licence today & I look like a corpse in it, ok so I was nursing a major infection at the time, but still.

Last night was the first time I took the lowered dose, so I'm feeling kind of funny today - a bit dizzy and a bit like my brain is having an argument with itself. But I get that every time I change doses with either the risperidone or my Naltrexone & it usually only last 3 days. Too soon to tell if I'm feeling any less flat.

[Jerrypharmstudent]

Originally Posted by splitimage

Hi Jerry,

I've been lucky - I haven't gained weight with the risperidone, but it does leave me with a slight hand tremor, although I'm not 100% sure it's the risperidone as it might just be my combo of meds (I'm on quite a few). But it's not bad enough to justify going on Cogentin.

The main side effect I don't like, is the flattenned affect - even my friends comment on it, and I know it affects me socially and professionally. I got my new driver's licence today & I look like a corpse in it, ok so I was nursing a major infection at the time, but still.

Last night was the first time I took the lowered dose, so I'm feeling kind of funny today - a bit dizzy and a bit like my brain is having an argument with itself. But I get that every time I change doses with either the risperidone or my Naltrexone & it usually only last 3 days. Too soon to tell if I'm feeling any less flat.

Hey Splitimage

You know - I wouldn't be surprised if the naltrexone is the cause or adding to the flattened affect. Naltrexone blocks opiates in the reward centers of the brain - so it would make sense that it would make you feel "blah." However, the Risperdal can cause this as well. So you'll have to make small changes and and be patient all the while until you can pick out which is doing what.

Adding a small amount of a stimulant may be an option to help dissipate the mood flattening - but I do not know your diagnosis or if you have tried stimulants in the past.

Keep me updated if you please!

Jerry

[splitimage]

Hi Jerry,

I didn't know that about the naltrexone. I'm going off it too, as soon as my current script runs out. It's too expensive for me to afford, as I don't currently have insurance for meds. I've been on both meds so long, the risperdal longer, that it's hard to remember what caused what when.

My pdoc and I did discuss adding a stimulant last summer, but it turns out it's not an option as I have tachycardia. Just too risky.

splitimage