[Lichenme]

I have a diagnosis of bipolar...not sure which one, but am prescribed lamictal - 300mg, prozac - 20mg, and risperdal - 1.5-2mg. However I also take Topamax - 100mg for migraines and toprol XL for HTN. I have tried to wean myself off of the risperdal because I don't like the idea of being on an anti-psychotic...have been on it for about 20months now. When I try to get off of it I have noticed that I become paranoid, see shadows, and become agitated. Is this a withdrawal effect?

[Oxidopamine]

Yes, those are likely withdrawal symptoms. The dopamine theory for schizophrenia suggests there are different dopamine receptors with different affinities for dopamine. As you wean yourself off the anti-psychotic, you may find dopamine levels increase, particularly at the dopamine D2 receptor. Another factor that comes into play is the specific medication. There are different potency levels of risperidone/Risperdal but in general, it can be a moderately potent anti-psychotic, although there certainly are several others that are much, much more potent, particularly your benzodiazapines.

Generally though, doctors are uneasy when a patient is off of their anti-psychotic medication unless they allowed it. Some patients go off of it because some of the side-effects are unpleasant, however, I gather your reason may be different as you said you dislike the idea of being on an anti-psychotic. Can you explain why you dislike it?

[Lichenme]

Originally Posted by Oxidopamine

Yes, those are likely withdrawal symptoms. The dopamine theory for schizophrenia suggests there are different dopamine receptors with different affinities for dopamine. As you wean yourself off the anti-psychotic, you may find dopamine levels increase, particularly at the dopamine D2 receptor. Another factor that comes into play is the specific medication. There are different potency levels of risperidone/Risperdal but in general, it can be a moderately potent anti-psychotic, although there certainly are several others that are much, much more potent, particularly your benzodiazapines.

Generally though, doctors are uneasy when a patient is off of their anti-psychotic medication unless they allowed it. Some patients go off of it because some of the side-effects are unpleasant, however, I gather your reason may be different as you said you dislike the idea of being on an anti-psychotic. Can you explain why you dislike it?

I have gained some weight since being on the risperdal and it has been hard to get it off, even with eating right. I also thought it was only going to be a temporary thing and it has been 20months now, I don't consider this temporary. The reason why I was put on it was for bipolar rapid cycling back in 11/2009. I have been stable since 2/2010 with small med changes. I think that I may be missing my highs a little too.

[Oxidopamine]

Originally Posted by Lichenme

I have gained some weight since being on the risperdal and it has been hard to get it off, even with eating right. I also thought it was only going to be a temporary thing and it has been 20months now, I don't consider this temporary. The reason why I was put on it was for bipolar rapid cycling back in 11/2009. I have been stable since 2/2010 with small med changes. I think that I may be missing my highs a little too.

I should've caught it sooner so my apologies. I looked and prozac and risperdal have an adversive drug-drug interaction on a specific enzyme (CYP2D6). Unfortunately, Toprol XL also uses the same enzyme and is known to interact with prozac in a way that yields greater amounts of Toprol XL's active metabolites than intended. In other words, the interaction causes more Toprol XL to be processed in your body than intended. The overall result would be a greater decrease in blood pressure than desired, so depending how the shadows appear, they could be a product of decreased blood flow but probably wouldn't result in the other symptoms.

I'm a little confused on something. When you mention "highs", do you mean manic or hypomanic symptoms, or simply feeling positive or euphoric drug-like highs? I get the feeling you mean manic or hypomanic highs but I just want to be sure.

Earlier you said you were on risperidone for 20 months, how long have you been weaning yourself off it? Unfortunately, some people do experience weight gain and it doesn't stop the longer you stay on it, however, risperidone probably wouldn't contribute to a reservoir.

[Lichenme]

Originally Posted by Oxidopamine

I should've caught it sooner so my apologies. I looked and prozac and risperdal have an adversive drug-drug interaction on a specific enzyme (CYP2D6). Unfortunately, Toprol XL also uses the same enzyme and is known to interact with prozac in a way that yields greater amounts of Toprol XL's active metabolites than intended. In other words, the interaction causes more Toprol XL to be processed in your body than intended. The overall result would be a greater decrease in blood pressure than desired, so depending how the shadows appear, they could be a product of decreased blood flow but probably wouldn't result in the other symptoms.

I'm a little confused on something. When you mention "highs", do you mean manic or hypomanic symptoms, or simply feeling positive or euphoric drug-like highs? I get the feeling you mean manic or hypomanic highs but I just want to be sure.

Earlier you said you were on risperidone for 20 months, how long have you been weaning yourself off it? Unfortunately, some people do experience weight gain and it doesn't stop the longer you stay on it, however, risperidone probably wouldn't contribute to a reservoir.

I miss the hypomania...definately not the mania. I have attempted to wean myself off a couple of times on my own, trying to go down a half mg every two weeks. Just going down to 1mg I begin noticing the difference in my sleeping and my mood. Going down to half a mg everything intensifies and paranoia sets in and I start to see shadows, sometimes I think I hear my name being called when no one is around. I think that I am going crazy. I know that I am not crazy...it has to be withdrawal from the meds and it's got to be temporary. However I am scared that it is not temporary and that the meds have created a dependence on the drug to maintain it's sanity. I just want off the drug. I feel trapped.

[mgran]

I went off it cold turkey, can't remember what dose I was on. I had to come off it, because my prolactin levels were through the roof. My body thought she was pregnant. As I came of it they put me straight on seroquel, which was a much better drug at the time. Right now I'm trying to come off seroquel, and it's surprisingly difficult.

[Lichenme]

Originally Posted by mgran

I went off it cold turkey, can't remember what dose I was on. I had to come off it, because my prolactin levels were through the roof. My body thought she was pregnant. As I came of it they put me straight on seroquel, which was a much better drug at the time. Right now I'm trying to come off seroquel, and it's surprisingly difficult.

I was on Seroquel before I was placed on Risperdal and all it did for me was made me groggy in the morning. It helped with the mania, but didn't help with the depression. I was intially on 3mg of Risperdal, but like you explained the prolactin levels skyrocketed and my body also thought I was pregnant so they decreased it to 2mg and they dropped back down within a normal range. The Risperdal has helped with both the depression and mania. But I feel like I am ready to get off of it now. With the reading I have done anti-psychotics are for short term use and for the reasons I stated above I want to get off of it.

[Notbipolarafterall]

I don't know about seeing shadows and agitation, but this is what tapering off was like for me, after twelve years of use: severe withdrawal dyskinesia, vomiting, joint pain, insomnia. It was a horrible, horrible experience. try to avoid that crap as much as you can!

[Life's_A_Beach]

When I came off the risperdal a few months ago I didn't find any side effects =/ then again I was only on it for about 3 or 4 months.