Anti-psychotics starting to not work?

So my pdoc suspects Psychotic Disorder NOS with me. I have been on Risperidone since October 2008. I started out rather low (0.5 mg once a day) and slowly increased it over the years to 1 mg twice a day about a year and a half ago. After working for that long is it possible for it to start to not work?

I was teaching last semester and almost every afternoon I would hear a group of people talking. I assumed it was the kids and would tell them to be quiet. They would swear no one was talking and I was hearing things. I thought they were pulling my leg since my antipsychotic stopped that over a year ago. But, now I am on summer vacation and I am still hearing groups if people talking some afternoons. So now I am thinking that maybe sometimes it was the kids while other times it was not.

Is it possible that I may need to adjust my medication again? Of course I wouldn't do this on my own, I would talk to my pdoc first.

I just want to know if anyone else has experienced this (medication becoming less effective than it has been in the past).

I just hate admitting things like this to my pdoc because I am always afraid it makes me look crazy.

I am in a similar boat as you. My pdoc just increased my Risperdal because of some mild visual hallucinations starting up again. Voices can be a tricky thing to figure out. If you're hearing groups of people, are the voices faint and hard to make out or are they very clear? Do you have any inherent hearing loss? What you're experiencing might not be hallucinations at all, but could be something called Musical Ear Syndrome.

http://www.hearinglosshelp.com/articles/mes.htm

If this article doesn't quite feel like what you're experiencing, then it may be time to call your pdoc. I know how hard it is to admit that you might be hallucinating - but I look at it this way: would you hesitate in telling your regular doctor about another part of your body feeling unwell? He's your pdoc. He's not going to think you're crazy. If anything, it will make you look responsible and proactive in taking care of your health - and that's nothing to be ashamed about.

Hmm..interesting article. I can't make out what my crowd of people are saying, but they are not faint. It's like being in a crowded room where everyone is talking, loud, but unable to make out conversations. So I kind of fit into both of what the article describes. Hmmm..

Though the article sayas the person is usually elderly, has hearing loss, and tinnitis...none of which describe me. So, I just don't know.

I did find my pdoc's email online last night and emailed him my concerns though, I got a brief moment of courage. So, whenever he checks his email, he will "know". I am better in writing and figured it was easier that way.

I have had a problem with my anti psychotics not working after awhile. They work great for a long time and then when there is a stressor, it stops working and not effective anymore. Also birthdays stop the pills from working for some very weird reason. Even if everything is great in my life, February, May, June, and the worst of all October are my absolute worst months. June is the most mild. Then on top of that when there is a stressor in any month, then I have problems. Basically it works out to about half the year that I have problems and the other months I am symptom free. I also read the article about Musical Ear and some of it fits me because I don't always hear my voices clearly but other times I do and can identify the gender of the voice but I am not ancient or have hearing loss. In fact I hear sounds louder than it should be. I have to hold my ears a lot of the time in crowded places because it literally hurts my ears. I have autism as well so that can be it. Sensory overload. I hear people talking and sometimes I think my annoying brother messes with my mind by saying no one is talking to me. I love him though. I understand what is going on with you because I went through the pills not working a lot of the time but thankfully there are times where it almost makes me normal. Close to it anyways. I hear both faint voices (whispering and hard to make out) to yelling and people threatening to kill me. I also hear my name being called very loudly. Also I hear my brother talking to me a lot of the time I hear him say "Hey schizo come here I have something to show you!" Yes he calls me schizo. Very nice. It was loud and clear. So I have both faint voices and loud and clear voices. I don't really hear music though only once or twice. Its good to talk to your pdoc soon as possible. You might need a med change or them increased. Sometimes my body becomes used to a certain dose of the meds and then it needs to be increased to work.

About a week ago I emailed my pdoc (I found his email last summer in a google search and emailed a concern to which he responded) my concern while I had the courage to admit it to him. He didn't respond this time (or at least not yet anyways). Maybe he is waiting to address it at my appointment on Monday (who knows). I'm kind of scared at what he is going to say now. I'm afraid that he'll want to increase my dosage. I'm afraid of increasing my antipsychotic because I heard they can had bad side effects at higher doses. Why did I have to send that email?

Squirrel, It's good you sent that email.

I have the same worries you are talking about. Actually you sound like me, or I sound like you. If you are worried about increasing the dosage because of side effects, I'd say give it a try first and see, everyone responds differently. You possibly could be one of the people that will not have many side effects.

Second, talk to your pdoc about your concerns with increasing your antipsychotic. I'm pretty stubborn about increases in my antipsychotics as well. But it's ultimately your choice.

Sometimes there are other options, I usually require two antipsychotics at a mid to lower dose.

I would rather add a second than go with a high dose with the first med, because I do get a lot of side effects, I find doing it this way keeps the side effects manageable for me.

I also do not like to admit my psychosis to my pdoc, or anyone else, for the same reason as you, but really that is what pdoc's do. If I'm being logical I know they are not going to think I'm crazy, they understand it from a medical point of view, and are trained to help you through it. Sometimes it helps to remind myself that they hear this stuff all the time, nothing new to them.

And yes, as I just found out, meds can stop working, or if you go on and off and on again they can almost magically not work anymore.

So I had my appointment with my pdoc this afternoon. He said he got my email and then asked what was going on. I told him. He asked if the voices were saying disturbing things. I said I can't make out what they are saying it just like being in a room with a group of people talking.

He suggested increasing my risperidone. I told him that I was afraid of having side effects at a higher dose. He told me that I would still be at what is medically considered a low dosage. So we increased it by 1/2 mg a day. So now instead of 2 mg a day (1 in the morning, 1 at night) I am at 2.5 mg a day (1 in the morning, 1.5 at night). Maybe it will help. Hopefully I won't get any side effects with the dose increase.

The biggest thing I've found with Risperdal is to watch your periods closely. Mine wasn't affected until I got up over 3mg and then it stopped for a few months until the dose was lowered again. The highest dose I was on was 4mg, and I think it can go up to 6mg, so yes, you're still on a low-end dose. I hope it works well for you.