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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Amanda Slade on February 28, 2000, at 19:54:16
Cam, The pdoc is trying .25 mg of risperdal at bedtime. I have been so sensitive to most other drugs and am wondering if the .25 will cause me to be a zombie? I exercise vigorously everyday and watch what I eat and am concerned about the weight gain. Is this drug used for ADD? What exactly does it do and will I be like one of those mental patients in "One flew over the coo coos nest?"
Posted by Cam W. on February 28, 2000, at 20:07:48
In reply to Cam w RISPERDAL amanda ASAP !!!!!!!!!!!!!!!!!!!!!!, posted by Amanda Slade on February 28, 2000, at 19:54:16
Amanda - 0.25mg is a very low, often effective dose of Risperdal. When Risperdal first came out the were saying titrate the dose up to 8-10mg. In practice we have found that lower doses do work, especially in the elderly (no offence). A 0.25mg dose shouldn't 'zombie you out'. This drug can be used as an effective adjunct in ADD. The weight gain with Risperdal occurs in about 20% of people and it usually causes less weight gain than is seen with Zyprexa and Clozaril. If you are exercising, weight gain shouldn't be an issue. Your exercises shouldn't be affected too much by drowsiness or dizziness (usually). The drugs the used in 'One Flew Over The Cuckoo's Nest' were probably high doses of Chlopromazine, Thioridazine, Chloral Hydrate and Bromide salts (as well as high voltage ECT and lobotomies). Zyprexa should leave you clear headed. I guess, in a nutshell, it is well worth giving Risperdal a trial. - Cam W.
Posted by JohnL on February 29, 2000, at 3:57:35
In reply to Cam w RISPERDAL amanda ASAP !!!!!!!!!!!!!!!!!!!!!!, posted by Amanda Slade on February 28, 2000, at 19:54:16
> Cam, The pdoc is trying .25 mg of risperdal at bedtime. I have been so sensitive to most other drugs and am wondering if the .25 will cause me to be a zombie? I exercise vigorously everyday and watch what I eat and am concerned about the weight gain. Is this drug used for ADD? What exactly does it do and will I be like one of those mental patients in "One flew over the coo coos nest?"
Amanda, if your doc is having you try an antipsychotic, it might make sense to be sure you are on the best one in its class for your unique chemistry. My pdoc has me on Zyprexa. Though I've had a decent response with it, he isn't stopping there. He wants to be sure I'm on the best match. Therefore, he's going to give me one or two week trials of three other antipsychotics to compare them. After comparison, he wants me to pick my favorite to continue. Regardless of how you respond to Risperdal, it might be worth comparing to a few other choices to be sure you are on the best one for you.
Risperdal is one of the ones I will be trying. My pdoc told me it doesn't have the sedation or the weight gain that is common with Zyprexa. It may or may not work better than Zyprexa for me, but he definitely wants to find out before getting too committed to any one drug.
Posted by Cam W. on February 29, 2000, at 7:22:21
In reply to Re: Cam w RISPERDAL amanda ASAP !!!!!!!!!!!!!!!!!!!!!!, posted by JohnL on February 29, 2000, at 3:57:35
Amanda and John - One of our pharmacopsychologists (Scott Purdon) out here is doing CAT scan studies using Zyprexa, Risperdal, and others. He has suggested that Risperdal seems to work better for right frontal brain dysfunction and Zyprexa for left frontal brain dysfunction. I haven't heard any more on this in the past year, but I thought it was an interesting concept. Really, with all the 'less filling - tastes great' fighting that the respective drug company marketers are doing between Zyprexa and Risperdal, I think one should use the medication that works best for them. If the first drug tried takes that edge off enough then stick with it, but if symptoms aren't 'tamed' enough with an adequate trial, try the other. I use to say use Zyprexa first, but after a number of successes on low dose Risperdal, my mind is changing. Disadvantages of these meds: Zyprexa - weight gain, sedation; Risperdal - EPS (at doses above 6mg/day, sedation, prolactin increases (not usuually clinically significant). Also, I believe the best antipsychotic we have is Clozaril but blood tests and paperwork are annoying. It still seems that the more 'toxic' (or more annoying side effects) an antipsychotic is (or has), the better it works. I believe that Zyprexa does work better for someone who is showing more positive side effects or extreme mania, but Risperdal is good for taking the edge off of someone who has fewer psychotic symptoms. Sincerely - Cam W.
Posted by ChrisK on February 29, 2000, at 8:41:30
In reply to Note on Zyprexa and Risperdal, posted by Cam W. on February 29, 2000, at 7:22:21
At one time or another I have taken both of these meds. When I was on Risperdal I was taking 2 mg twice a day. At this level I did feel sedated and chose to drop it as I felt nothing happening after a week. My own experience with the anti-psychotics is that I notice a change within a few days.
Now, I take 7.5 mg of Zyprexa at night. I have found it to be a good augmentation for my AD's. It all comes down to your personal reactions to each drug but the one thing I can say is that you are starting on a very small dose. If you are med-sensitive this will probably be the best route to try.
Chris
Posted by judy on February 29, 2000, at 12:04:29
In reply to Re: Note on Zyprexa and Risperdal, posted by ChrisK on February 29, 2000, at 8:41:30
I was on risperdal at doses from 3mgs-6mgs/day for close to a year. (6mgs for mania). When my pdoc raised the risperdal during a manic episode about 6 months ago, it worsened my akathisia and actually made me more manic which brought in the mellaril. So I was switched to zyprexa after that when experiencing auditory hallucinations- it worked great at 15mgs/day, but I felt somewhat sedated (not as much as mellaril) and put on 10 pounds! in one month. Good luck with whatever you choose.
Posted by Eric on February 29, 2000, at 12:35:04
In reply to Note on Zyprexa and Risperdal, posted by Cam W. on February 29, 2000, at 7:22:21
Cam, what would you say about someone who tried low dose Risperdal...1/2 a mg...in combination with an antidepressant and the Risperdal "blocked" the antidepressant? What causes this? Any ideas? Id like to know what happened to me when I tried this. Other people seem to be able to combine low dose Risperdal/Zyprexa with antidepressants with ease but I never could. What is the deal?
Posted by Cam W. on February 29, 2000, at 15:42:18
In reply to Re: Note on Zyprexa and Risperdal, posted by Eric on February 29, 2000, at 12:35:04
Eric - Risperdal is a serotonin-2 receptor (5-HT2) blocker and the antidepressants (for simplicity sake) are serotonin reuptake inhibitors. The two drugs are acting on two different parts of the serotonin system. Actually, Serzone is an SSRI antidepressant with 5-HT2 receptor antagonism (blockade). This is supposed to decrease the side effects of the SSRI antidepressants and improve sleep. Many people successfully use Risperdal with antidepressants. Also, Risperdal is not an irreversible 5-HT2 binder, so some serotonin signal is being transmitted onto 5-HT2 receptor-containing nerve cells. The older 1st generation antipsychotics sometimes caused what looked like a depression, but these new atypical antipsychotics do not seem to cause them, as much. I am not sure of the mechanism of the relapse to depression after adding Risperdal, but it probably could happen for a number of reasons (eg were starting to relapse and adding the Risperdal didn't stop the relapse from happening). You may have a different set of serotonin receptors (maybe genetic) that react differently when exposed to serotonin or serotonin blockade (eg fewer 5-HT2 receptors than the 'average' person). It is really hard to say why you went into a depression after starting Risperdal. Sorry I cannot help more. - Cam W.
Posted by Eric on February 29, 2000, at 17:07:18
In reply to Re: Note on Zyprexa and Risperdal, posted by Cam W. on February 29, 2000, at 15:42:18
>
> Eric - Risperdal is a serotonin-2 receptor (5-HT2) blocker and the antidepressants (for simplicity sake) are serotonin reuptake inhibitors. The two drugs are acting on two different parts of the serotonin system. Actually, Serzone is an SSRI antidepressant with 5-HT2 receptor antagonism (blockade). This is supposed to decrease the side effects of the SSRI antidepressants and improve sleep. Many people successfully use Risperdal with antidepressants. Also, Risperdal is not an irreversible 5-HT2 binder, so some serotonin signal is being transmitted onto 5-HT2 receptor-containing nerve cells. The older 1st generation antipsychotics sometimes caused what looked like a depression, but these new atypical antipsychotics do not seem to cause them, as much. I am not sure of the mechanism of the relapse to depression after adding Risperdal, but it probably could happen for a number of reasons (eg were starting to relapse and adding the Risperdal didn't stop the relapse from happening). You may have a different set of serotonin receptors (maybe genetic) that react differently when exposed to serotonin or serotonin blockade (eg fewer 5-HT2 receptors than the 'average' person). It is really hard to say why you went into a depression after starting Risperdal. Sorry I cannot help more. - Cam W.Yes, that is exactly what happened. The Risperdal worsened my depression when I added it to the antidepressant Remeron. However, when I just took Risperdal by itself with no antidepressant, the Risperdal improved my depression a little. Not nearly as much as Remeron did all by itself but Risperdal by itself helped a little. But add it to Remeron or another antidepressant and almost immediately the antidepressant effect was blocked and Id be plunged back into depression. This was not oversedation or anything either, but a complete blockage of the antidepressant.
Id just really know what causes it for me. I hear about others combining these meds routinely with great results and I just never saw it for myself.
Eric
Posted by Amanda S on February 29, 2000, at 19:39:28
In reply to Re: Note on Zyprexa and Risperdal, posted by Eric on February 29, 2000, at 17:07:18
Not sure if this drug can be combined with xanax. I could not fall asleep last night after taking risperdal. When I took it today I was heading to a dentist appt. My dentist asked me a question and I just couldn't seem to grasp what he was saying, it was like my mind went off. It was very strange. I didnot feel in control of myself. Is this normal? My pdoc will be disappointed if I quit this one so soon. I am so afraid of gaining weight and feeling wierd on these medicines. I don't even know if I can drink alcohol with this drug or what types of medicines I can take along with it. Does it affect your libido? Ifeel stupid asking my pharmacists since I have asked to many questions about other drugs I have taken and not stuck with. Sometimes I would rather keep taking xanax because of it's calming effect, but I have heard it is habit forming. I was previously taking 0.5 mg. once a day. I just don't understand why my pdoc won't just put me on a antianxiety med. I have always been anxious. I am sick of trying these wierd drugs that don't work and explaining to my pdoc that I just can't take it. My therapist thinks there is some reason I won't stick with these meds. I have told her it is because I don't want awful side effects. She doesn't seem to buy what I am telling her, but I can't seem to tell her anymore than what she wants, she was really wigging me out yesterday. Iwas really lost.
Posted by judy on February 29, 2000, at 20:56:01
In reply to Re: Note on Zyprexa and Risperdal, posted by Amanda S on February 29, 2000, at 19:39:28
If you are just anxious, I don't know why your doc doesn't just increase your xanax either. Giving risperdal to an anxious person (who is not having delusions or hallucinations) is like overkill. Most people who take benzos for anxiety don't increase their dose unless they have addictive personalities (like me). Risperdal can be very energizing- like I said in my earlier post- so I'm not surprised you couldn't sleep. You cannot drink alcohol with it and at the dose you're taking you probably won't have bad side effects, unless you're incredibly sensitive. Maybe it's time for a second opinion. Take care.
Posted by anita on October 8, 2000, at 19:23:03
In reply to Note on Zyprexa and Risperdal, posted by Cam W. on February 29, 2000, at 7:22:21
Hi Cam,
I came across this old post of yours, and was wondering if you had any thoughts about the difference in risperidone and zyprexa's hemispheric effects in regard to depression.
thanks,
anita>
> Amanda and John - One of our pharmacopsychologists (Scott Purdon) out here is doing CAT scan studies using Zyprexa, Risperdal, and others. He has suggested that Risperdal seems to work better for right frontal brain dysfunction and Zyprexa for left frontal brain dysfunction. I haven't heard any more on this in the past year, but I thought it was an interesting concept. Really, with all the 'less filling - tastes great' fighting that the respective drug company marketers are doing between Zyprexa and Risperdal, I think one should use the medication that works best for them. If the first drug tried takes that edge off enough then stick with it, but if symptoms aren't 'tamed' enough with an adequate trial, try the other. I use to say use Zyprexa first, but after a number of successes on low dose Risperdal, my mind is changing. Disadvantages of these meds: Zyprexa - weight gain, sedation; Risperdal - EPS (at doses above 6mg/day, sedation, prolactin increases (not usuually clinically significant). Also, I believe the best antipsychotic we have is Clozaril but blood tests and paperwork are annoying. It still seems that the more 'toxic' (or more annoying side effects) an antipsychotic is (or has), the better it works. I believe that Zyprexa does work better for someone who is showing more positive side effects or extreme mania, but Risperdal is good for taking the edge off of someone who has fewer psychotic symptoms. Sincerely - Cam W.
This is the end of the thread.
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