![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by chris2011 on October 16, 2012, at 12:05:39
I started taking Risperdal a couple of days ago for OCD and am dealing with a few uncomfortable side-effects. Thought I'd see if I could get some feedback here to see if it's worth a trial. For the past two days since I started taking it I've been very irritable/agitated and have had trouble thinking clearly, especially when conversing with others. Are these SE's that will go away? If so, after how long? I can't go more than one week. The only positive I've noticed so far is a slightly improved mental libido, something I haven't had for a few years now. That's definitely a positive but wouldn't warrant a continued trial.
I'm only taking 1.25mg as I am hypersensitive to most meds. I'm also taking 2.5mg Lexapro and 1gm Clonazepam. I've been diagnosed with major depression (although could be dysthymia), OCD, and generalized social anxiety disorder. The OCD and SAD are the most problematic for me.
My gut tells me to stop now with the Risperdal and not waste my time with it but I thought I'd see if anybody here has some insight. Any info would be greatly appreciated.
As a sidenote, I'm considering a Parnate trial if the Risperdal doesn't pan out. My social anxiety is pretty severe and I've heard Parnate can help with OCD as well as the SA.
Posted by phillipa on October 16, 2012, at 12:37:36
In reply to Risperdal side-effects, posted by chris2011 on October 16, 2012, at 12:05:39
Have you tried luvox? For the ocd? If not the new time release could be an option for you. If now psychotic why resperidol? If my gut says stop I do but that is me. Phillipa
Posted by Chris2011 on October 16, 2012, at 14:54:01
In reply to Re: Risperdal side-effects » chris2011, posted by phillipa on October 16, 2012, at 12:37:36
I tried Luvox a few years ago and couldn't tolerate the sides. Worked well for the ocd but made me feel like a zombie. I've also tried Anafranil, which also is very effective for the ocd, but makes my social anxiety much worse and wipes out my already poor libido. My pdoc prescribed Risperdal to augment the Lexapro for the ocd & depression. I think she's also of the opinion that my social anxiety borders on paranoia (as far as an intense feeling of being judged by others). I don't really agree with her on this. Intense hypervigilance like I have is a hallmark symptom of SA and can be easily confused with psychosis. This is why I'm considering an maoi like Parnate, which can be effective for both SA and ocd. I know there's also Nardil, but Parnate has a better side effect profile from what I've read.
> Have you tried luvox? For the ocd? If not the new time release could be an option for you. If now psychotic why resperidol? If my gut says stop I do but that is me. Phillipa
Posted by Christ_empowered on October 16, 2012, at 15:35:15
In reply to Re: Risperdal side-effects, posted by Chris2011 on October 16, 2012, at 14:54:01
why not up the klonopin to 2mgs/day? that's a fairly standard dose. I wouldn't take an off label neuroleptic, especially risperdal.
Posted by jono_in_adelaide on October 16, 2012, at 17:38:43
In reply to Risperdal side-effects, posted by chris2011 on October 16, 2012, at 12:05:39
The dose is quite high to start with, I'd try 0.5mg for a week, then 1mg for a week, then see
The dose of lexapro is too low to do anyting - the minimum theraputic dose is 10mg, and in OCD you'll likely need 20..... taking 2.5mg is like taking a quater of an aspirin when you have a headache.
Posted by phillipa on October 16, 2012, at 20:37:11
In reply to Re: Risperdal side-effects, posted by jono_in_adelaide on October 16, 2012, at 17:38:43
Guilty:( Phillipa
Posted by Chris2011 on October 16, 2012, at 21:57:40
In reply to Re: Risperdal side-effects, posted by jono_in_adelaide on October 16, 2012, at 17:38:43
Whoops, I meant .125mg of Risperdal. I am incredibly sensitive to all the psychotropic meds I've ever tried. There are a small percentage of people that respond to subtherapeutic doses of meds, just like some respond to incredibly high doses of meds. I've tried 10,15,20mg of Lexapro a few weeks at a time and only ended up severely agitated and anxious. SSRIs in high amounts do not work for me. 2.5 of Lex seems to somewhat stabilize me. I do appreciate your response though!
> The dose is quite high to start with, I'd try 0.5mg for a week, then 1mg for a week, then see
>
> The dose of lexapro is too low to do anyting - the minimum theraputic dose is 10mg, and in OCD you'll likely need 20..... taking 2.5mg is like taking a quater of an aspirin when you have a headache.
Posted by Chris2011 on October 16, 2012, at 22:03:44
In reply to Re: Risperdal side-effects, posted by Christ_empowered on October 16, 2012, at 15:35:15
Thanks for the response. For some reason, whenever I take an individual dose of klonopin more than .25mg I feel agitated and apathetic. I've tried varying dosages and the .25mg 4x/day is what I can tolerate.
> why not up the klonopin to 2mgs/day? that's a fairly standard dose. I wouldn't take an off label neuroleptic, especially risperdal.
Posted by jono_in_adelaide on October 16, 2012, at 22:36:36
In reply to Re: Risperdal side-effects ))Christ_empowered, posted by Chris2011 on October 16, 2012, at 22:03:44
Sorry, hope my last post wasnt rude
Could you try clomipramine, start off at 12.5mg at bedtime, and slowly build up to a dose that is effective or as high as you can tolorate
Klonopin has a reputation as a heavy hitting benzo, could i suggest changing to Librium 5-10mg 2-3 times a day, you'll find it much genteler
Posted by Chris2011 on October 16, 2012, at 23:44:50
In reply to Re: Risperdal side-effects ))Christ_empowered, posted by jono_in_adelaide on October 16, 2012, at 22:36:36
jono, Your post wasn't rude at all.. I hope my response didn't seem defensive: ) You're absolutely right in that it would make sense to increase the dose of lexapro. I'm just one of those rare slow metabolizers unfortunately: / I like your suggestion of low dose clomipramine. I think it's a good choice as I'm pretty desperate for relief from the ocd and 12.5mg has worked for me in the past. I just have to learn to cope with the side-effects from it.
I think I might switch to librium (or possibly valium?) as well. I've been wanting to taper off klonopin completely and librium sounds like a good alternative. Thank you for the suggestions. Much appreciated!
> Sorry, hope my last post wasnt rude
>
> Could you try clomipramine, start off at 12.5mg at bedtime, and slowly build up to a dose that is effective or as high as you can tolorate
>
> Klonopin has a reputation as a heavy hitting benzo, could i suggest changing to Librium 5-10mg 2-3 times a day, you'll find it much genteler
Posted by jono_in_adelaide on October 17, 2012, at 1:35:27
In reply to Re: Risperdal side-effects jono_in_adelaide, posted by Chris2011 on October 16, 2012, at 23:44:50
Also, the side effects of clomipramine fade over time, so while you might start off at 12.5, you might be able to get to say 50 over a couple of months.
I sugested Librium over Valium because it is more slowly adsorbed, and has to be converted to an active metabolite before it takes effect, so it hits you much more slowly, hence fewer side effects
Posted by phidippus on October 20, 2012, at 16:56:05
In reply to Risperdal side-effects, posted by chris2011 on October 16, 2012, at 12:05:39
>I'm also taking 2.5mg Lexapro and 1gm Clonazepam
According to the APA's treatment algorithm for OCD, the first line of defense is ERP. If there isn't enough response to exposurre therapy, an SSRI is recommended for treatment.
Here's the deal. People with OCD have lower levels of serotonin in the brain. To treat this defecit of serotonin, antidepressants are prescribed to increase those levels. Antidepressants recommended by the APA are: SSRIs, Effexor, Mirtazapine and Clomipramine.
Once an AD regimen is established and there are still symptoms, augmentation is recommended with atypical antipsychotics and glutamate antagonists.
Typically, those with OCD have an over active nucleus accumbems and an atypical antipsychotic can help lower dopamine levels in this part of the brain, lessening OCD symptoms.
One problem I see already is your less than therapeutic level of Lexapro. 40 mg is the recommended treatment dose for OCD.
Risperdal isn't going to help you much if you aren't taking an adequate dose of AD.
>I've been diagnosed with major depression (although could be dysthymia), OCD, and generalized social anxiety disorder. The OCD and SAD are the most problematic for me.
First off, you need to be on an adequate dose of AD to tackle all these issues. 2.5 mg of Lexapro is sub therapeutic.
>My social anxiety is pretty severe and I've heard Parnate can help with OCD as well as the SA.
Parnate and most other MAOIs are not recommended for the treatment of OCD. Studies show MAOIs are inadequate in treating the condition.
Eric
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.