My wife has been in the process of changing from Risperidone (1mg morning and 3 mg evening) to Aripiprazole. Because she had high Prolactin levels. With disastrous results. At the moment she has disturbed sleep at night, the voices keep her awake. Has unusual behavior, does not want to socialise or leave the house and spends a lot of time in a trance-like state in discussion with the voices. We gradually introduced the Aripiprazole and reduced the Risperidone over a three month period, at present she is on 20 mg of Ariprazole in the morning and 2mg of Risperidone at night. We are in contact with the psychiatrist who says we must give the medication time to work. But I am at my wits end my wife is impossible to live with. I would be interested in your experiences and opinions. She was reasonably normal before the change of medication, she had voices but we could manage our lives.
I currently take 900mg of lithium and since I began years ago, I've taken it all at dinner.
My current pdoc has changed the dosing, with 300mg at breakfast and 600mg at dinner.
Since I started this new scheme, I feel off. I've been very snippy with my husband and am having trouble being productive. We just bought a new house and I'm not helping at all between hiring the painters and cleaners and packing up so we can be out of the rental by the end of the month. I also have a big event coming up next weekend, and I've started to think I should cancel it since I'm having so much trouble trying to get ready.
Folks on lithium, how many times a day do you take it, and when?
Anyone else have these issues when moving it around?
Will try to sum up shortly the nature of my problem:
- Jun'17. Big family tragedy. Got nervous, could barely sleep at night (3-4 hours daily max.), lost appetite. Used simple herbs-based anti-axiety pills to calm myself. No big impact.
- Jul'17. Nervousness continues, sleepless nights, poor appetite. Added other more potent natural pills (as I live in Germany - Neurexam). Took Stillnox (aka Zolpidem) as sleeping aid. To no avail. To calm down took 1 single pill of Laif 900 (Saint John's Wort, SJW). My anxiety paradoxically increased even further. maybe because I drank juices (which is not advisable with SJW).
As my nervousness continued went to doctor, who prescribed escitalopram 10 mg per day (in the morning). To be on the safe side, took half of the pill (i.e. 5 mg), immediately felt unwell (sweating, heart palpitations, giddiness). Took char coal to wash the pill out. As I did not know what an antidepressant is (thought it to be a sort of anti-anxiety / sleeping pill), took 2.5 mg before sleep for the next 2-3 days. My agitation got worse. In retrospect I think that I provoked a mild serotonin syndrome, given that I took escitalopram soon after taking SJW. My body was shaking, trembling, I was not able to control my hands. Neede even to call sick from work. Got strange suicidal thought which I had never had in my life. Did not know this state was provoked by pills. I somehow foolishly decided that because of my insomnia and malnutrition, my brain started to die off.
Dropped escitalopram. Got electric splashes in my head. Panicked. Did not know it was a side effect of escitalopram withdrawal. Was afraid that my brain was harmed beyond repair and decided to commit suicide by jumping from the balcony. My relative held me tight, but I somehow managed to drop him on the floor and get loose. Panicked that I harmed my relative. I called ambulance but they came not alone but with ... police (apparently neighbors called them as I shouted a lot). Was not able to understan what was going on, tried to jump off the balcony in the presence of doctors / cops. Was hospitalized in the ward involuntarily.
- Aug'17. Spent 14 days in the ward on 4 mg risperidone (aka risperdal) daily in pill form + tranquilizer (lorazepam).
After this "treatment" did not feel well. No thoughts, no emotions, personality erased. Dropped risperidone cold turkey.
Was not able to sleep for a week. Went to private psychiatrist. He reinstated risperidone at 1 mg ( I went from 1 mg daily to 0 within 1 month) + gave lerivone (mianserin) 15 mg as antidepressant for sleep.
Have been on various doses of mianserin (from 15 mg up to 45 mg and then progressively down to 0) from September to December (i.e. 3 months). Dropped the last 5 mg cold turkey.
Since Dec'17 - drug free. Though my initially poor thinking / no thoughts etc has dramatically improved (thanks God), I still suffer from a symptom which first appeared somewhere in mid November: genital numbness, loss of sexual interest, decrease in libido. I found out it is PSSD.
My questions are as follows, to which I would kindly ask to help me:
1. Why is this impotence? What is the more likely culprit: risperidone or mianserin. I ask as I have read that SSRI / SNRI are the most likely culprits of PSSD, whereas mianserin is actually used to treat it (with varying success though).
2. How can it be cured?
3. Has anyone experienced reduced eyesight (increased myopia) on antipsychotics / antidepressants and will the issue resolve itself?
Thank you very much in advance for your kind help !!!!
I've been on a low dose of risperidone (currently at 0.75 mg) for a little under a year now to keep racing and intrusive thoughts down. I have GAD, OCPD and some OCD traits, and the only other med I'm on is venlafaxine 225 mg, also for about a year. OCPD makes my thoughts regarding how much I can accomplish in a day go completely out of control and I end up working myself to the point of breakdown. The risperidone slows me down enough that I can consider if what I'm thinking is reasonable. It's been a blessing to me. As I mentioned, it also has reduced my intrusive thoughts enormously, as well as my ruminations.
I ran out of pills yesterday, taking a partial dose that day and nothing today. Physically, I've been vibrating all day and my anxiety has been high. I feel like I've had ten cups of coffee (or maybe an anxiety attack). I'm jumpy and twitchy, and all I can think is, "Wow, I can get a lot of work done with all this energy!" Already someone today told me I was being too ambitious, haha. My thoughts are going pretty fast and I'm building these huge lists of what I'm going to do today. But I feel like I can do it. My energy feels boundless. Part of me hopes I can maintain this, but from experience I know that these moods tend to crash hard usually in about a day's time.
I'm going to pick up my refill later today, so no worry there. What I'm wondering is, can such a low dose of risperidone affect me this strongly? And has anyone else noticed major changes on and off risperidal at a similar dosage?
Utterly intolerant to Antipsychotics, Strongly considering Lithium or Lamictal as Monotherapy for Schizoaffective Disorder.By SheltieUnderdog
I've been on and off antipsychotics sporadically for the last 7 years since age 22 (since 2011). I'm extremely sensitive to them and have a very high response to every one I've been on. I've gained 145lbs from an increase in appetite and metabolic changes, have severe akathisia that is utterly insane and makes me want to cut my own legs off, I developed severe gynecomastia from Risperdal and Invega respectively (Won the Risperdal lawsuit, but no surgeon will touch me because of my weight), experience anxiety (The most on Abilify), fatigue, drowsiness, impotence (On Fanapt), anhedonia (From aggravated depression on Haldol), blurred vision (On Fanapt), lack of concentration, mild tardive dyskenesia (In combination with TMJ syndrome, I think it's permanent), dry eyes (Can't secrete my own tears), nasal congestion (aggravated, because I have it anyway without taking APs) , disorganized speech (Literally developed a speech impediment from a combination of Fanapt and Topamax), GI issues, etc
I've experienced almost every common recorded side effect from this category / class of drugs. The lack of control over my weight and appearance and the akathisia are the worst (that's why they're listed first and reiterated). These drugs have destroyed the relatively abysmal life I had before I developed this illness and presently cut it down to absolutely nothing. I have no life. I spend the majority of my life either going to multiple doctor's appointments for my medical issues or otherwise eating uncontrollably, and pacing back and forth and smoking cigarettes occasionally. I browse the internet with my thoughts racing. I might try to watch a TV show or play video games or play bass guitar like I used to but I can barely hold concentration or focus long enough. I want this to end, I really want out. I want to experience a fraction of life again.
I was previously diagnosed Bipolar 1 With Psychotic Features before my 2nd and most recent episode. As I said, I haven't taken APs consistently for 7 years. I've gone off of them twice for pretty significant periods of time before I relapsed. I usually last about 10 or 11 months (almost a year) without symptoms and perform consistently better in life in general with everything gradually going back in my life to when before I was 22. The side effects and depression usually disappear within a week. At 5 to 8 months I'm very stable, but in just under 11 months I start feeling like I'm on top of the world, become severely manic and delusional, hallucinate, experience an episode, and get into legal trouble. The 1st time around, I resisted arrest during a welfare check called in by my parents and went to the hospital and the 2nd time I successfully eluded the cops by motor vehicle on the highway and got caught hours later and went to county jail.
I understand I could be facing harsh consequences but I've never been on a heavy mood-stabilizer before. All they do is overload me with APs. After the 1st episode I stopped taking psych meds completely because of how much I despised how I felt except for Zoloft and resisted almost all treatment. I avoid SSRIs now and will this time because I think it may have been responsible for raising my mood too much before the 2nd incident took place.
The key to preventing future incidents for me, I believe, is to make the hallucinations and mania more tolerable to where I won't feel the need to act on them. The delusions are a joke, I can easily handle them. I'm currently taking Latuda 20mg and I'm requesting that my psychiatrist allow me to keep 2 or 3 bottles stored in my cabinet or 1 on me at all times in case any symptoms were to occur while taking Lithium. During the last episode, I was frantically searching for antipsychotics or any appropriate psych medication but didn't have them because I threw all of my former meds away after the first episode had taken place. This time I will have them to back me up and if it turns out that I need to suffer immeasurably on Latuda 20mg or another AP for the remainder of my life then so be it but I deserve a chance on a mood stabilizer simply because of what I've gone through and what I'm experiencing on APs.
Has anyone ever tried Lithium as monotherapy for schizoaffective disorder or bipolar 1 with psychotic features? I hear it still has some side effects (would like to know what all of those are) but that it's immeasurably more tolerable than antipsychotics. I realize many people use it in combination with an antipsychotic but this is not in reference to that. Is there anything better than those two that's not an AP? This post is simply to inquire about anyone's thoughts or experiences about using Lithium or Lamictal as monotherapy for schizoaffective mania. A dosage and frequency recommendation would also be appreciated from those that have taken it, although I realize that I will ultimately need my psychiatrist to determine that.
I found 1 study on this subject from the early to mid 1980's here: https://watermark.silverchair.com/10-1-30.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAcYwggHCBgkqhkiG9w0BBwagggGzMIIBrwIBADCCAagGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMAypxqSBIPHx7kbXfAgEQgIIBeTskilYIIUxtfy4i-FH7a6BQ4SrsYxqZG44q7kWx1rVJdLbZ4PMxE33_FUje8rDj4FoUYJI27hYGzv-06pCL6xPDrbVg7n-g9QzqTwoPiRxgDv2VnqzwifudoudTuskAGEKItv5TfD1_V9opXCFF7vJXJln8ij8NeNkMLUpe_n-Xbp6TtkU7rXYdPCZ9dObhTfmQ4PEHkwKfcJcOVAjXzelMWD1EPzWPxCK5zu1l1d2w8ojnqH68mbvgaDuvBxyPTY-EEdADh9N0NIUPQCWHXZKWE2gEBsG_AbWS-bkPdgjxtXcn8Y_5KljQbU2Geb_ERYYWuWFMEk6CRs7FYte_16TOiCQVlahMabKxw0BdjlqvdGaPYZTKBoBWb9Poswigg8jbF1whmlo7WWRyCLCLdbKt4xkmZCU0qmv_j5FTFzeXsq05ptOFY10M3jpUft1xV75pMsPtVJ8U7d42OYqMksXhZyrA8B5k9XNhfJGS0XgmTTSLHNOdcTY2