Jump to content

Recommended Posts

I've been feeling like absolute shit, and DH for some reason suggested that the lithium was interacting with the risperidone, but I hadn't heard of that. But I was falling into walls as I walked around the house. My hands are shaking so badly I can't really knit. I knock over everything in my vicinity, even things that I don't believe I've actually touched. DH has started running in front of me to clear a path to lessen the destruction (ironically, I do this for him when he is in a post-ictal fugue state).

I'm not exactly dizzy, but I'm unsteady on my feet. I feel sick to my stomach most of the day. I am confused, and having trouble thinking clearly. All of the sudden, I am pissing copiously. Copiously. I say that as someone who has to use the bathroom at least 12 times a day because I have a spastic bladder (that was the diagnosis, not my calling my bladder names).

I actually thought to myself, "This reminds me of when I was toxic on lithium." It didn't occur to me that that could actually be what was going on. Two days ago, my blood level was normal, and my normal is considered sub-therapeutic.

So I looked up "risperidone, lithium, interaction" in Pubmed, and came up with a study on topa, and 4 case studies, one of which wasn't applicable (different circumstances). The three remaining case studies say that neuroleptics can sometimes interact with lithium, and cause lithium toxicity even at low doses. So in theory, my actual blood level isn't the indicator of toxicity, the symptoms are.

This fits perfectly with what I am experiencing. But 3 case studies? Can I really go in and say to a covering pdoc, "Well, there were these 3 case studies of this phenomenon on PubMed, and they remind me of what is going on with me?"

So has anyone here experienced this? It says it is a rare interaction, but I am one of those people who often has rare side effects (bruxism with atenalol, anyone?). But I feel like I have heard of this from someone or some people here. Is this possible (with the caveat that that doesn't mean that is what is wrong with me)?

I think I'm toxic. As of Friday, my blood level was .5, which is the level it is always at. On Thursday night, I had my first risperdal, and when I woke up on Friday, I fell, and had trouble walking, but it cleared up, so I attributed to normal AAP start up SEs. By Friday night, I was falling down regularly, but I actually do fall down a lot more than the average person, so I was thinking it was just a really bad day. It has just gotten worse and worse.

I took myself off the risperdal. It is only 1mg, and if the pdoc thinks I made a mistake, I'll only have missed one day. I am scared. If she is mad at me for stopping it (not that I think she will be), thems the breaks. No more risperdal for me. I am hoping I'll be allowed to stay on the lithium, but am realizing the copious pissing may be the last straw. But I'll keep taking it until told not to.

This always happens when my pdoc is out of town. Ugh. In some ways, it pisses me off, because while he believes what I and his colleagues say about my state when they saw me, *he* has never seen me at the height of an episode. My worst time of year coincides with his vacation. Nobody's fault, that's just how it is. He takes me seriously, but I feel like because he hasn't seen it with his own eyes, he doesn't really believe it. This is completely a made up thing I have in my head that makes me cry as I tell you it is imaginary.

Vomiting words again.

Ahh! I totally forgot to tell you about the crazy bad derealization I am experiencing, the worst ever. And other things. And I have more hallucinations, I can't remember them all anymore.

Edited by crtclms
More whining.

Share this post

Link to post
Share on other sites

It is interesting, I am on Lithium and used to take risperidone too. I would regularly feel something like that even though my levels stayed normal.

Share this post

Link to post
Share on other sites

You havent checked this maybe:


And something your pdoc didnt employ:

Lithium toxicity can be avoided by conservative prescribing, care in combining drug therapies, and, above all, educating the patient and caregivers to recognize early signs of the condition.

Share this post

Link to post
Share on other sites

Actually, my pdoc didn't put me on it. The covering pdoc of the covering pdoc put me on it. My pdoc is pretty restrained with my use of lithium, because I've been toxic before, and because I have mild kidney disease. If this is a known interaction, he'll probably know. The covering pdoc doesn't know my entire health situation, there just hasn't been time to fill her in on the last 48 years.

I don't tend to look at drugs.com, they are extremely risk averse, and unfortunately, you sometimes have to take a risk.

Anyway, Titania, that is interesting to know. I think as much as I can say this with any confidence as a layperson, it is an interaction. Otherwise, it is a pretty uncanny imitation of lithium toxicity, at least as I remember it. I am really more interested in other people's experiences, so I have an idea of how to present this to a pdoc that isn't mine. I have to call her tomorrow, because I stopped a med, and also because I should probably get another creatinine level, just to make sure my kidneys aren't in free fall. My next face to face appt. is actually on Friday, though.

Share this post

Link to post
Share on other sites

I present maybe four or five times a year with these kinds of symptoms, sometimes linked to hot weather/change in fluids/food intake, when they get around to doing my tests, my levels are steady and my kidney function is fine. My pdoc has wanted me off risperidone for a while (I now finally am) and so maybe he has been aware of an interaction. It seems, over here at least, until you're in a emergency state of toxicity, it is regarded as a not a big deal, therefore I have learned to endure it.

Share this post

Link to post
Share on other sites

My level went up .3 (From .7 to 1.0) on starting Saphris, So it can happen. I've had my level double checked a few times, and its held steady at 1.0.

Different drug, but same sort of effect. I'm getting more GI side effects, tremor is under control using inderal still.

Share this post

Link to post
Share on other sites

I personally was on risperdal and lithium for several years, and had no problems. But I do recall (right?) that you recently increased your lithium dose? Even though you may have a sub-therapeutic level, maybe the increase is too much for your body and kidneys. Can you get the on call dr to run a lithium test 12 hours after your last dose to see where it's at right now?

As a side note, I had therapeutic levels of lithium, and drank like a fish and pissed like a racehorse. I also had whole body tremors. So those wouldn't worry me, ESP if you have had them awhile. But the clumsiness would be concerning if you had mental lack of clarity and proper functioning. I think toxicity causes you to be lethargic and get dizzy and vomit, doesn't it?

Call the pdoc and keep us posted.

Share this post

Link to post
Share on other sites

I talked to the pdoc's pdoc's pdoc today, and she agreed with my decision to take myself off the Risperidone. At first, she was really skeptical, and said "well you took it last summer and didn't have a problem." :wall: She doesn't listen to me, and she doesn't look at the notes, and I knew as soon as we started interacting that she sucked. (I wasn't *on* lithium that time, and I told her that, and it was in my pdoc's notes).

I like my pdoc's "real" covering pdoc, but this one is just who they could find an appt with on an emergency basis.

But the fortunate thing about not seeing my pdoc's usual covering pdoc is that my DH just did an intake for depression (hooray for wifely nagging!), and he was assigned to her. We actually had appointments on the same morning.

Ah! My brain is going in 100 directions at once, sorry. When I left my message yesterday, I told her I thought I needed a level and another creatinine level. After realizing I hadn't been on Lithium last summer, she agreed to my kind of insisting on the tests, even though it is rare. Um, rare doesn't equal impossible. And I ran down the list of symptoms listed for toxicity in a number of places, and had almost all of them (obviously, not coma). AND it happened in the exact time frame it would have. But because it is rare, she didn't think I needed to test my lithium level, or even my creatinine after I told her I had been peeing a HUGE amount.

Gizmo, you remember correctly that I was actually prescribed a higher dose. But before I could start it, my pdoc called me and said not to raise it, because my creatinine level had risen. I am allowed to stay on enough to bring me to .5, and I would like to go higher, but cannot. .5 truly does help, it just doesn't knock it out. I am now concerned that something is up with my kidneys, and if so, I will have to be taken off of that. Which means fuck me; I don't know what we are going to do with my meds if that happens.

The course tremor from the lithium sucks. Just saying.

Share this post

Link to post
Share on other sites

Just shoot my horrible memory!

I'm glad you are able to back off the risperdal. I hope you return to yourself soon.

I hope your husband's appt. went well and that he gets the help he needs.

Share this post

Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

Sign in to follow this  

  • Similar Content

    • By LanieD
        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.
    • By batshitprincess
      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?
    • By BenyaMarubo
      Hi everybody!
      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 !!!!
    • By echolocation
      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?
    • 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