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I've been doing pretty well with most of my mental issues for a while now. I have only had two tiny hypo episodes in hmm, almost 10 months thanks to Risperdal. My depressions are almost covered by wellbutrin.

But my paranoia hasn't gone away. I see signs in the bushes in front of my house, I am terrified of being attacked at night by demons, etc etc. I know it's irrational, but it still really upsets me. Logically, I should probably increase my risperdal, but that gives me side effects I don't like (namely, leaky nipples). I've tried adding a bit of seroquel, but that makes me tired and gave me a rash (like the first time I was on seroquel alone.) My doctor will probably suggest zyprexa, but I am afraid of it. I don't wnat to be a big fat zombie. I would honestly rather die than gain any more weight thanks to meds.

Honestly, I don't even want to try. However, since thats not really an option, I'm curious as to what's left. Is Abilify available in canada? Has anyone found mood stabilization without prolactin problems from an old school AP? Risperdal does such a good job of it, it's a terrible shame to think of getting rid of it. I was thinking about asking about haldol, or would that be even worse for prolactin problems?

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Have you tried adding a dopamengenic agent to the risperdal to counter that? Topamax induced aphasia is kicking my ass and I'm having trouble remembering the name of both the hormone that's being affected and the drug that's most commonly used. It's an old anti-viral that's now used for Parkinson's.

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But my paranoia hasn't gone away. I see signs in the bushes in front of my house, I am terrified of being attacked at night by demons, etc etc. I know it's irrational, but it still really upsets me.

I have the same paranoia problems even after being stabilized. So we started the Propanolol and it worked wonders. (See my signature for all my meds.) I think that my paranoia was mostly psychosomatic, so the beta blocker worked well.

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OK, the problem is prolactin. According to Stahl, Dopamine inhibits prolactin production in the pituitary gland wheresas serotonin stimulates it. Together they act in a regulatory capacity. Conventional APs act as D2 antagonists, therefore opposing dopamine' s inhibitory role on the section of prolaction from the pituitary. As many of the atypical APs also act HT2A antagonists, the effect on the pituitary is therefore evened out.

Unfortunately, I've heard risp. called "the most typical of the atypical." I guess this is one of the ares where that applies.

Because they have so many different mechanisms of action, you don't want to combine atypical APs. Adding a low dose selective typical AP would be a lot safer.

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Things like dopaminergic agents never came up with either of my two psychiatrists when i mentioned the problem. it was my second dr's idea to add the seroquel, in hopes of getting more antipsychotic without more prolactin issues. Are pro-dopamine drugs the sort of thing they aren't told about? do they just not like doing it? It seems kind of counterproductive, to inhibit dopamine and increase it at the same time. I'm a little loathe to tell my doctor what I want her to give me, because that hasn't worked out well in the past (different dr, though.)

I do appreciate your suggestions though. The study Luna linked is particularly nice in that it says there wasn't a change in mental status. The link to bromocriptine mentions a contraindication for it and risperdal specifically though. I checked it on my interaction checker and it didnt say anything about it though.

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The link to bromocriptine mentions a contraindication for it and risperdal specifically though.

So... that wasn't the best link to support the suggestion. sorry. I believe the contraindication is due to possibly increasing the effects of bromocriptine.

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