Jump to content
CrazyBoards.org

Sign in to follow this  
Ferdy

Risperdal Vs. Seroquel Vs. Zyprexa Experiences

For those that have tried ALL 3, which gave the best results for depression/anxiety?  

18 members have voted

  1. 1. Which worked best for anxiety and PD/Agoraphobia?

    • Risperdal
      6
    • Seroquel (IR)
      4
    • Seroquel (XR)
      2
    • Zyprexa
      6


Recommended Posts

I have suffered with severe anxiety and panic disorder w/agoraphobia for nearly 5 years.

As you can see in my signature line, I've tried almost everything under the sun and moon---but nothing has worked. I am completely intolerable to SSRI's and SNRI's---they make me feel REALLY bad.

The only thing that even dents the anxiety is Klonopin, which I am trying to D/C over time, since I have been taking it for so long, and have really lost their effectiveness. I don't want to go up anymore in dose than I am already taking.

I MUST find a solution to this terrible disabling nightmare of being completely homebound---I have been told that it will eventually deterioate my physical health. By the way, COUNTLESS hours of CBT have been completely ineffective, so I have no choice other than finding a med that will work for me.

My Pdoc has been great, a very patient doctor that has done and still is doing everything that he can to help me find the right med to cure this affliction. His latest suggestion is that we try one of the atypical antipsychotics (He doesn't want to try TCA's or MAOI's due to their cardio side effects---I have an irregular heartbeat (PVC"S) and HBP well controlled with Bystolic and Hyzaar).

So he has given my the choice of Risperdal, Seroquel or Zyprexa. Obviously, cost is an issue and Risperdal is the only generic available at the moment. My pharmacist tells me that Zyprexa's patent expires in November this year and Seroquel expires in March 2012. But, COST ASIDE, which (in real world experiences) would be your choice?

Thanks in advance for your comments and sharing your experiences with me with these drugs---

Edited by Ferdy

Share this post


Link to post
Share on other sites

For me Zyprexa and Risperdal caused more isolative and agoraphobic type behavior. Risperdal was the worst in this aspect. Zyprexa was better. And seroquel was the best, it even made me more proactively socially. All of them can effect blood pressure, causing low blood pressure and orthostatic hypertension.

Edited by Blart752

Share this post


Link to post
Share on other sites

For me Zyprexa and Risperdal caused more isolative and agoraphobic type behavior. Risperdal was the worst in this aspect. Zyprexa was better. And seroquel was the best, it even made me more proactively socially. All of them can effect blood pressure, causing low blood pressure and orthostatic hypertension.

Hi Blart, thanks for responding.

That's great that Seroquel is working for you---maybe it will be the one that I try first. Is this the general consensus do you think, or different strokes for different folks? I'm sure hoping to avoid the never ending med-go-round, and getting opinions such as yours will hopefully help me make the right choice the first time---but sometimes as I (and I'm sure you, too) know ALL to well, sometimes you just have to try it yourself to see.

The problem with that is that I am unemployed, disabled by this God awful affliction and have no insurance, so it's hard for me to cough up several hundred dollars just to take 1 or 2 doses of drug "A" only to find it ineffective or intolerable. And, for some reason, my pdoc does not give out samples---

The lowering blood pressure part may be a good thing---maybe I could get off the HBP meds, I guess I'll have to watch it and see.

Thanks again

Edited by Ferdy

Share this post


Link to post
Share on other sites

For me Zyprexa and Risperdal caused more isolative and agoraphobic type behavior. Risperdal was the worst in this aspect. Zyprexa was better. And seroquel was the best, it even made me more proactively socially. All of them can effect blood pressure, causing low blood pressure and orthostatic hypertension.

Hi Blart, thanks for responding.

That's great that Seroquel is working for you---maybe it will be the one that I try first. Is this the general consensus do you think, or different strokes for different folks? I'm sure hoping to avoid the never ending med-go-round, and getting opinions such as yours will hopefully help me make the right choice the first time---but sometimes as I (and I'm sure you, too) know ALL to well, sometimes you just have to try it yourself to see.

The problem with that is that I am unemployed, disabled by this God awful affliction and have no insurance, so it's hard for me to cough up several hundred dollars just to take 1 or 2 doses of drug "A" only to find it ineffective or intolerable. And, for some reason, my pdoc does not give out samples---

The lowering blood pressure part may be a good thing---maybe I could get off the HBP meds, I guess I'll have to watch it and see.

Thanks again

Whoops, I just noticed that you aren't taking it anymore---may I ask why?

Thanks!

Share this post


Link to post
Share on other sites

It sounds like you are in a similar situation as I am with respect to the lack of insurance. I voted Risperdal, but I don't think it is the best for anxiety and depression. I just wanted to see the results of the poll. I really haven't tried the others.

Share this post


Link to post
Share on other sites

To be honest, I don't know if there is a clearly best choice there - from what I've seen, any of the three are used for anxiety disorders. Seroquel is the one I've seen MOST often, but that's just my subjective memory of people I've met here.

If it were me, and finances are an issue, I would try the cheapest one first. To me, there isn't enough evidence behind any of them in particular to justify forking out when there's a decent chance that the cheaper one could help. In this case, it's going to be more a matter of figuring out what's best for you, rather than any general consensus.

I am on Seroquel myself, and it has really helped with my anxiety, though I do not have Panic Disorder. But I've never tried any of the others, so I can't do a head-to-head comparison.

Share this post


Link to post
Share on other sites

It sounds like you are in a similar situation as I am with respect to the lack of insurance. I voted Risperdal, but I don't think it is the best for anxiety and depression. I just wanted to see the results of the poll. I really haven't tried the others.

Yeh, jt, no insurance sucks, especially if the voting ends up in favor of Zyprexa. Don't know if you've priced that stuff, but it is SHOCKINGLY expensive. I don't know if it's OK to post Rx prices on the board, but I can tell you that it EXCEEDS MY MORTGAGE PAYMENT for a month's supply!!!!!! And Seroquel is still half that as well. Risperdal is BY FAR the cheapest, but if one of the other two is better, I'm prepared to pay the price---I have no choice other than find one that works.

Share this post


Link to post
Share on other sites

I hate to say it but seroquel and zyprexa are more calming (to me at least) than risperdal ever was. My friend is on serquel and takes it during the day for anxiety. I am on zyprexa and take it at night for sleep but it also helps all day long for anxiety. I found on risperdal that it was no help for anxiety (this was before I was on klonopin) and that risperdal was not sedating or calming in the least. I was on I think up to 6mg of the risperdal.....so I wasn't taking a baby dose of 0.5 or 1mg either. Not to offend anyone on that dose of risperdal either, just sayin' that I was on a high-ish dose compared to some.

But I see your situation. You don't have insurance. I understand money problems, believe me I do. Can your doctor give you samples of Zyprexa until oct. when it becomes generic? (I had heard oct. for when it becomes generic, but it could very well have been moved back to nov.) That could be an option. Or can you afford 2 full months of zyprexa? Maybe ordering it from canada? That is another option. I think some people here on this board do that, but for the life of me I can't remember who. Darn memory!

Or your other option is simply trying the risperdal first. It may work out well for you. Some people find it sedating and must take it at bedtime. It never helped me sleep. I don't know. I just hate to see you possibly waste your money on a med that is not PARTICULARLY known for being very calming/even slightly sedating (helps you sleep at night).

This is just my experience. I'm sure others will jump in and disagree and say risperdal is the best in their opinion. Who knows. It's the internet! :)

Share this post


Link to post
Share on other sites

Or your other option is simply trying the risperdal first. It may work out well for you. Some people find it sedating and must take it at bedtime. It never helped me sleep. I don't know. I just hate to see you possibly waste your money on a med that is not PARTICULARLY known for being very calming/even slightly sedating (helps you sleep at night).

First, the OP isn't asking for a sleep med. Second, Risperdal IS sedating for many, if not most, people.

My doctor wants me to try Risperdal first for panic/agoraphobia because he feels that Seroquel and Zyprexa can be too sedating and cause a lot of daytime sleepiness etc. Zyprexa really might be like killing a fly with a sledgehammer for panic and anxiety.

It's really going to be a trial and error, but if money is a concern, you can get the generic for $20 or so at Costco.

If the CBT didn't work, find another therapist that does something else-- DBT, schema, talk therapy, something. Ultimately therapy and figuring out your coping skills is going to be what makes the big difference for you. My therapist had me do a lot of exposure therapy, and that probably worked more than anything. I don't really like straighy CBT and it's never done much for me.

Share this post


Link to post
Share on other sites

I hate to say it but seroquel and zyprexa are more calming (to me at least) than risperdal ever was. My friend is on serquel and takes it during the day for anxiety. I am on zyprexa and take it at night for sleep but it also helps all day long for anxiety. I found on risperdal that it was no help for anxiety (this was before I was on klonopin) and that risperdal was not sedating or calming in the least. I was on I think up to 6mg of the risperdal.....so I wasn't taking a baby dose of 0.5 or 1mg either. Not to offend anyone on that dose of risperdal either, just sayin' that I was on a high-ish dose compared to some.

But I see your situation. You don't have insurance. I understand money problems, believe me I do. Can your doctor give you samples of Zyprexa until oct. when it becomes generic? (I had heard oct. for when it becomes generic, but it could very well have been moved back to nov.) That could be an option. Or can you afford 2 full months of zyprexa? Maybe ordering it from canada? That is another option. I think some people here on this board do that, but for the life of me I can't remember who. Darn memory!

Or your other option is simply trying the risperdal first. It may work out well for you. Some people find it sedating and must take it at bedtime. It never helped me sleep. I don't know. I just hate to see you possibly waste your money on a med that is not PARTICULARLY known for being very calming/even slightly sedating (helps you sleep at night).

This is just my experience. I'm sure others will jump in and disagree and say risperdal is the best in their opinion. Who knows. It's the internet! :)

Thanks for the reply, llama.

You know, it REALLY pisses me off about Eli Lilly and the price of Zyprexa. My pharmacist (who sells me my Rx's just over his cost---known him a long time)we were talking about Zyprexa, and he said the price has been steadily rising over the past few months---he said 8-10 months ago it was HALF of what it costs now (which would put in in line with the price of Seroquel---which is still high but NOTHING like Zyprexa). I asked him why that was, and he really didn't know for sure, but we both conjectured that it was because it was about to go off patent, and Eli Lilly was just price gouging everyone so that they can make hay while the sun's still shining knowing they're going to lose their market to the generics when it goes off patent.

Does that not suck and piss you off that they take such advantage of folks with mental illnesses? And especially with a bad economy and so many people without insurance? OK, OK that's my rant for today. Maybe I am unDX'd bi-polar lol!!

Anyway, thanks for the anecdotal advice, let's see what others say. So far, it looks like everyone is favoring Zyprexa and Seroquel over Risperdal, more so for Seroquel. Actually, though, looking purely at the pharmacology of the three, Risperdal's side effect profile looks better in almost every respect except for the possible prolactremia----which usually only occurs at dosages over 6mg/day, which I doubt I would ever get that high. But being a guy, I would certainly not want to end up with enlarged breasts!! Risperdal also seems to have a better cardio profile (the least QT prolongation---a big concern for me since I have PVC's and HBP---but I'm sure my pdoc will consider these factors when we decide the way to go---he didn't seem concerned about any of them, though)---and has the least effect on blood lipid levels (I am borderline for high cholesterol)--as a matter of fact, in a comparison chart, Risperdal actully lowers bad cholesterol and raises the good.

Edited by Ferdy

Share this post


Link to post
Share on other sites

Or your other option is simply trying the risperdal first. It may work out well for you. Some people find it sedating and must take it at bedtime. It never helped me sleep. I don't know. I just hate to see you possibly waste your money on a med that is not PARTICULARLY known for being very calming/even slightly sedating (helps you sleep at night).

First, the OP isn't asking for a sleep med. Second, Risperdal IS sedating for many, if not most, people.

My doctor wants me to try Risperdal first for panic/agoraphobia because he feels that Seroquel and Zyprexa can be too sedating and cause a lot of daytime sleepiness etc. Zyprexa really might be like killing a fly with a sledgehammer for panic and anxiety.

It's really going to be a trial and error, but if money is a concern, you can get the generic for $20 or so at Costco.

If the CBT didn't work, find another therapist that does something else-- DBT, schema, talk therapy, something. Ultimately therapy and figuring out your coping skills is going to be what makes the big difference for you. My therapist had me do a lot of exposure therapy, and that probably worked more than anything. I don't really like straighy CBT and it's never done much for me.

Thanks Muriel, comment appreciated and well taken.

About therapy/counseling, I completely understand the steps required to beat this and the theories behind them. First is controlling anticipatory fear, which I haven't been able to master. Second is, like you said, exposure to the panic and agoraphobic situations, which desensitizes you to the fear/exposure cycle. If you can do just those TWO things, you're on your way to recovery. I simply have not been able to master them, and not for lack of trying. Living alone DOES NOT help, either, since you have no crutch to help you along (I'm divorced with no children and no family or close friends)---so, it makes this even MORE stressin and difficult to deal with. As a matter of fact, this whole ordeal started with the death of my mother, subsequent divorce, subsequent in-patient hospitalization, then being fired from my job for non-productivity (I was a regional sales manager for one of the biggest companies on Earth).

My pdoc thinks I'm doing surpisingly well for all that I've endured. But it is what it is. Sorry for going on this rant---sometimes I just have to vent a little, LOL!!

Oh, and incidentally, we don't have Costco's here in Louisiana. The best price my pharmacist can make for me is $80---WalMart is $99---

Edited by Ferdy

Share this post


Link to post
Share on other sites

Or your other option is simply trying the risperdal first. It may work out well for you. Some people find it sedating and must take it at bedtime. It never helped me sleep. I don't know. I just hate to see you possibly waste your money on a med that is not PARTICULARLY known for being very calming/even slightly sedating (helps you sleep at night).

First, the OP isn't asking for a sleep med. Second, Risperdal IS sedating for many, if not most, people.

My doctor wants me to try Risperdal first for panic/agoraphobia because he feels that Seroquel and Zyprexa can be too sedating and cause a lot of daytime sleepiness etc. Zyprexa really might be like killing a fly with a sledgehammer for panic and anxiety.

It's really going to be a trial and error, but if money is a concern, you can get the generic for $20 or so at Costco.

If the CBT didn't work, find another therapist that does something else-- DBT, schema, talk therapy, something. Ultimately therapy and figuring out your coping skills is going to be what makes the big difference for you. My therapist had me do a lot of exposure therapy, and that probably worked more than anything. I don't really like straighy CBT and it's never done much for me.

I stated that risperdal is sedating for many.

I guess I misread that the OP was not having sleep issues. I'm so sorry for having made a mistake.

And really any AAP may be like killing a fly with a sledgehammer for anxiety issues. But some people can't take benzo's or SSRI'S, etc. And some people's anxiety really is just THAT BAD.

Really when it comes down to it, the OP is going to have to have a good long discussion with his/her pdoc about which AAP will be the best choice for him/her.

Share this post


Link to post
Share on other sites

Does that not suck and piss you off that they take such advantage of folks with mental illnesses? And especially with a bad economy and so many people without insurance? OK, OK that's my rant for today. Maybe I am unDX'd bi-polar lol!!

You obviously have not priced a brand name medication for other illnesses. They are not targeting us, they are targeting everyone.

nf

Share this post


Link to post
Share on other sites

Does that not suck and piss you off that they take such advantage of folks with mental illnesses? And especially with a bad economy and so many people without insurance? OK, OK that's my rant for today. Maybe I am unDX'd bi-polar lol!!

You obviously have not priced a brand name medication for other illnesses. They are not targeting us, they are targeting everyone.

nf

I had to laugh a little when I saw your handle, because I AM FRED, that's my name.

Yeah, I hear ya about brand name drugs. If you'll notice, I take Bystolic for HBP, which has no generic (and won't for many, many years). I get raped every month on that one, but it still is only 1/4 of the price of Zyprexa.

Share this post


Link to post
Share on other sites

I haven't ever taken Risperdal, but my advice is to try that first. They're all similar in terms of side-effects and you're going off label with them anyway, so why not try the cheapest first? Personally, Zyprexa didn't help my anxiety with leaving the house and going to school, although I never took more than 5mg/day. It made me gain a shitload of weight. Going from underweight to chubby in a month or two. It's the worst for that. Seroquel helps a little with my anxiety but I have been needing Valium so it hasn't really helped that much. It might be better if I took some in the morning (or the XR) because it's probably worn off during the day anyway. I'm only on 200mg. I'm pretty sure higher doses of any of the three would have a good chance of working (albeit with some significant long-term risks) as they're used to tranquilize very agitated inpatients.

Share this post


Link to post
Share on other sites

I haven't ever taken Risperdal, but my advice is to try that first. They're all similar in terms of side-effects and you're going off label with them anyway, so why not try the cheapest first? Personally, Zyprexa didn't help my anxiety with leaving the house and going to school, although I never took more than 5mg/day. It made me gain a shitload of weight. Going from underweight to chubby in a month or two. It's the worst for that. Seroquel helps a little with my anxiety but I have been needing Valium so it hasn't really helped that much. It might be better if I took some in the morning (or the XR) because it's probably worn off during the day anyway. I'm only on 200mg. I'm pretty sure higher doses of any of the three would have a good chance of working (albeit with some significant long-term risks) as they're used to tranquilize very agitated inpatients.

Thanks jimjam, so far very few folks have recommended Zyprexa, and the limited results of the poll are for Risperdal at the moment. Surprising that no one has mentioned Geodon or Abilify, but those aren't on my list of drugs to consider---the important thing is reducing anxiety with the least amount of SE's and to a much lesser extent, cost---

Share this post


Link to post
Share on other sites

Actually my experience with risperdal is that it has been the best for anxiety and ruminative thoughts, and i"ve tried all 3. Quel makes me, oddly, TOO sedated. It's great for sleeping off anxiety, not so great for getting things done. In fact, on daytime quel, I am highly anxious and irritable because it impairs my functioning so much. I know that's not everyone's experience, by far. I do take quel for sleep and I DON'T ever see myself completely off it, even though I am switching to risperdal as my 'main" AAP (I can take pretty low doses of it, too, relatively speaking). i also like the relative lack of risp. side effects for me, compared to the others. I find zyprexa the most STABILIZING generally, overall, but more for mood generally than anxiety and mental chatter.

To be honest, were I in this situation, i would try the risperdal first for the money issues alone, and if I had no success, move on to seroquel (XR will be out of your price range still, though, which is less sedating in some, though not me) and save the zyprexa for last. Honestly, I base that mostly on side effects though, as well as price, and efficacy.

It just happens to be the most efficacious med for me, overall, but that's a chance thing. Given the situation and that it's been going on awhile, i don't see that you have much to lose by trying a month or two of risperdal first... AAPs kick in relatively quickly, so really a month or two's trial is going to be a fair trial, overall.

Anna

Share this post


Link to post
Share on other sites

Risperdal also seems to have a better cardio profile (the least QT prolongation---a big concern for me since I have PVC's and HBP---but I'm sure my pdoc will consider these factors when we decide the way to go---he didn't seem concerned about any of them, though)---and has the least effect on blood lipid levels (I am borderline for high cholesterol)--as a matter of fact, in a comparison chart, Risperdal actully lowers bad cholesterol and raises the good.

I have a heart arrhythmia and my cardiologist isn't concerned with me taking Risperdal or any of the AAPs I've brought up-- none of which have been Geodon, however. He even looked at my EKG with me and my QT interval and thinks I'll be fine. Of course, my arrhythmia isn't starting in the ventricles, which may make a difference. As it is, exhaustive searches of the literature seem to show that the risk with Risperdal is very low, with the risk for Zyprexa being the lowest AFAIK.

About therapy/counseling, I completely understand the steps required to beat this and the theories behind them. First is controlling anticipatory fear, which I haven't been able to master. Second is, like you said, exposure to the panic and agoraphobic situations, which desensitizes you to the fear/exposure cycle. If you can do just those TWO things, you're on your way to recovery. I simply have not been able to master them, and not for lack of trying. Living alone DOES NOT help, either, since you have no crutch to help you along (I'm divorced with no children and no family or close friends)---so, it makes this even MORE stressin and difficult to deal with. As a matter of fact, this whole ordeal started with the death of my mother, subsequent divorce, subsequent in-patient hospitalization, then being fired from my job for non-productivity (I was a regional sales manager for one of the biggest companies on Earth).

I completely understand, more than I want to get into because you don't need to hear my life story. Being alone is a HUGE trigger for me-- at this point, I can do pretty much anything with someone else, but even a quick grocery store trip by myself has my vision blurring and my chest pounding. I've also had a lot of life events in the past couple years-- deaths, illnesses, divorce, moving, being poor, etc. that have really screwed me up with the panic and anxiety. Honestly, I have no idea sometimes how I used to go anywhere and do anything by myself without a second thought. My doc and I have tried a lot and we just settled on trying Risperdal as well. My main issues right now are panic and agoraphbia as well.

I can't afford my therapist, and I really need to see her because the therapy piece really helps. However, I know what you mean in terms the therapy not working unless you have a little bit of control-- and that's hopefully what the meds will do. It's just finding the right ones.

Oh, and incidentally, we don't have Costco's here in Louisiana. The best price my pharmacist can make for me is $80---WalMart is $99---

I'm pretty sure they do mail order too. It's worth checking out because their prices are obscenely low.

Thanks jimjam, so far very few folks have recommended Zyprexa, and the limited results of the poll are for Risperdal at the moment. Surprising that no one has mentioned Geodon or Abilify, but those aren't on my list of drugs to consider---the important thing is reducing anxiety with the least amount of SE's and to a much lesser extent, cost---

Abilify and Geodon aren't really known for being sedating/anxiolytic as much as the others, and can be a little activating, which you don't need.

Good luck, anyway, and I hope you find something that works.

Share this post


Link to post
Share on other sites

Surprising that no one has mentioned Geodon or Abilify

OK, I'll play. My family told me I am more calm on Geodon than without

Share this post


Link to post
Share on other sites

You got a price quote on the risperdal from your pharmacist? Because the cash price listed on my script from walgreens says $336 for 60 3mg pills. I can't remember what seroquel was when I took it, but I thought it was in that price range. Zyprexa was the highest - cash price of 30 20mg tablets was $920.

Until it tripled my triglycerides and crapped out on me, zyprexa was the best med for me on reducing my anxiety. It also worked very well on my mood. But I don't take it now - I take risperdal, which keeps the mood episodes away (knock on wood) but doesn't do all that for my anxiety. Seroquel did nothing to me except make me sleep 15 hours a day. But I was only on it a month.

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Sign in to follow this  

×
×
  • Create New...