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stardreamer

Do you find Risperidone alone worked to stabilize you?

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Hello everyone,

 

I'm on Risperidone for my anti-depressant induced BP-II (had serotonin syndrome). I really would like to just keep it with anti-psychotics if possible. So my question is, what AP have you found stabilizes you without the need for other meds?

 

I've been on 0.5mg up to 1mg daily (currently trying 1mg at night). I tried spreading it out during the day but got unacceptable side effects such as sedation and nervousness. I'm so far not feeling a great stabilizing effect, I've been getting swings every few days still.

 

So I'm not convinced this is the best choice.

 

A year ago I did find Seroquel worked wonders for stabilizing mood, but at the time had something of a fragile dopaminergic system so it ended up causing panic attacks after 3 months of working up the dose to 250mg. However after that I was able to ride it out without medication (before I upset my balance again with lithium orotate) so I'm wondering if I should try Seroquel again. 

 

An alternative would be Abilify, unsure whether the partial dopamine agonist (so called 'dopamine stabilizer') would be good or bad considering my propensity for anxiety, and sensitive dopaminergic system, or whether its just a matter of finding the right dose.

 

Has anyone had a pdoc willing to mix 2 different APs successfully? Such as Risperidone and Abilify for example, or maybe risperidone and Seroquel (quetiapine)? I know the standard wisdom is it increases the chances of EPS but I doubt that would be a problem with Abilify in a small dose, or even Seroquel (since its a loose binding dopamine antagonist).

 

Would be pleased to hear your thoughts :)

 

Thanks

 

 

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You can't create a cocktail by trying to guess which neurotransmitters are affected by what. As Ti says, everyone responds differently. There are many, many antidepressants that don't interfere with seratonin.

 

I feel like this post should be in the meds section somewhere, but you aren't talking about a person with an illness, you are talking about a chemistry experiment. So I don't know where to put this. That's not how treatment works.

 

Why only AAPs? Why not more traditional mood stabilizers?

 

Are you seeing a therapist?

 

It would be nice to have a picture of what is going on.

 

Did you really have serotonin syndrome, or did an SSRI make you manic? They are different things.

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Is there a reason you are excluding mood stablisers?

 

Risperdal had a definite, tangible mood stabilizing property on my bipolar. However it wasn't until we tried Lithium that I saw any real stability, we added Lamictal to treat seasonal depressive drops. I weaned off the risperdal because the prolactin and weight gain was giving my poly cystic ovaries and I wanted to streamline my med intake. It did a lot for me, but I find being a mood stabiliser a lot more preferable, less sedation, less weight gain, lower dosages to get the stability etc.

 

I know that SSRI's makes me manic, but there are tricyclics and other AD's with a more sedating effect if you need to try another but don't want to go back to mania.

Also, I'm not discounting what meds have done for you, but I'd recommend not getting to caught up in the brain chemistry side of things. I hate to say it, but medication is a bit of a crap shoot, we're in the infancy of knowing how these meds really affect brain chemistry. Given that we're not at the brain scan and medicate according to brain chemistry stage, I'd go on what works for you in terms of results, not a dopamine recipe.

 

Thanks for your reply. I'm glad you saw some effect from the risperidone, I'm thinking it may work for me at 1mg or slightly higher taken only at night time. Yes there are reasons, for one thing Seroquel alone has previously worked for me. For another, the potential side effects of the only one I'd be willing to try (Lamictal) are a bit scary, so that would be an absolute last resort. I can't have any stabilizer that works with GABA as I have a paradoxical reaction somewhat like kindling due to past over-use of GABAergics. I can't do lithium as I already tried Lithium Orotate which is able to cross the blood brain barrier much more effectively, but the repercussions from trying that were severe, destroying all my good progress and regressing me 6 months, due I believe to its serotonin release enhancing abilities.

 

I've just started Valdoxan (Agomelatine) which doesn't increase serotonin so I have high hopes for that.

 

Unfortunately I'm very caught up in chemistry due to all the drug use and damage in my past, so I need to be roughly aware of what will be bad and what will be good for me.

 

 

You can't create a cocktail by trying to guess which neurotransmitters are affected by what. As Ti says, everyone responds differently. There are many, many antidepressants that don't interfere with seratonin.

 

I feel like this post should be in the meds section somewhere, but you aren't talking about a person with an illness, you are talking about a chemistry experiment. So I don't know where to put this. That's not how treatment works.

 

Why only AAPs? Why not more traditional mood stabilizers?

 

Are you seeing a therapist?

 

It would be nice to have a picture of what is going on.

 

Did you really have serotonin syndrome, or did an SSRI make you manic? They are different things.

 

It sounds like this might be a better suited question for the meds forum, my apologies.

 

I am seeing a therapist yes.

 

Its a very long story so I will try and explain with an outline.

 

My past drug use lead to a very fragile brain, after an accidental OD on a dopamine reuptake inhibitor 2 years ago, I escaped the long lasting repercussions of that by going on Moclobemide a reversible MAOI. But it wasn't quite enough so I was still cautiously supplementing with tryptophan and using tranquilizers. I know, thats bad but I thought I was keeping it under control.

 

One day I had a psychedelic with a friend (which I had previously been cautious with, never felt any potentiation on my MAOI), but at some point it turned into a bad trip for my friend, which freaked me out so I had a benzo which I found out later has very weak SSRI activity. I quickly began to feel weak, I panicked and my vision distorted wildly, I collapsed on a sofa losing consciousness for 4 min. After that my heart raced at over 100 resting for over 24h. After this I knew I had to come off the MAOI. But the withdrawal was extreme, I found myself out of my mind supplementing with too much tryptophan (I didn't realise it had been a scrape with SS). I had another incident at work where I was so weak I had to lie on the floor, I had paresthesia all over and was sure I was going to die. I was taken to hospital and shorty recovered. 

 

Following that was the beginning of my BP-II saga. Wild month long hypomania followed by lifeless depression. I eventually sought help and went on seroquel, which smoothed my swings successfully, but was less kind being a loose dopamine binder, I eventually developed recurrent panic attacks and palpitations. I couldn't taper it one bit without serious panic and palpitations - I tried several times. But then one day I just took none, and had zero withdrawal. Then I just hung in there for a few months and nearly recovered before I stupidly tried the lithium orotate supplement to try and help all the stress and still minor mood swings. It caused super anxiety that I had to sedate myself 24/7 on antihistamines for a few days. That was back in July and I'm still on a rollercoaster following that. It was super terrifying for a few months and now its beginning to feel more manageable.

 

I tried to make it brief :)

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