So, this is more exploratory than anything. I accept that, as someone with bipolar disorder, taking an antipsychotic might be a necessary part of my maintenance treatment, and lately that has become more evident. I had been taking Rexulti (brexpiprazole) in varying doses since 2017 when I started it with Depakote ER (divalproex, 24-hour) and Trintellix (vortioxetine). Still taking the Depakote (now up to 1500mg), but Trintellix and Rexulti have worked their way out of the equation, as of late.
My medication regimen has taken a more classical turn due to a breakthrough hypomanic episode in Dec./Jan., and I am currently taking a combo of Depakote ER at night along with 0.5mg of Risperdal (risperidone). Because of persistent issues with depression and anxiety, I am also now taking 50mg of Pristiq (desvenlafaxine) each morning along with 50mg of Vyvanse (lisdexamfetamine) for ADHD that I have been taking for some time.
This combo seems to be working fairly well for me. When I started the Risperdal at 0.25mg/day at bedtime, I didn't really notice much difference at all during the day, but I suppose it was nice as a sleep aid. I increased to 0.5mg on Day 4 and I've parked here to try it out for a bit before deciding to increase further. The Risperdal is really to deal with those breakthrough hypomanic/mixed symptoms such as irritability and agitation, which have always been tough for me. In the beginning of my treatment (2014), antipsychotics were used as monotherapy for mood stabilization, but I could never tolerate the doses necessary to calm those symptoms, because I was easily susceptible to EPS like akathisia. Fast-forward a few years, and we've found that using an anticonvulsant as the primary mood stabilizer with the antipsychotic as a secondary has generally served me well without too much incidence of akathisia.
I started Risperdal on June 8th and increased to 0.5mg a few days afterward. So it's been almost 3 weeks at this dose. My experience so far tells me to keep increasing. I'm curious to know people's experiences on Risperdal, particularly in combination with another established mood stabilizing agent like lithium or valproate. I recognize that I take Depakote and that a combo of lithium+Risperdal may not be the same, but the mood stabilizing effects of lithium and valproate are generally regarded with equal respect in most literature for the time being.
Any thoughts on lower dose Risperdal?....particularly in concert with another mood stabilizer?
What are the overall best (atypical) antipsychotics for Depression, Anxiety, Agitation, OCD, Bipolar...?By Adolf
"Best" as in being effective with fewer side effects. Which ones were the best for you? Which ones did you take? What condition(s) did you treat? What side effects did you get? How did the antipsychotics compare to "conventional" antidepressants?
Can antipsychotics be an alternative to "conventional" antidepressants? What are the risks? What are the benefits? Do they make you a tomato with time? Psychiatrists prescribe them more often in recent times, it seems.
I had a terrible manic/psychotic episode last August, and I'm having a great deal of difficulty letting go of certain elements of the experience. I keep being gripped with the feeling I've made a terrible mistake of some kind that's going to result in something bad, but other times I'm able to reassure myself that's not the case. What's really bad is when i start to argue with myself internally about it, which can make me panicky. I do take Depakote and Zyprexa, so it's not like I'm not taking my meds. Has anyone else had this kind of trouble? I thought about posting this in OCD but it seemed more relevant here.
So about 5pm every day of late, my mood just turns black. I can't buy a neutral (forget positive) cognition or emotion, I start to feel and think very negatively no matter what I do. Of course, I'm feeling and thinking badly beforehand, but it just sinks to another level, or depth if you will.
So I'm wondering if it's a med (or meds) that I'm taking that's losing effect around 5pm. I take the following meds - yes, it's a crazy-looking brew I know, but it allows me to function somewhat - at 6am (in milligrams):
200 Provigil, 2.5 Abilify, 40 Fetzima, 30 Lexapro, 15 BuSpar, 150 Lyrica, 10 Percocet and these at 2pm:
150 Lyrica, 15 BuSpar and these 4 times a day, where the last dose is typically 2pm:
15 Adderall 10 Percocet (for chronic pain) and these at 7pm for sleep:
150 Trazodone, 50 Benedryl It's impossible to confidently predict a "culprit" but if anyone has any hunches, I'd love to hear them.
For example, today I'm splitting (some of) the 6am batch into two and taking the second half at 2pm as an experiment. I feel that empirical experimentation might be the way to go because the theory is too complex with this many psychotropic medications in play.
Cheers , Pete