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?
I'm tapering off clomipramine, right now I'm down to 75 mg.
I've been on it for almost a year, but I'm not impressed with the results. I was hoping it would work better than my last two SSRI's (which seemed to do the best job when I took them for the first time) but I can't go higher than 100 mg because of side effects.
A few months ago risperidone was added to the clomipramine. I'm on 1 mg a day. I've seen some improvement, but I can still have difficult days or even weeks where I'm having too much intrusive thoughts (or thought, since it's been only one thought which bothers me).
I've had good results from fluvoxamine and escitalopram, but both pooped out. Maybe clomipramine had pooped out too.
According to my pdoc, taking risperidone as a monotherapy won't have much effect. And with OCD, an antipsychotic is mainly added as an augment treatment.
So what to do next?
So today is my seventh day on 0.50 mg risperidone.
I wanted to try this kind of medication for a long time. I've been on ssri's for about 10 years and switched to clomipramine July 2018 because ssri's didn't work like they did before.
(My main problem....I have 'white polar bear' ocd and was free of symptoms for about 6 years. 3 years ago big relapse). I'm on 100 mg of clomipramine.... I tried increasing but then the side effects become too much for me.
I don't think risperidone is doing anything special. I expected a little more, but maybe I'm just impatient.
I was hoping the constant intrusive thought (which has overtaken normal thinking patterns) would become less frequent.
I hoped silence would come.
Or that it would flatten the emotion that always follows after thinking 'it'. Like: "I don't care that you (intrusive thought) are on my mind" and that my attention would quickly shift to something else.
On the plus side....I'm sleeping even better than before. It is nice to be able to sleep the whole night instead of getting out (sometimes thrice a night) because I have to pee(which is a side effect of clomipramine).
May I expect better results after two weeks? Of should I ask for a higher dose of risperidone?
Sorry I read through a lot of posts in the middle of last night, but am too restless to read through them again. BUT! I did see some posts related to my concern regarding restlessness as a side effect for Vraylar. I have been taking Vraylar , 1.5fl - 1 wk and 3 fl- 5 days, and am extremely restless. Would someone please let me know whether this will go away on its own, or is it permanent? I just got off lithium which I took for many, many years...
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.