Risperidone for lows

[dontrunwithscissors]

I need to move over to a different antipsychotic (currently on Quetiapine), and Risperidone is the next on the list. However, my pdoc wasn't exactly optimistic that it would work well for me. I have bipolar II, but 99% of my problems are with lows.

How have people found Risperidone? Has it helped with depression? (I also take Lamotrigine and Agomelatine.) I'd also like to hear what side effects people have had.

Many thanks!

I'm also bipolar (1 though) and have also just started risperidone having had to stop quetiapine!

From what I can gather it won't really help with the lows and does in fact make some people depressed having brought them down from a high mood. However the lamotrigine should address your lows. Failing that an antidepressant?

Risperidone is only a temporary measure for me and I should be starting lamotrigine shortly. My main problems are highs and mixed episodes and I'm not convinced how good lamotrigine will be at addressing those though but my options, med wise, are fairly limited these days.

That's my worry, I already take an antidepressant (Agomelatine). I need all the antidepressant effect I can get. I certainly don't need anything to 'bring me down'---99.5% of my problems are with depression and the very rare highs are mild. Bugger.

The Quetaipine has been brilliant for my moods, but for the last 3 years it's caused joint and muscle pain. I'm now at the point where I can't even walk to the play park with the kids. I tried changing to Abilify over Christmas, but that ended in a suicide attempt and hospital. Eugh.

Oh dear, that sounds rough.

I didn't get on with Abilify either. I literally couldn't sit still and it didn't stabilise my mood at all.

I took quetiapine for years and was easily the best med I've ever taken. I've developed cardiac problems though which I obviously can't just deal with.

Abilify sedated me like no other med--it was 10 times more sedating than Quetiapine. Apparently I have rather unusual reactions to meds…..

Really? Wow, that is unusual.

I take risperidone, I don't have bipolar though.

I have got on with it so well, when I was initially put on it it was very sedating (I was like a zombie it was awful) so we stopped it and started again building up from a very low dose to the 4mg that I am on now. I think it has definitely helped my mood, I am not as down as I was before I went on it.

In terms of side effects I have had hardly had any, I think it helps me to get to sleep but it is not sedating at all during the day (but like I say only when I built up very slowly on it). However, it has stopped my periods which is why I am about to come off it :( I am starting aripriprazole which doesn't sound any good from this thread, hmmm.

Hi FDG, I remember you saying you were having to switch. I hope you don't mind me asking lots of questions (tell me to bog off if I'm being too nosy):

• How long were you on the Risperidone when these problems occurred?
• What dose were you on when the problems started?
• Has your pdoc explained why this is such a concern? If it wasn't for the fact you are thinking about TTC (I think that's right?), were they willing to keep you on it?

Abilify has worked well for some people so don't give up hope. The problems tend to be it's very activating, rather than sedating. (I just seem to have a very odd brain.)

Don't worry about asking questions!

When I first started it the psych Dr put me on 4mg straight away and within a few hours I felt zombie like. After a week of feeling so awful I stopped it and started it again at 0.5mg building up to 4mg over a few months. Since then I have been side effect free apart from the fact that it stopped my periods. I have not had a period since I started on it last June.

If it wasn't for us wanting to ttc they would be happy for me to stay on respiridone.

For me it has made me more stable than I have been in years I have managed to stay out of hospital for over s year now and I think my meds have played a big part in that.

Hope this helps!

I have recurrent depression with psychotic episodes. I have had several short courses of rispiridone for agitated thinking, paranoia and intrusive thoughts, but that's alongside sertraline and amitryptaline. I found it very good for that. It was a bit sedating but that was better than the paranoia!

Hope you find something that works for you.

I was on quetiapine until I got muscle and joint pains too. I couldn't manage on risperidone - I couldn't sleep, couldn't sit down . . . literally. As soon as I sat on the sofa, I would jump up again thinking I needed to be doing something.

For a week, I never stopped. It was like speed.

Heart was pounding, everything seemed intensified, was very different to anything else I've ever had that seems to just numb me.

Thanks FDG, if you don't mind me asking a really personal question…has it made you lactate? (As I know can happen with high prolactin levels as I had this problem with a non-spych med.)

Thanks weegiemum, I could do with something moderately sedating to replace Quetiapine.

keatsybeastsy--or maybe not always sedating! Do you mind me asking what you went on to from Risperidone?

Don't mind at all - think it's great that we can all be so open here and ask the questions we can't anywhere else .

I decided to ttc so came off everything that was 'full-time' - just used diazepam, temazepam, and zopiclone as and when I needed it. Didn't have a baby after all, but a few years later am still just taking those three when I need them.

I actually do think I need something else, but nothing ever worked like quetiapine , and there's not much left for me to try, so I'll probably just stumble along.

It's good to hear you managed to come off everything, kb.

I would love to just come down on the Quetiapine, but I tried that without success. My fear is just what you've said--my pdoc has already said that Quetiapine is unique as an AP in terms of its anti-depressant qualities.

Oh well, I see my pdoc on Tuesday, when I intend to ask many questions about Ripseridone and what other options there might be.

Hi there :)

Risperidone and Quetiapine as you know are both anti-psychotics with mood stabilising properties. They won't act as anti depressants so much.. that's what the Agomelatin is for. Risperidone should hopefully do a similar job to quetiapine in levelling out your moods a bit, reducing anxiety and helping sleep too. The lamotrigine is responsible for mood stabilisation also. Sorry, I'm sure you know all this - hope it doesn't sound patronising.

Always worth having good informed chat with your doctor though to make sure the side effect profile of risperidone is something you're prepared to experiment with.

Good luck!

I took risperidone for a bit. I found it quite calming, and it really helped to focus my actions during the day (flat was never cleaner) and I slept much better at night.

Sadly, the bastards wouldn't let me have it long-term.

dontrun - I've just remembered another that worked for me: Imipramine I had side-effects on that too, but, while I didn't, it was very good.

I really didn't find Risperidone helped with anxiety as I was bouncing off the walls with it. I wouldn't say things are perfect on no meds, and I do still use the three I mentioned when I need them, but I'm coping and I don't have the flatness of being on something all the time.

I don't think it's forever though - I'll be back on something soon so it's good to see other people's thoughts on meds here.

Thanks for your messages. My pdoc explained to me that Quetiapine does have antidepressant properties--it is metabolised to a form that has been found to have serotonergic qualities. It's apparently unique in this respect.

I've just had my appointment and we're going to try adding in 5mg of Abilify to the normal dose of Quetiapine. Apparently pdocs at the Maudesely have recently found that this can act as an antidote to the problems I'm having. I was fine at 5mg when I tried it before, but went up to 10mg relatively quickly so we'll see what happens. I'm happy about this; I'd much rather try to find a way of staying on the Quetiapine, given that it is so effective in keeping the lows at bay.