Extreme anxiety

Hi there, I was put on Risperidone due to psychosis, delusions. They are completely gone now but I'm very anxious in my recovery. I was fearless before I was treated but now that I'm better I'm full of anxieties, it's quite disabling, every new day is a threat full of anxieties and on holiday in Italy recently I was full of anxieties. I just want to be the person I was, loved travelling and trying new things. Any ideas? Thank you 

Right, this is something you should surely discuss with your psychiatrist, a doctor who knows you best and can adjust the treatment. I'm sure you know that risperidone belongs to the newer generation of antipsychotics called ‘atypicals’. While all of these drugs were design to safely treat long-term psychotic conditions (in schizophrenia and bipolar disorder), each of them has a rather unique profile. I would say that risperidone is the most activating one, which is great for people suffering from schizophrenia negative symptoms (or a psychotic depression). However, this also means that if there were any underlying anxiety problems present, risperidone is probably going to make them worse. This action is similar to SNRIs – for example, depressed patients who also experience anxiety (like GAD or social phobia) should avoid SNRIs (like venlafaxine) because while they help with depression, they also make the anxiety worse (as they bind to the norepinephrine transporter).

An option worth considering would be switching from risperidone to aripiprazole (in US known as Abilify, but it went generic some years ago). This is also an atypical antipsychotic, but it’s less stimulating than risperidone and it can be safely used in an adjunct therapy with sertraline – one of the most potent anti-anxiety SSRIs out there. I know that psychiatrists in UK prescribe this combination when a single medicine is not effective enough to provide a patient with a quality of life she/he deserves. The switch would take some effort from your side as replacing one neuroleptic with another is never easy and has to take time, so as I mentioned before – discuss this with your doctor and then think whether you feel prepared to move on.

Just one more remark here. Some doctors prefer to treat anxiety with benzodiazepines. If someone offered you this course of action, you should refuse as your anxiety is not limited to very specific events (like fear of flying) and would require staying on benzos for a long time. This would surely put you in a worse position that you’re in now.

I hope this helps!

Thanks so much for this, I've felt so alone in my anxieties although I have a very supportive partner and family and friends, but great to know there is a community out there that understands what I am going through 

Personally I recommend good old benzos.they work well, don't have side effects and can make your anxiety go away until you find the underlying problem. Why suffer in the mean time, there drugs are designed for anxiety, they are safe effective and if you take them on a need to basis you will not get addicted. I have anxiety every day but only take 3 pills a week. Some people take 3 a day. I only take them when my anxiety does not allow me to work or really function. The rest of the time I make myself cope the old fashioned way, exercise, a few drinks or a good old snooze. Hope this helps, ps clonezepam is great, long lasting, side effect free and does not make you zoned out like Xanax.