Risperidone

Hi Ann,

It probably depends on the individual experience of each clinician. Augmentation of SSRIs is one of a few strategies in the psychiatric arsenal that may help when the initial response is not satisfactory. One of the factors always taken into account is patient safety – do the risks outweigh the potential benefits? With antipsychotics – even the new ones (‘atypical’) the risks are serious – tardive dyskinesia, weight gain, memory problems, emotional flattens, etc. When making a decision, a psychiatrist needs to consider the alternative options. The first one would be to switch a patient from SSRI/SNRI to tricyclic antidepressants. These are equally effective, but are lethal when overdosed and also interfere with other medications, particularly with these commonly used in elderly. So while they may appear safer, they cannot be used in certain groups of patients (like these willing to commit a suicide). Another option is to use MAO inhibitors, but their safety profile is even more problematic (would you trust a psychiatric patient to follow a very strict diet, knowing that eating cheese could trigger a potentially lethal interaction?). So… in some cases SSRI augmentation may be the only available option. It works, clinical trials have confirmed that combinations of SSRIs with antipsychotics are more effective than SSRIs alone, whereby Sertraline and aripiprazole (Abilify) seems to be used most frequently. When it comes to side effects – these are inevitable as the modification of the brain D2 receptors activity (all antipsychotics target these) is permanent. However, this is a very slow process and it may take many years for the first side effects to manifest. While this is a serious problem in patients suffering from psychotic conditions (schizophrenia, bipolar disorder), who rely on these drugs for their whole life, it doesn’t necessarily need to be a problem in patients suffering from depression as the treatment usually lasts for only a few months, up to a year. So… yes, it is a risk, but it may be worth it.

Thank you for your most informative detailed reply.  It just confirms all i have suspected for a while. The decision lies with me and whether i am willing to go down this route.  Unfortunately i also have other health problems and being on warfarin is one, I alsomhave stomach issues since gallbladder op did not go to plan.   So I find myself with nausea and d a lot of the time.  I am not sure i want to add more medications to the list but realise something will have to be done.   Thanks again. Much food for thought and discussion with psych, who im afraid has no other patients on warfarin so i am wondering if a geriatric psychiatrists views ought to be sought.

One very good reply but nothing from anyone else, i am beginning to think not many people use this combination and that may be because of the side effect profile, making me wonder if its a good idea because of my other health problems.

Well, mr gp persuaded me to take the respirodone.  A week on and I have felt like i have been given a horse dart.  I have no motivation and feel tired, grouchy and my sleep is nott great.  Its like ive been doped.  My personality has disappeared under a blanket.  Its just a horrid feeling.  I am drinking tons of water and waking with heart palpitations.  Whatnis going on.  If imstop,taking it now after a week do you think i will get any problems?

"If I stop taking it now after a week, do you think I will get any problems?"

?Only a qualified doctor or nurse could answer that question. I would suggest you go back to your gp and discuss how you feel. Also ask will I still have these side affects. Be honest and tell gp exactly how you feel, bearing in mind you were dubious about taking them, but was persuaded by your gp. 

Ann, is it better to live like this, or being terrified from dying from fear, hopelessness ? Fear is however more natural to humans than that s**t. I am struggling myself, do not take it, face your fears, they are all just trying to communicate with you, all those symptoms, states, feelings... Do not kill your spirit, just start communicating, calm down, be compassionate towards your feelings, experiences... And mostly, be aware that even if you take pills, medication without inner work and love acceptance, (just try.. ) is futile. Primary is inner work, patience

cheers

You are so right but trying to find that inner peace which was there all my life is proving hard.  I am on a very low dose anti dep, almost ready to stop but i seem to need diazepam to calm me as nervy and going places even to doc spikes my anxiety.  Just want rid of all these meds. Psychology has been suggested. Maybe thats a better route.

If you google risperidone , you will see info about side effects. It also warns about taking it with other drugs. One of which is diazepam, which I think you said you were taking

psychotherapy is always a good solution but there are not many specialists out there who could really help you. But go ahead if you can, human hand and support is needed. Just be careful not to lean on someone who is total fool.

Inner peace is there, no need to try to find it... Maybe this can be hypnotic enough for you to calm down. We have it in ourselves since always, just your mind is too conditioned, you were convinced you can not, you are incapable and all that s**t, deeply , so now its hard to believe otherwise... Step by step, real slow, real slow... No expectations, no need to look far in future and freak out. There is no future.

Just slow down and hear yourself...

Medications are not the problem. It's the conditioning of our mind that is.