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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by James on April 13, 2002, at 23:24:22
Hi, I'm a relative newcomer to the board, and this is the first time I have gotten up the courage to post.
Anyways, I'm curious about two medications: Risperdal and Gabitril. My pdoc put me on Risperdal (only a few doses so far) after a particularly severe manic episode. I had slept 3 hours in the past 3 days and was essentially bouncing off the walls. I had experienced plenty of manic periods like that, but this was the first time I had heard and seen something like hallucinations; specifically mice. (The ironic/funny part is what happened last month. I am a college student living in a small old dorm room on campus. Last month my floor had some kind of infestation with mice thus adding an additional guest to my room. I didn’t mind his presence so much until he brought his friends to stay with him. That was when I realized it was time for Mickey (the mouse) to leave. So, I chased him around with a hockey stick until I chased him out. To make a long story short, it became a little problem when I was really manic last week, freaking out of my box hearing and seeing mice, and then not knowing if they were real or hallucinations.) So, the doc put me on a little bit of Risperdal, “to slow you down” she said. Then she gave me a sleeping pill, Gabitril, to, “slow you down a little more”. The slowing down isn’t the problem because I’ve already crashed its too late to catch that one. Truth be told, its really quite relaxing compared to the insanity I just went through!)
My question is, I know Risperdal is an anti-psychotic. I’m not that psychotic. Even if there were mice, bipolar has manic phases, which may be characterized by qualities of psychosis. I don’t care. I just want to know more about the drug and its use in bipolar. Also, I’ve never heard of Gabitril. I just want to know why the heck a pdoc would give Risperdal. Unless, of course, I really am psychotic and I’m just hallucinating this whole bulletin board thing also.--James
Posted by jay on April 14, 2002, at 4:40:39
In reply to Risperdal, posted by James on April 13, 2002, at 23:24:22
Hi James:Your situation bothers me, because it seems to be such a popular fashion to precribe atypical antipsychotics (like Risperdal) and mood stabalizers like Gabatril. I went through a year in a 'fog' on Zyprexa (another atypical antipsychotic.) DOn't get me wrong...I think they have their place. But, to just use Risperdal to.."slow you down a bit" REALLY is odd. There are many, many safer and more effective meds you can/should be taking.
For starters, clonazepam can knock out mania right away. It is safer than Risperdal and Gabatril. There are also a number of other benzos to choose from, that work "perfectly" for everything from mania to anxiety.
There are also some excellent sedating antidepressants that could be of help. The tricyclics are older, cheaper, but no other a.d.'s are considered better. (Of course, people emphasize side effects like the anticholinergic actions...possible effects on the heart in those who have a problem..), but I can give you a ton of side effects for every a.d. and Risperdal too.
Anyhow...that's my thoughts. Please hang around and here what others have to say. Good luck!
Jay
Posted by TSA West on April 14, 2002, at 6:52:40
In reply to Risperdal, posted by James on April 13, 2002, at 23:24:22
Here is the basis for Risperdal's use in bipolar disorder. I sincerely hope that you make a complete recovery on Risperdal and Gabitril:
J Clin Psychopharm, April 1998:
RISPERIDONE
"This encouraged us to conduct an open trial on the efficacy and safety of risperidone in the treatment of 10 patients with rapid cycling bipolar disorder who were refractory to lithium carbonate, carbamazepine, and valproate... Patients fulfilling Research Diagnostic Criteria for bipolar I or bipolar II disorder with DSM-IV rapid cycling were included... Risperidone was administered orally twice a day in morning and evening dosages, starting from 1 mg twice a day. This dosage was subsequently modified depending on clinical status and side effects...
Eight of the 10 patients improved after the implementation of risperidone. Two patients dropped out because of agitation and noncompliance, respectively. The number of episodes within 6 months after baseline was significantly lower than before baseline.
The results of this study suggest that risperidone could have mood-stabilizing effects and be a good choice in the treatment of refractory rapid cycling bipolar disorder."
Posted by James on April 14, 2002, at 11:02:26
In reply to Re: Risperdal » James, posted by TSA West on April 14, 2002, at 6:52:40
> Here is the basis for Risperdal's use in bipolar disorder. I sincerely hope that you make a complete recovery on Risperdal and Gabitril:
>
> J Clin Psychopharm, April 1998:
> RISPERIDONE
> "This encouraged us to conduct an open trial on the efficacy and safety of risperidone in the treatment of 10 patients with rapid cycling bipolar disorder who were refractory to lithium carbonate, carbamazepine, and valproate... Patients fulfilling Research Diagnostic Criteria for bipolar I or bipolar II disorder with DSM-IV rapid cycling were included... Risperidone was administered orally twice a day in morning and evening dosages, starting from 1 mg twice a day. This dosage was subsequently modified depending on clinical status and side effects...
> Eight of the 10 patients improved after the implementation of risperidone. Two patients dropped out because of agitation and noncompliance, respectively. The number of episodes within 6 months after baseline was significantly lower than before baseline.
> The results of this study suggest that risperidone could have mood-stabilizing effects and be a good choice in the treatment of refractory rapid cycling bipolar disorder."
Thank you very much for your all of your responses. I didn't know that Risperdal is used to treat bipolar at all. The choice of Risperdal over others might be because of my previous experience with Zyprexa, which was helping at the time, but also raised my liver enzymes to a dangerous level, so I was forcved to discontinue its use. Thanks a lot both of you.
--James
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