It’s time for another med review, this time of the atypical antipsychotic drug risperidone (/Risperdal). As ever, please remember that this post is based purely on my experience of this med, and that it may work differently for different people.
My psychiatrist introduced me to risperidone after I found olanzapine (Zyprexa) and quetiapine (Seroquel) to be of little use in conjunction with the 60mg of fluoxetine (Prozac) I had been taking for months. He was sure an antipsychotic paired with my antidepressants would work miracles for me, but knew I was nervous about side effects given my back luck with the previous drugs. He told me risperidone was a lot milder. Private research kept me worried though; even if it didn’t massively boost my appetite like the olanzapine, I found studies that showed this med increases weight in the long term by causing the body to increase fat storage. But my depression was persistent enough that I agreed to give it a go.
After having an ECG and blood tests to give me an ‘all clear’, I picked up a prescription for 0.5mg taken nightly. That dose had me sleeping a lot better, and a few days later I was bumped up to 1mg. I wrote the following in my journal:
…this has me feeling kind of drunk – like my movements don’t match up with quite what I’m seeing, so I can’t really walk in a very straight line, and I don’t feel particularly stable.
So at 1mg nightly I would sleep like a log, and then wake up the next morning feeling drowsy and wobbly. The drowsiness always wore off after an hour or so, but the instability didn’t. When I stood up the world would spin, without fail. Usually I’d just wait for it to pass, but sometimes I’d begin to black out, and I nearly fainted a couple of times. When I informed my GP he assured me that the risperidone wasn’t responsible, because ‘it used to be prescribed all the time ten years ago’ and he ‘never had a case like this’.
A few weeks later my depression hadn’t really improved, and sleeping problems were starting to creep back in, so it was decided that it was time to start taking 2mg risperidone each night. Two days later I nearly passed out in a supermarket. And at this dose I found my appetite beginning to soar. In my journal there’s a little debate about whether or not to keep taking risperidone, which went as follows:
Reasons to stop taking it: lose my appetite and get control back on eating, reduce dizziness
Reasons to keep taking them: marginal help with sleep, mood stabilizing effect, withdrawal symptoms
I’m kind of ashamed that my main reason for not taking it was diet-related, but maybe that isn’t surprising given my strange relationship with food and weight. Anyway, I stopped, and the next day my GP pushed me very hard to keep going with it because ‘we’re almost out of therapeutic options here’, he wasn’t happy to leave me taking only fluoxetine because he remembered the ‘dark times’, and said the dizziness situation would sort itself out with time. He gave me another prescription in high hopes I would take it. After discussing it with my therapist (who was irritatingly neutral), I binned it.
I haven’t had any issues with dizziness since I stopped taking risperidone, so I’m pretty sure the med was to blame. I experienced something similar with quetiapine (Seroquel), so I guess it’s possible that I have a strange reaction to atypical antipsychotics.
Doses: 0.5mg, 1mg, 2mg
Positives: I slept really well on this medication, and I found my mood stabilized over the period I was taking it.
Negatives: Dizziness every time I stood up, occasionally to the point of losing vision. Increased appetite when taking 2mg daily
Conclusion: I was grateful to have improved sleep since I struggle with insomnia, but ultimately it did little for my depression beyond stabilizing my lows. It certainly wasn’t worth the difficulties caused by persistent dizziness, or weight gain. Not the med for me.