risperdone

Can anyone tell me how Risperdone and Depakote together affect you. My 70 year old partner was very recently hospitalized and diagnosed with Bipolar. He was released with 2000 mg of Depakote and 2mg of Risperdal daily. He is doing quite well except for having to be hospitalized for a minor surgery and a temp, which during this time the depakote and risperdone were held for three days. Just before being added back he began to show symptoms of the delusions again, after being back on meds none whatsoever. My question is he doesn't seem to be typical Bipolar, never has had the depressions part only the manic, psychotic phase. His psych said stay on these meds two more months then he will gradually taper off and stop the Risperdone. It seems to me that it's the only one he needs, since delusions were the only major symptom. Never had the ups and downs just the hyper and delusional symptoms. Is this not what the Risperdone addresses?

[ILADVOCATE]

Depakoate is of course a mood stabilizer but it generally works better on mania than depression. Risperdal is of course an antipsychotic but it also has full mood stabilization effects. Generally (it states this on the package insert) anti-psychotics are used with caution in people that are elderly so his psychiatrist is probably seeing whether he absolutely needs it or not. Of course if any psychotic symptoms return if a medication is adjusted or discontinued bring it to the psychiatrist's attention.

[cornyguy]

Your partner's Psychiatrist wants to taper and stop the Risperdone once your partner is better and wants to maintain him on Depokoate which is a good mood stabilizing med.Risperdone will be tapered slowly over 4-6 weeks and only then stopped.

[cleo730]

Yes, but he only showed symptoms of delusions and mania, is the Risperdone not the drug of choice for this, I'm just concerned that will return when the Risperdone is discontinued. Do you think?

[cornyguy]

Yes but he needs Risperdone to bring him to normal level and later Depokoate to keep his mood stable.Risperdone has numerous serious side effects especially in elderly patients so is kept only till required.It will tapered very slowly over 4-6 weeks so generally symptoms wont return.It can be restarted by his psychiatrist if they do so dont worry.

[cowgirlnerd]

My insurance company has changed Abilify to a "Non-Preferred" drug and suggests Risperidone as an alternative.  Would they be classified as equivalents in your opinion?

Abilify is working pretty well, but wanted to see what you thought before I talk to my pdoc.

THOUGHTS?

Racheal

[ILADVOCATE]

If your psychiatrist can write up why Abilify works better for you that can be appealed. Abilify is somewhat different than Risperdal as it is a SDA (Serotonin Dopamine Agonist) and as well it is the least likely out of the antipsychotics to cause weight gain and diabetes and less sedating. If it has helped you better or caused less side effects for you than Risperdal your psychiatrist needs to write a letter documenting why. What you need to do is to call your insurance company and find out how to contest a denial of coverage. They should send you a form and include the psychiatrist's letter with that.

[cowgirlnerd]

Why does Abilify cause diabetes?  I know that is one of the side effects on there and I have been watching mine lately, but I was wondering how it chemically causes that to happen???

Racheal

[ILADVOCATE]

Weight gain and diabetes is a problem with all of the atypical antipsychotics because of the receptors they target in the brain (in addition to the ones they are supposed to work on) which cause metabolic imbalances. If kept in check it generally is not permanent though but any changes in weight or appetite should be reported to a psychiatrist. The antipsychotics most likely to cause this are Clozaril and Zyprexa. The least is Abilify though of course it can and does happen. Diet regulation is the key. As I've posted that will not be a problem with the next generation antipsychotics because they are more specifically targeted to the receptors they need to work on.