question about Risperdal

Hello! I wanted to ask a question and see if I could get a little info from you all on my situation.
5 yrs ago I suffered a stroke due to a brain aneurysm at age 29. I was left with a lesion on my brain which left me with no peripherial vision in my right eye and a portion in my left eye was gone as well.
Shortly after that, I was diagnosed with Severe Anxiety Disorder, along with severe depression. In the end, I was diagnosed with Bipolar. I was placed on Serzone, Celexa, and Depakote... as well as I was given Ativan to use as needed. During the two years of my treatment on these meds, I did not really notice a change except when I was feeling as if I was on the edge of depression, I would sorta of 'numb out' rather than really get depressed. As far as the mania was concerned, I bypassed feeling as if I was on top of the world and in a super high mood.. to total rage. I also developed seizures... and I felt that they were caused by my psychiatrist raising my dosages in attempt to cancel out other side effects from the other meds I was taking. Because it became so frustrating, I stopped all of my meds for months. Eventually, I cycled around, and this time I became worse than I have ever experienced with this. I resorted to inflicting physical pain on myself because my mind tried to convince me that this was the way out of all the mental anguish I was having. I was contemplating a plan of suicide... and I had just the nerve to do it at this point because I was pissed off that much with life and everyone in it.
When I realized that I was way over the line and treading ground that I had no control over, I went in to see a new psychiatrist 4 weeks ago. At the time, he only saw the low side, and assumed I was just severely depressed. He treated me with Effexor... which did not set well with my other side of this coin..... the Manic side. I became totally out of control, and had reached a very high level of hallucinations, as well as I thought I was about to see the last of myself! I went back in to see my psychiatrist, where he told me to immediately stop the Effexor, and he placed me on 2mg of Ripserdal for the first few days. I noticed a suttle change the very next day when I awoke. A couple of days passed, and I became depressed. But not like the depressed that I was used to.... and I depended on my husband alot to listen to what I was feeling. Talking to him got me into another state of mind and out of the depression soon.
Now, that has tapered off, and I am not experiencing the depression but only once a day, and it only lasts for a few hours. My psychiatrist is aware of this, and is holding off on giving me an antidepressant unless I get to a point where I cannot get out of it on my own. So it isnt posing a big threat at this point.
My concern is.... it has been almost 4 weeks since I began the Risperdal. I attempted to back the dosage down to 1 mg a day after the first few days, but found out quickly that THAT was not gonna work for me. So I stayed with 2mgs... and this past week I have experienced some rapid thoughts daily, which caused my psychi to move the dose up to 3mgs a day. Despite the higher dosage, I am still experiencing these thoughts daily.. bad attitudes.. and anger outbursts. Altho they do not last long, they are still coming. It only seems like it is getting worse, and its as if the med is not working for me anymore.. already. I am in fear that I am gonna wake up one morning and be in a total fit of rage unexpectedly... and I DONT wanna do this. (lol WHO DOES!?! )
So, what would you guys do? Should I contact my doctor ASAP and tell him about this? Or should I give the extra dosage time to work? Its only been a couple of days since I began 3 mgs a day... and I am really at a loss for direction on this one.
Any advice or suggestions would be greatly appreciated!!

~kimmy

I was on risperidal at a very low dosage (1 mg) for years. Its an anti psychotic and is there to keep you from having hallucations if u go extremely manic. U should tell ur doc what is going on and ask him to put u on meds for mania. I have been on both Lithium and Depakote over the years. Lithium is much cheap if u can tolarate the side effects.

Hi, Kimmy,

Are you taking anything aside from Risperdal? I've been rx'd the same for acute treatment of mania, including what you mentioned - to counteract negative effects of anti-d's that I should never have been prescribed in the first place. I can relate completely to your feelings of rage and fear of it. It has been one of the most dangerous types of feelings/episodes I have ever experienced - more so than even very severe depression. If I am in a frenzied state with no outlet, harming myself becomes a very viable option (in my mind, during that state). I would definitely talk to your doctor in more depth about what you are experiencing. If you have just started seeing a new psychiatrist, it will probably take some time to fully communicate all you need to - and he is just learning how you respond to meds - so, unfortunately, it make take some time to get things right.

I have not found any especially successful combination of meds, despite trying just about everything over the years. (I have taken Risperdal several times for acute mania). Sometimes the initial effect I may get from a particular med seems to wear off or stop working after a while. In other cases, I have changed meds unsuccessfully, but when I changed back to the better meds, for some mysterious reason, I no longer benefited from them in the same way. I have read about this and wondered if anyone else has had a similar experience. I am wondering if the Risperdal isn't doing the same thing for you anymore. It may simply be that you need something ELSE or something in addition to Risperdal. Every BP case I have heard of so far has been treated with multiple meds, so it would not be surprising that Risperdal alone is not doing the trick.

I cannot tolerate A-Ds so all any professionals worry about is curbing the mania and otherwise I just have to fend for myself. As much as I hate this, ADs are clearly very bad for me... and there is no other solution, as of yet. I am quite certain, in my own case, that AD's actually triggered this anger/rage, as it is totally out of character for me and I previously did not have an issue with it.

It's great that you have your husband there for you. If you can communicate with him about what you are experiencing, he might be able to help you monitor these feelings and maybe help you figure out some strategies for coping with it, when it does arise. The rage can become intensified so quickly that it can be a serious problem before you have a chance to recognize it. Unfortunately, I don't have any solutions of my own - benzos are my only resort, if I catch the anger early on I can sometimes sedate myself, but even this is not always affective.