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Old 01-19-12, 10:14 PM
nevermessymind nevermessymind is offline
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Klonopin w/ Risperdal

I was recently diagnosed w/ ADD--inattentive type. My psychiatrist won't prescribe me a stimulant med because I have had seizures w/ a medication I took while in college (I am in my 40's now), and because I have trichotillomania (hair pulling) which can be worsened by stimulants.

Instead, he prescribed Wellbutrin xl 150mg to be taken in the morning, Klonopin .5 mg to be taken morning and night, and Risperdal .5 mg to be taken at night. I was too scared to take the Risperdal last night, but I did take the Klonopin. Because I was so sleepy this morning I was afraid to take my morning dose of Klonopin. I just took the Wellbutrin. I continued to feel pretty sleepy for most of the day.

The dr wants me to take the Klonopin partly because it raises the seizure threshold in patients like me who are apparently predisposed to seizures. This is to counteract the Wellbutrin which lowers the seizure threshold And the Risperdal??? I can't even remember why he wants me to take it--anxiety, I think--which is not what I was there for. Anxiety is not my main problem. The ADD is. Even the trich has improved on it's own with age. Not as much a problem for me. I am scared to death to take the Risperdal and the Klonopin at the same time. In the office the dr acted like these were very low doses, but the Klonopin didn't feel like a low dose to me. Any insight as to how the 2 combined might affect me?
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Old 01-20-12, 01:34 AM
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Re: Klonopin w/ Risperdal

Risperdal for anxiety? It's an anti-psychotic. Now that I think about it, there are some people who use it for anxiety. I don't know how successful it is treating anxiety. Klonopin will help with anxiety.

Are you diagnosed with anything else? Besides ADHD? Bipolar? Depression?

If you're concerned about taking it, I'd have to say you'd be better off to call the doc and ask why he wants you to take it.
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Old 01-20-12, 06:57 AM
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Re: Klonopin w/ Risperdal

Seems like a strange choice of meds... I typically would say to stay away from the antipsychotic class of medications until you've tried your other options. On rispedal I had orthostatic hypotension and a breast lump (I'm a guy) something to do with prolactin... Olanzapine was more tolerable for me but I don't think it helped me much. It's pretty common for an atypical antipsychotic to be used as a mood-stabilizer in conjunction with an antidepressant though at low doses, which .5mg risperdal is. If you have a history of seizures, I'm wondering why the doctor is reluctant to prescribe Buproprion, but will not try stimulants, as both are containdicted with people with seizures... but maybe the risk with Buproprion is lower?

I also suffer from a seizure disorder, by the way. Clonazepam is a pretty standard thing for anxiety and it is an anti-convulsant. Atomoxetine (I've never been on it) is an SNRI approved for ADHD. Carbemazepine , which I have been on, is used as a seizure medication but also as a mood-stabilizer, and has been successfully been used off-label as a treatment for ADHD.

Like BR549 said, do you have any other psychological conditions, especially depression because there are so many options like SSRIs, tricyclics (can lower seizure threshold), etc. There are just so many options. I usually don't even like to recommend SSRIs to people because of my personal experiences, but they do work very well for some people in treating depression as well as anxiety. Clonazepam works wonders, but now that I'm on a stimulant, I am tapering off with no change in my anxiety.

Hope this helps somewhat. I encourage you to actively participate in your treatment and let your doctor know what you think and exactly how you feel. Don't be insistant that you know more about your doctor's profession than he/she does because that just challenges them, but make suggestions based on your research and how you feel, because you're the best judge of how you feel and function.
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Old 01-20-12, 12:08 PM
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Re: Klonopin w/ Risperdal

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Originally Posted by BR549 View Post
Risperdal for anxiety? It's an anti-psychotic. Now that I think about it, there are some people who use it for anxiety. I don't know how successful it is treating anxiety. Klonopin will help with anxiety.

Are you diagnosed with anything else? Besides ADHD? Bipolar? Depression?
I have had trichotillomania since childhood, so I'm thinking he believes I have OCD tendencies. He kept questioning me in that direction, but none of what he asked me about ocd symptoms applied to me. Trich is an impulse control disorder--not OCD. Still, I'm thinking maybe that is why he prescribed the Risperdal??? I made a point to tell him that the trich is not nearly the problem that it used to be. It has dramatically improved as I've gotten older. And yes, I do have some anxiety, but not enough to need an anti psychotic! Seems like overkill on top of the Klonopin.

Quote:
If you have a history of seizures, I'm wondering why the doctor is reluctant to prescribe Buproprion, but will not try stimulants, as both are containdicted with people with seizures... but maybe the risk with Buproprion is lower?
That is exactly what I was wondering. I really don't get it--except maybe he just has some personal bias against them. Or maybe he is not convinced that I really have ADD--I am afraid that is the case. He spent very little time questioning about my ADD symptoms. Kept going down the OCD trail and seizure disorder trail--which are the least of my worries at this point.

Quote:
Like BR549 said, do you have any other psychological conditions, especially depression because there are so many options like SSRIs, tricyclics (can lower seizure threshold), etc. There are just so many options. I usually don't even like to recommend SSRIs to people because of my personal experiences, but they do work very well for some people in treating depression as well as anxiety. Clonazepam works wonders, but now that I'm on a stimulant, I am tapering off with no change in my anxiety.
It was a tricyclic antidepressant that caused my seizures--Anafranil. I was taking it for the trich--many, many years ago. I never got past the build up phase on that med.

Quote:
Hope this helps somewhat. I encourage you to actively participate in your treatment and let your doctor know what you think and exactly how you feel. Don't be insistant that you know more about your doctor's profession than he/she does because that just challenges them, but make suggestions based on your research and how you feel, because you're the best judge of how you feel and function.
This helps very much. I do feel like I need a "do-over" appointment w/ this doctor. I had my first appt w/ the therapist yesterday, and that was more encouraging. He works w/ the psychiatrist, so I think that will give me more credibility if I need to go back to the psy. and say that I need to try something else. I am a little concerned about what you said about "challenging" the doctor. The psychiatrist said that back when he was in surgery (med school) the doctors would tell them that the "dumb blonde" patients were the best and healed the fastest because they were trusting and didn't worry about anything. It was the "professors" who had all the problems and complications w/ healing. So he said I needed to take the "dumb blonde" approach to my treatment. don't read anything--just take the meds and don't worry about it. How convenient for him, right?

Anyway, I did get brave and took the Risperdal last night along w/ the Klonopin. But I did not take another dose of K this morning as directed because I'm still so groggy. I'm thinking about cutting one in half and taking it at lunch. I know some of this grogginess should go away after a few days on this stuff. On a positive note the Risperdal didn't seem to make it worse. I was afraid I would be nearly comatose on it!

I do plan to call the dr and have him explain to me again the benefit he sees for me in taking the Risperdal. Thank you to both of you for your input. I really appreciate it.
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Old 01-20-12, 12:40 PM
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Re: Klonopin w/ Risperdal

Quote:
Originally Posted by nevermessymind
The psychiatrist said that back when he was in surgery (med school) the doctors would tell them that the "dumb blonde" patients were the best and healed the fastest because they were trusting and didn't worry about anything. It was the "professors" who had all the problems and complications w/ healing. So he said I needed to take the "dumb blonde" approach to my treatment. don't read anything--just take the meds and don't worry about it. How convenient for him, right?
Oh my....NOT at good sign, IMO. I definitely wouldn't play the 'dumb blonde'. Doctors do have knowledge and have gone to school and through training. However, that doesn't mean that they don't make mistakes or that there aren't some who don't know what the heck they are doing. It's really up to you to investigate and learn about the medication you are taking before you take it. You are taking some pretty serious meds. An anti-psychotic, a benzodiazepine and an NDRI.

While I don't always put much stock into online drug interaction lists, I do check them and then check with my pharmacist or doctor (although it sounds like your pharmacists may be your best bet in this case.....) to see what they say.

You can check drug interactions here. This site states a moderate interaction between Risperdal and Klonopin; Klonopin and Wellbutrin and a major interaction between Wellbutrin and Risperdal M-Tab:

http://www.drugs.com/drug-interactio...8-440-203.html
http://www.drugs.com/drug-interactio...7-440-203.html
http://www.drugs.com/drug-interactio...2019-1305.html


There have been times that I've questioned a drug combo that my doc prescribed only to be told "yes, there is a reported drug interaction, sometimes severe, between these two medications, but I've never had a patient who had a problem before."

Well, just because he's never encountered any problems with the combo he's prescribed doesn't mean that one won't happen. I always feel like these things should be talked about when the medication is prescribed AND I should be told why I am being prescribed a combo that has been reported to potentially have an interaction.

Again, don't know that I'd rely solely on the site above. It's your responsibility to do some more homework and see if in deed an interaction does exist before you take any medication. Don't rely solely on what this doc says. Especially if he's telling you to just take it and don't give it another thought!
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Old 01-20-12, 12:55 PM
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Re: Klonopin w/ Risperdal

BR549--I totally agree w/ you. I think at this point I am so desperate for some help that I am willing to try working w/ him. After my next appt, if I do not feel like he is taking my concerns seriously, I will switch doctors. I already have someone in mind. Does any of you know... Do neurologists treat ADD? This psychiatrist actually mentioned I might want to see a neuro some time about the seizure thing. ( I rarely, about once a year, smell smoke that isn't there--apparently some other sort of sign of a seizure disorder). I was thinking a neurologist might be more likely to treat me w/ more typical adhd meds since he would be very knowledgeable about this predisposition to seizures. I mean, many people w/ seizure disorders also have adhd--pretty common for the two to go hand in hand.
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Old 01-20-12, 01:00 PM
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Re: Klonopin w/ Risperdal

A neurologist can diagnose and treat ADHD. I'd recommend finding one who has experience with ADHD, simply because not all doctors (pdocs included) believe ADHD is a real disorder. You could encounter a costly visit and numerous tests (which, if you have seizure disorder are more than likely necessary and a good idea) and come away untreated.
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Old 01-20-12, 01:22 PM
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Re: Klonopin w/ Risperdal

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Originally Posted by BR549 View Post
A neurologist can diagnose and treat ADHD. I'd recommend finding one who has experience with ADHD, simply because not all doctors (pdocs included) believe ADHD is a real disorder. You could encounter a costly visit and numerous tests (which, if you have seizure disorder are more than likely necessary and a good idea) and come away untreated.
I think, despite the evidence that exists, that there are both psychiatrist and neurologists that are reluctant to acknowledge ADHD. A issue that further exacerbates this problem is the polemics between the two professions. In my opinion, psychiatry and neurology are so interconnected and the disconnect between the two has slowed down, at least within the medical profession and academia, understanding developmental disorders and mental illness IMO.

The most important thing when looking for a psychiatrist, neurologist, neuropsychiatrist, psychologist, is trust. You are a patient paying (a hefty sum) for a service. That service is good treatment, respect, confidentiality, trust, etc. If you're not getting that, take your business elsewhere. It can be difficult, but it's often more difficult if you don't. Your doctor is not one to be in control of you, they're getting paid to help. That being said, show respect for your doctor, it is often reciprocated.

Apologies for my rants, I've had a lot of doctors over the years, some very good, some absolutely awful and I did not question anything when sometimes, I should have.
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Old 02-09-12, 09:59 AM
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Re: Klonopin w/ Risperdal

I'm currently prescribed 1mg of Risperdal in the morning and 3mg at night with Klonopin 3x a day at the dose of 0.25 and to be honest there working great so don't be afraid of taking them together.
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Old 02-09-12, 09:51 PM
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Re: Klonopin w/ Risperdal

I have been taking all 3 meds as prescribed, and I am doing better. I sure do sleep well at night. And for the first time in years, I don't have trouble waking up in the morning. ( I was concerned that taking the Klonopin w/ the Risperdal that I would really have trouble waking up.) The jury's still out on whether the Wellbutrin is helping my ADD. I do feel better--more motivation, but I'm still struggling w/ procrastination, prioritizing, time management, etc. I am supposed to double my dose of Wellbutrin after 3 weeks (which has probably already past), so maybe that will help. I'm being a chicken again, though, and not wanting to take that second Welbutrin pill. I'm really gun shy of all meds since I seem to be one of the types that have weird side effects.
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