I am conflicted (choosing an AP)

Geodon vs Risperidone

Geodon Pros
-Works very well for my negative symptoms
-Lowers my appetite which helps me lose weight
-Takes away my sex drive which is a pro for me bc it triggers my psychosis

-Only positive symptom it worked for was voices, did not help with anything else
-If I take it during the day it heavily sedates me and makes me unable to drive or really go anywhere for long periods of time due to side effects (also makes me dizzy and lightheaded)
-When I tried to take it only at night I begin getting bad withdrawal effects in the morning (anxiety, strong gag reflex, vomiting, etc)

Risperidone Pros
-Completely took away all my positive symptoms
-No sedation
-No akathisia or anxiety

-Made negative symptoms slightly worse
-10 lb a month weight gain (though this may have been due to the elevated prolactin)

Both meds prevent me from orgasm but Wellbutrin helps to reverse that so I would probably ask to stay on a small dose of Wellbutrin with either.

I’m so conflicted because geodon was really so wonderful for my negative symptoms and now that I’m going off they’re coming back again and it’s miserable. But Risperidone was so amazing for my positive symptoms and didn’t come with side effects that negatively impacted my functioning and ability to go places independently. I’m not sure what the solution is for this and I’ll ask my doctor but what do you guys think?

If only I didn’t get withdrawal from geodon maybe I could take it at night and Risperidone during the day. But that could create worse issues w prolactin because both elevate it, even if I do go on something to help with that. And the double dopamine blockade could give me higher risk for TD later on.

I’m just not sure what to think.

(Summary: Geodon works really well for my negative symptoms but not positive, risperidone works really well for my positive but not negative, wondering if I could somehow have the best of both worlds)

Like you said, you can try risperidone with low dose Abilify.
Ask your pdoc about it.

But it doesn’t help my negative symptoms. Geodon was so good for my negative symptoms, I felt like it gave me my willpower back and I could even do things like watch long tv shows and movies again. I am sorely missing that now that these are coming back. All I do is lie in bed all day again.

So I have to ask, what is your doctor’s opinion on this matter? Ultimately he or she will decide what to prescribe. I say let your dr do his or her job, but with some input from you. I just think too often people want to choose their own meds, instead of letting a person with years of education and training do it for them.

Sorry if that came across wrong; I didn’t mean it in any kind of mean way. Or maybe I misunderstood what you’re saying here.


Have you tried Vraylar?
Very effective for Negative symptoms.

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No I think that’s a very good point, I should let the professional decide. He actually recommended haldol, saying it was very similar to Risperidone only with no risk to raise prolactin. But I have heard only very bad things about haldol so I refused. I’m also sick of trying new medication at this point, especially now when I have classes starting and a new job. I can’t afford to go through the whole process of adjusting to a new medication right now.

I think it depends on the scenario. My pdoc said it’s “at least 50% your decision what meds You take”. After all you don’t have to take them necessarily if you don’t like them. If my pdoc gave me clozaril against my will I’d say no way and not even fill the prescription. That wouldn’t be something my pdoc wouldn’t do. I chose and suggested abilify klonopin and Zoloft. He suggested naltrexone. The 4 meds work great for me and I suggested 3 of them! I also mAke it my call to change dosage. I think when I was very psychotic my pdoc made all the decisions. It wasn’t till we really started working together we made great progress. I know my self better than my pdoc does I feel. But I think much of the time pdoc knows best but us educated board folks may have some good suggestions to make!

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Abilify works very well for me. It’s the best medication I’ve been on, although it does tend to mess with my vision. Pros: No positive symptoms, helps with motivation issues, regulates mood; Cons: Blurred vision, decreased libido, anhedonia (slight).