Mood stabilizer (Mania) vs Antipsychotic

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Now that I recognize my symptoms after stabilizing sz with 4mg Risperdal, I think I sometimes get mania symptoms that stop after taking my AP at night. Mania symptoms only happen after 3pm as AP blood lvl decrease. To test this I split my 4mg into 2mg at night and 2mg at noon. Definitively pushed manic symptoms to just an hour or less before taking my AP and now it happens much less, maybe 2-3x a week.

Problem is that the AP worsen my negative symptoms. Do mania meds do the same? I am thinking maybe reducing my Risperdal to 2x 1.5mg and take a mood stabilizer at the same time. I read that APs are also used to treat mania so my theory is correct about having mania when AP blood lvl is low.

I need to apply for a new psychiatrist though as now I have none.

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It feels like mania, a rush of bad unstable energy, agitation, hyperactivity, irritability/aggression not related to paranoia, etc

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I am thinking about Lamictal. Does it worsen negative symptoms like APs?

Edit: Lamictal is not for mania so its carbamazepine or valproate.

I am reading about mood stalizers side effects and they can be serious. Idk if I should just stick to AP only.

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Lamictal is quite an activating drug.
It’s usually for depression not so much for mania at lower doses.

Lamictal made me anxious and manic.

I couldn’t tolerate it at doses over 25mg.

Another good mood stabilizer that is better suited towards mania would be Tegretol.

It’s also pretty much weight neutral.

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Thanks, I just read about Tegretol on Wikipedia, its for mania and has the least serious side effects vs others.

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Did you try Tegretol?

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I was on Tegretol for decades.
Minimal side effects but it could interact with Risperdal.
It reduces the effectiveness of risperidone.

Tegretol interacts with lots of different meds.

Periodic blood tests are required for Tegretol.

This means you would probably need to be on an increased amount of risperidone while taking Tegretol.

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Oh that sucks. I wonder how many mania meds there is.

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Isnt lithium one ?

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Lamictal works on mania at higher doses.
It doesn’t interact with risperidone.

And it might even help with negative symptoms.

Blood tests aren’t required for Lamictal.

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When I have hypomania, typically in August, I lower my antidepressants and increase my antipsychotic.

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Yes but it can likely cause thyroid and kidney problems. 50% of those on lithium have kidney problems according to Wikipedia.

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Stay away from lithium.
It’s toxic.

It destroyed my thyroid and it wreaks havoc on your kidneys.

Frequent blood tests are required.

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I’m on over the counter Lithium. I believe it is neuroregenerative,

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I think I will just stay on Risperdal then, more meds more side effects. Maybe I will increase to 5mg Risperdal, 3mg at night and 2mg at noon.

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At lower doses, lithium can be neuroprotective.
But higher doses are needed to be effective against mania.

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I’m just on Risperdal with no added mood stabilizer.
And I may have bipolar disorder.

Risperdal is a very effective mood stabilizing medication

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That’s fine. I take a small dose of Lithium Orotate as prescribed by my supplements guy.

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My negative symptoms are a bit worse since splitting the 4mg during the day but I feel better, much less mania. Maybe I will go 5mg, 3mg+2mg if the mania gets bad or causes problems.

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Yes, I feel best on Risperdal out of the 4-5 APs I have tried.

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