Paranoia came back - Adding risperidone to clozapine?

Medications
1

I increased clozapine by 25mg to total of 250mg. I don’t want to increase it further or else i get serious side effects like bed wetting, postural hypotension.

I asked my pdoc if instead of increasing clozapine to fix paranoia, we add risperidone. He agreed and said only max dose of 1mg risperidone can be added.

So i wanted to ask is will adding 1mg risperidone will cause significant side effects ? Will it increase prolactin too much ? WIll I require trihexyphenidyl or benztropine at this dose ? Is 1mg enough to fix paranoia, given that i also take clozapine 250mg.

2

No,it’s safe combo.Did you ever take risperidone?Actualy,i was on combo with both.No side effects.

3

Never tried risperidone. Have tried paliperidone 6mg but it gave me sexual dysfunction, so i stopped it.

4

It’s the same as paliperidone since it is delivered from risperidone.I think 1mg risperidone is libido free,it’s half of begining dossage

5

Pdoc told me low dose risperidone is better than amisulpride.

6

Give it a try.Wont hurt.

7

Risperdal Consta 37.5 mg injection every two weeks gives me total sexual anesthesia. And has for years and years. It’s wack but, it works on my paranoia, thought broadcasting and reception, so, I don’t complain about it. Nothing else ever worked.

8

What is about this"sex" thing.Like it’s only thing to live for!

9

I’m thinking on the same line. I don’t care about sexual dysfunction anymore. Let it be. I will have to make trade off between being mentally sane or being sexually functonal.

Will start risperidone once i get the prescription. Will also discuss about amisulpride with my pdoc.

10

Hope you fine the right combination of meds and begin to feel better @clinic.

11

So the meds that you’re currently on don’t give you sexual dysfunction? What meds are you on now? I’m on paliperidone and I’ve had sexual dysfunction for 9 months.

Edit: I see you’re on clozapine. Dw.

12

Yes, I have not started risperidone and I still have sexual dysfunction maybe because of paroxetine. But who knows. I don’t get orgasm at all

I’m on clozapine 250, paroxetine cr 37.5, clobazam 10mg and will soon add the 4th med - risperidone.

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13

I used to take 100mg clozapine + 4mg risperidon and it helps A lot with thinking ability,

Don’t start with a high dose of risperidon but with low doses like that 1mg and then increase it if needs,

No noticeable side effect for me,

14

risperidone was helping with thinking ability ? like what ? Does 4mg was giving u any side effects?

15

did u had Extrapyramidal symptoms on risperidone ?

16

No not itself but when combined with clozapine, like ability to understand math or other matters,

No side effect,
In addition: both of risperidon and clozapine are of category of new generation APs so you will not need anticholinergics like biperidin or trihexyphenidil,
Good luck

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17

No, nothing as I think,

18

So why did u stop risperidone ? What meds r u taking now ?

19

I take 50mg clozapine+ 4mg risperidon+ 100mg sertraline now, in mornings,

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20

ok good, all antidepressants(ssri/snri/tricyclic) except paroxetine worsen my psychosis

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