Depression medication, Risperidone alternatives?

[glbv]

Currently on Risperidone 1mg twice a day for depression and I used it for 6 months with a supply I had from the states. Worked well and zero weight gain. So ive run out as of a week ago and man oh man do I feel the difference.

Now the problem isn't getting it her its the cost. The pharmacy I use sells x20 1mg pills for about 2500B, seeing as I take them twice a day that's 5000b a month as well as the issue of availability which they seem shaky on.

Does any one have alternative suggestions in the Anti-psychotic medicine range for someone paying out of pocket? Ive used Seroquil in the past for 11 years and gained roughly 150lbs, so Id rather be massively depressed than a just depressed whale again.

[Deserted]

This is a little confusing risperidrone isn't an anti-depressant its an anti-psychotic, meaning all it does is control dopamine levels. I'm really very surprised that you've been prescribed that for depression.

My advice is go to Ramathibodi Hospital and register as a patient. The psychiatric unit is on the Tuk Chang intersection, they have open days on tuesday and thursday I think. A visit plus medication isn't going to cost you more than 500 Baht and the doctors do know what they are doing, they also speak English very well.

Would be interested to know why you were prescribed that. Are you bi-polar if I may ask?

[WitawatWatawit]

Can't help you on that one. But an Aussie friend of mine who was on the evil Xanax brought his medical records and a doctor's cert up here and was given restricted amounts of the drug by a hospital (can't remember which one). I note there are a number of similar drugs to this one, so maybe you can list them and go and talk to a doctor. Hope you tapered off and didn't go cold turkey.

[Deserted]

Xanax is part of the first wave of anti-psychotics, all of which are crude out-dated drugs. The OP needs an anti-depressant. Like anti-psychotics they have come a long way, the second wave of them are refined and are clinically proven to help change people's lives. Xanax came out of the 60's and was superseded a long time ago.

[jrtmedic]

I am surprised you have been able to purchase this medication as there are restrictions associated with its supply.

" S = Special Controlled Drug (controlled substance).

A first Grade pharmacist shall be on Duty at the Premises selling Modern drugs. Sale to Public is on prescription only. Daily Purchase and Sale Record Required. " (Ref Mims Thailand)

As the medication requires a doctors prescription it is likely only available via a hospital pharmacy.

I believe the Thai Government Pharmaceutical Organization manufacture a generic version of Risperidone but I have no information about cost.

Do not be tempted to "try" alternative medications unless guided by professional medical advise.

Edited July 18, 2013 by jrtmedic

[glbv]

I'm going to try Ramathibodi Hospital and see what they can do sounds like the best thing. Sadly I did go cold turkey and I'm feeling it.

As for what it was prescribed for I have never been officially diagnosed with bipolar but I feel like I'm more on that side of the scale than straight depression.

I appreciate the help. For buying everything and anything there's always someone willing to sell it, expecially in bkk.

[WitawatWatawit]

I'm going to try Ramathibodi Hospital and see what they can do sounds like the best thing. Sadly I did go cold turkey and I'm feeling it.

As for what it was prescribed for I have never been officially diagnosed with bipolar but I feel like I'm more on that side of the scale than straight depression.

I appreciate the help. For buying everything and anything there's always someone willing to sell it, expecially in bkk.

Jesus christ, man, don't go that route. I did, and I'm paying for it. Badly. Suggest you check out a website called benzobuddies - a couple of hours of reading that forum will frighten the living c*ap out of you. Follow their link to the Ashton manual and read it. Thoroughly. If you've gone cold turkey, it's often (but not always) better to keep going and suffer the withdrawal symptoms. Find a sympathetic doctor - not easy in this area. But be very careful if they want to put you on other medication. They don't always know what they're doing with these drugs in this country.

[Sheryl]

There is a locally made GPO (Government Pharmaceutical Organization) brand which will be substantially less expensive.

There is also a brand imported from China called Neuris which, while it will cost more than the GPO version, will still be much less than the imported Risperdal brand which I assume is what you have been taking.

It is however a controlled drug available on prescription only. While there may be some pharmacies that will supply it on that basis, in general Thai pharmacies do not deal in scripts and you will likely have to go to a hospital for it.

Although originally developed as an anti-psychotic, risperidone is indeed used in teratment of depression that does not respond to first line drugs. Although usually given in combination with other meds. It is also used to treat biloar disorder.

That this was prescribed for you in the US suggests a fairly severe and/or complex problem. I suggest you get your medical records or a short medical summary from your doctor in the US stating the diagnosis and prescription and then get under the care of a psychiatrist here. All the major hospitals have psych. depts but government hospitals will be more likely to have the generic drug in stock.

The red tape and waits at government hospitals can be a bit daunting especially for non-Thai speakers, if possible bring a Thai speaker with you at least the first time. Even the forms to fill out are all in Thai.

I don't know about Ramatibhodi but Chulalonghorn Hospital has an after hours clinic starting about 4 PM on their 13th floor of the OPD building where you can more quickly access a specialist (will need to first register on the 1st floor to get a patient card and number).

Another possibility might be St Louis Hospital which is a non-profit. I would expect (but am not sure) they would have generics in their pharmacy. This link will take you to a listing of doctors and their hours http://www.saintlouis.or.th/clinic/listdr.php?dept_id=12

St Louis will be much easier to deal with in terms of English speaking and speed of accessing a doctor. just can't 100% guarantee their pharmacy will carry GPO brand but I would think they would.

[mrtoad]

There is a lot of conflicting advice here on this thread.

1) Risperidone is an anti-psychotic - not normally prescribed for depression, as a front line drug, I think Sheryl has made that clear in her post, so this would suggest that you have had treatment resistant episodes.

2) Xanax - is an anxiylotic which is not prescribed for Psychosis or depression. It is widely mis-prescribed, and widely abused. It also seems to be the favoured cure all for lot's of ex-pats. Don't do it - it's highly addictive, and should only be used for short term interventions, under the care of a Mental Health Professional.

Have a read of this site http://recovery-road.org/

Given the information, and the possibility of the complexities of your presentation, suggest that you see a suitable Psychiatrist. There are a few suggestions. Dr Worawat at Samitivej-Srinakrin I have also found to be good. It's interesting, that the prescribing and your description alludes to Bi-Polar, and it may well be worth having a suitable assesment undertaken by a Psychiatrist, or a certified Psychologist /Therapist.

Whatever you do, don't just go and obtain these types of meds from a pharmacy without proper consultation.

[CPH]

Risperidone is an antipsychotic which can have long term complications. If you only suffer from depression I would suggest that you try an antidepressant like Fluoxetine which is available as generic in Thailand and very cheap.

[Deserted]

Am inclined to agree. The feeling from Risperidone takes quite a bit of getting used to. I certainly couldn't.

[Sheryl]

The OP was prescribed risperidone by his doctor and states it is working well. We have no way of knowing what factors may have lead his physician to choose that particular drug, he may have more than simple depression, or other drugs may have failed to work. I would not advise changing medications without medical supervision.

[DtemJai]

Natural option: Ginseng, Omega3, B-complex + extra dose of B12, Durian fruit, bananas – Don’t try to solve the entire world problem in your mind. Ms Sheryl advice seems makes a lot sense. BTW, I never have experience depression myself, nor done any research. Goggle topic.

[MrHammer]

Natural option: Ginseng, Omega3, B-complex + extra dose of B12, Durian fruit, bananas – Don’t try to solve the entire world problem in your mind. Ms Sheryl advice seems makes a lot sense. BTW, I never have experience depression myself, nor done any research. Goggle topic.

There are some natural options which actually do work. A relative of mine has schizophrenia and depression and has been on antipsychotics and antdepressants for years, however, he managed to function for some months (which is a first) without medication by taking a natural root extract called Sarpaghanda (http://en.wikipedia.org/wiki/Rauvolfia_serpentina). It is a very well known plant in traditional medicine. Ghandi himself used it as a tranquilizer. It contains a compound called reserpine which has actually been extracted in the past to make antipsychotic medicine.

Its effects are quite potent and according to my relative (who has more serious issues than the OP), it does actually calm the mind similar to antipsychotics and antidepressants.

It MIGHT be enough.

[jrtmedic]

MrHammer

Dangerous advise !

"Extreme caution should be exercised in treating patients with a history of mental depression. Reserpine may cause mental depression. Recognition of depression may be difficult because this condition may often be disguised by somatic complaints (Masked Depression). The drug should be discontinued at first signs of depression such as despondency, early morning insomnia, loss of appetite, impotence, or self-deprecation. Drug-induced depression may persist for several months after drug withdrawal and may be severe enough to result in suicide."

Ref http://www.drugs.com/pro/reserpine.html

A little ill informed knowledge can be fatal !

Edited August 18, 2013 by jrtmedic

[MrHammer]

MrHammer

Dangerous advise !

"Extreme caution should be exercised in treating patients with a history of mental depression. Reserpine may cause mental depression. Recognition of depression may be difficult because this condition may often be disguised by somatic complaints (Masked Depression). The drug should be discontinued at first signs of depression such as despondency, early morning insomnia, loss of appetite, impotence, or self-deprecation. Drug-induced depression may persist for several months after drug withdrawal and may be severe enough to result in suicide."

Ref http://www.drugs.com/pro/reserpine.html

A little ill informed knowledge can be fatal !

It is good that you are paying attention, but Sarpaghanda is not Reserpine.

Reserpine has some of the same compounds as Sarpaghanda.

Sarphaganda combats depression, it does not cause it.

In any case, have you read the side effect label from an anti-depressant, one of the side effects is 'depression' and 'suicidal thoughts'.

I know from close experience that sarphaganda does work - for this case at least - it made a person who had been on anti-depressants and anti-psychotics for YEARS be able to function without both.

Do your own research but don't fall into the trap of thinking the establishment drugs are 'safe.

[jrtmedic]

"There are some natural options which actually do work. A relative of mine has schizophrenia and depression and has been on antipsychotics and antdepressants for years, however, he managed to function for some months (which is a first) without medication by taking a natural root extract called Sarpaghanda(http://en.wikipedia....lfia_serpentina). It is a very well known plant in traditional medicine. Ghandi himself used it as a tranquilizer. It contains a compound called reserpine which has actually been extracted in the past to make antipsychotic medicine."

I know nothing about quackery. The above are your words which claim the magic potion contains reserpine. Reserpine is a dangerous medication when used in an uncontrolled manner by amateurs.

Reserpine has been discontinued in the UK for some years due to its numerous interactions and side effects.

[FBN]

"Trying out" medication suggested on an open forum for someone who has been diagnosed and treated with specific medication is irresponsible of both the poster and the patient.

The OP has indicated he will seek the appropriate medical advice suggested by a poster on this thread and I suggest we hear from the OP of any outcome which may be of benefit so people out there with similar problems; advising unproven alternative and possibly even dangerous medication in this particular case is of no benefit to anybody.

[MrHammer]

"Trying out" medication suggested on an open forum for someone who has been diagnosed and treated with specific medication is irresponsible of both the poster and the patient.

The OP has indicated he will seek the appropriate medical advice suggested by a poster on this thread and I suggest we hear from the OP of any outcome which may be of benefit so people out there with similar problems; advising unproven alternative and possibly even dangerous medication in this particular case is of no benefit to anybody.

'Dangerous medication'.

Have you ever read the side effect folder of SSRI's.

Let us list some quick ones from NHS.co.uk

Antidepressants and suicide risk

Some people have experienced suicidal thoughts and a desire to self-harm when they start taking SSRIs. Those under 25 years of age seem particularly at risk.

Some but not all antidepressant drugs known as SSRIs pose a very small but serious heart risk, say researchers.

Citalopram and escitalopram, which fall into this drug group, can trigger a heart rhythm disturbance, a new study in the British Medical Journal shows.

But I will admit that I was mistaken in recommending Rauwulfia Serpentina for depression, when it is actually used against psychosis, but why is the OP on an anti-psychotic if he is being treated for depression? More likely is that he is being treated for bipolar.

So, I would like to ask a mod to delete the posts I made recommending it for depression, but I will still maintain that it can be a natural treatment of schizophrenia. Keep in mind that Rauwulfia Serpentina root extract is not the same as pure reserpine.

In fact there are several clinical studies out there:

http://link.springer.com/article/10.1007%2FBF01568739

The effectiveness of Rauwolfia serpentina drugs in the control of overt anxiety in ambulatory psychiatric patients is equal to that of a conventional treatment of anxiety, as shown in a study of matched patient groups.

BUT IT IS NOT TO BE USED FOR DEPRESSION.

I apologize for recommending it as such.

[jrtmedic]

The link given directly above relates to the 1950's.

Since that time reserpin has been discredited and many countries have banned its use.

Attempting to influence (or impress ?) by providing such outdated information is , to put it mildly , grossly irresponsible!

Edited August 20, 2013 by jrtmedic

[MrHammer]

The link given directly above relates to the 1950's.

Since that time reserpin has been discredited and many countries have banned its use.

Attempting to influence (or impress ?) by providing such outdated information is , to put it mildly , grossly irresponsible!

As compared to new studies which find that ,modern SSRIs carry significant risk of heart complications and suicidal thoughts.

Unlike you, I have first hand experience with the root in question, which is still not the same as reserpine. Lets be clear though, psychiatry is largely a quack science at best and at worst torture. Psychiatrists have done horrible things to people (lobotomy, ice 'therapy', electroshock), not to mention the thousands of people who are living zombies from taking that 'well tested' mainstream medicine.

So jrtmedic, you are not a doctor or a psychiatrist as far as I know, your opinion is no better than mine.

[Sheryl]

The incipient flamefest stops now or the concerned parties will find themselves on a posting holiday.

Again, the OP who has been prescribed a specific psychotropic medication by a physician familiar with his condition should not make an changes except under a physician's guidance.

It is difficult enough for trained professionals to distinguish between "pure" depression, depression mixed with anxiety and other mood disorders. It is impossible for a lay person to do so and also impossible for anyone, even a mental health professional, to do so online.