Mental Health

Have Mental Health Questions? Ask a Psychiatrist Online

Ask an Expert,
Get an Answer ASAP!

Mental Health
This answer was rated:

I was diagnosed with traumatic brain injury and psychosis

Hi. I was diagnosed with...
Hi. I was diagnosed with traumatic brain injury and psychosis not otherwise specified about 8 years ago. I have been symptom free for these 8 years while on 3 and then 4 mg of risperidone. up until last year where i felt i was experiencing some symptoms of psychosis after a bad drug interaction with xenical weight loss I got back to normal but now stopped drinking coffee and tea as it tended to increase or stimulate me. I also upgraded some months ago to 5mg risperidone. i asked my doctor and he said ok. I have felt a bit off today and and worried that possibly a relapse is happening. so my questions are could the upgrade to 5mg have caused a resistance, causing the medication to not work. and if i am headed toward relapse, what should i do mitigate the problems, for instance changing meds or increasing the dosage again, what should i do exactly what steps should i take? I dont want to relapse. thanks
Show More
Show Less
Ask Your Own Mental Health Question
Answered in 1 hour by:
4/10/2017
Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4,723
Experience: MD Psychiatry
Verified
Greetings.
Welcome to the site.
I am a Psychiatrist and I believe that I can help you with your query.
Well, since it has been a very long time that you have been using risperidone so there are high chances that you may have developed tolerance or resistance against this drug which is evident from the fact that a fairly high dose of 5 mg is now not enough to contain your psychotic symptoms, according to me , you need to augment the action of risperidone by adding another anti psychotic medication but at a modest dose so that your symptoms get stabilized plus you will be able to reduce the dose of risperidone also thereby mitigating its potential side effects. Another Alternative would be to replace risperidone altogether but this may pose a risk of relapse since you will have to introduce new anti psychotic drug while lowering the dose of risperidone which may allow the symptoms to flare up.
So I would suggest that you ask your doctor to use an another anti psychotic medication as Aan augmenting agent , some good ones would be Lurasidone at dose of 40 mg per day or aripiprazole 5-10 mg per day while lowering the dose of risperidone to 4 mg after 1 week of introducing any one of these two. This shall hell you to over the impending relapse or prevent it in the first place.
Once your symptoms have been stabilized then your doctor can decide on keeping one of the two anti psychotic medications and removing the other preferably risperidone since it has been there since long and is losing it's edge.
I hope this makes sense and hopefully it will solve your problem.
Wish you all the best.
Please kindly leave a POSITIVE RATING if you are satisfied with the answer.
Regards
Ask Your Own Mental Health Question
Customer reply replied 9 months ago
your saying its ok to take risperidone and abilify at the same time? dont I have to cut one out?
it is okay to take them co comitantly , while risperidone can be taken at night , on the other hand abilify in the morning.
I hope this helps.
Wish you all the best.
Please kindly leave a POSITIVE RATING if you are satisfied with the answer.
Regards
Ask Your Own Mental Health Question
Customer reply replied 9 months ago
The issue is, I am not sure if i am relapsing. I still am pretty normal, keeping in mind my situation. I mean can type to you read, write watch tv, Im not sure if its how I normally am or its something happening, im not sure how to tell
Customer reply replied 9 months ago
is there a way to tell if I am having problems, can i take both medications permanetly or should i stop on eventually?
Well, if your mind starts getting bizarre thoughts rendering you confused and ambivalent then it would be the right time to start on abilify while continuing on risperidone. You see one or two days of feeling odd or uncomfortable cannot actually tell if it us relapse, so you need to wait and watch over your symptoms for next couple of weeks at least so as to know if you are relapsing or not.
At the moment I feel you should just wait and watch over your mood and the thought process and if you find some changes on the lines of psychosis then you ask doctor to prescribe you this abilify.
I hope this helps
Wish you all the best.
Please kindly leave a POSITIVE RATING if you are satisfied with the answer.
Regards
Ask Your Own Mental Health Question
Customer reply replied 9 months ago
Hi.sorry for the delay. Would I have to stay on both of the medications permanetly?
Also, if i feel that I am stable at this point, and dont need abilify, would it be ok to go back down to 4mg of risperidone. Would that help to reduce the chances of resistance to the medication? if it hasnt happened yet?
No you do not have to be placed permanently on both the drugs but as I said earlier one of these two will have to be weaned off , preferably the new drug abilify should stay while risperidone will have to be tapered off since it is the one that has become ineffective due to increased tolerance aka resistance of the body against this drug .
If you feel okay then there is no need to start on abilify but do not go down to 4 mg just as yet since it will be too fast tapering too soon. The reduction of dose would not increase the chances of lowered resistance.
I hope this helps.
Wish you all the best.
May I please request you to kindly leave a POSITIVE RATING if you are satisfied with the answer.
Regards
Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4,723
Experience: MD Psychiatry
Verified
Dr. Kaushik and 87 other Mental Health Specialists are ready to help you
Ask your own question now
Customer reply replied 9 months ago
Thanks. So ho would I go on the abilify? Would I start with 1mg for a week at time until 5 mg? I want no sideeffects. I am in the middle of school and life etc, i dont want any set backs. Is there and interaction with abilify and rispierdone?
You may start at at 2 mg of abilify to be taken in the morning while continuing on risperidone in the night, this to be continued for 1 week after which increase the dose of abilify to 5 mg while still continuing on risperidone at present dose, continue​ this for 10 days and then further up the dose of abilify to 10 mg in the morning while still continuing on risperidone as it is at night time.
This strategy and pattern if you follow will lower the chances of interaction between these two however, you must ask your doctor to also start you on trihexylphenidyl 2 mg twice a day dose for preventing any sort of side effect with the concomitant use of these two antipsychotic medications.
I hope this sums it up for you.
Wish you all the best.
Regards
Ask Your Own Mental Health Question
Customer reply replied 9 months ago
what interactions are possible, because i have a doctor telling me its pretty risky to take these to meds
Extrapyramidal side effects like tremors, dystonia , akathisia, poor balance and incoordination, etc but these can be prevented by use of trihexylphenidyl as mentioned above, mention this drug to your doctor, hopefully he will understand and his apprehension can be mitigated.
Regrds
Ask Your Own Mental Health Question
Ask Dr. Kaushik Your Own Question
Dr. Kaushik
Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4,723
4,723 Satisfied Customers
Experience: MD Psychiatry

Dr. Kaushik is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much

Corrie MollPretoria, South Africa

I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well!

ClaudiaAlbuquerque, NM

Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion.

KevinBeaverton, OR

Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
I feel better already! Thank you.

ElanorTracy, CA

Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem.

JulieLockesburg, AR

You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions.

John and StefanieTucson, AZ

I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!!

Janet VPhoenix, AZ

< Previous | Next >

Meet the Experts:

Dr. Keane

Dr. Keane

Therapist

1,379 satisfied customers

Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.

TherapistMarryAnn

TherapistMarryAnn

Therapist

4,021 satisfied customers

Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.

Dr. Olsen

Dr. Olsen

Psychologist

2,336 satisfied customers

PsyD Psychologist

Norman M.

Norman M.

Principal psychotherapist in private practice. Newspaper contributor, over 2000 satisfied clients on JA

2,246 satisfied customers

ADHP(NC), DEHP(NC), ECP, UKCP Registered.

Dr. Michael

Dr. Michael

Psychologist

2,177 satisfied customers

Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.

Steven Olsen

Steven Olsen

Therapist

1,728 satisfied customers

More than twenty years of expertise in counseling, psychological diagnosis and education

Anna

Anna

Mental Health Professional

1,656 satisfied customers

Licensed Clinical Social Worker with 29 years in addictions and mental health.

< Previous | Next >

Related Mental Health Questions
The term mental breakdown I believe is typically a layman's
The term mental breakdown I believe is typically a layman's term in rarely used clinically; the affluent, uber wealthy, celebrities specifically are known to check themselves into types of facilities,… read more
TherapistMarryAnn
TherapistMarryAnn
Therapist
Master's Degree
4,021 satisfied customers
Message for Dr. Kaushik Psychiatrist: My son, aged 20yrs, is
Message forCustomerPsychiatrist: My son, aged 20yrs, is currently on a daily dosage of 20mg(Zyprexa) and 20mg(Abilify). He takes the Abilify around noon and the Zyprexa at night. He also takes 2mg eac… read more
Dr. Kaushik
Dr. Kaushik
Psychiatrist
4,723 satisfied customers
How can I support a struggling friend? She is 29, in good
How can I support a struggling friend? She is 29, in good physical health, usually fairly steady, very bright and kind. Her behavior has changed dramatically in recent months: ending a relationship, q… read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
772 satisfied customers
I was continuously bullied and dismissed. I have been seeing
Hi doctor,My name is***** was continuously bullied and dismissed. I have been seeing GP for more than 18 months for depression, anxiety and PTSD. Recently, I was admitted to hospital for six weeks. No… read more
Linda D.
Linda D.
Master\u0027s Degree
795 satisfied customers
My stepson 18 yrs old talks to himself and giggles a lot.
My stepson 18 yrs old talks to himself and giggles a lot. Even when we are in a discussion or in public he tunes out and starts this monologue. If I ask him about it he just says he's thinking of some… read more
Dr. Kaushik
Dr. Kaushik
Psychiatrist
4,723 satisfied customers
My son, aged 20yrs, is currently on 20mg of Zyprexa (i
My son, aged 20yrs, is currently on 20mg of Zyprexa (i tablet oral per night). However he still complains of the positive symptom of audible hallucinations. His Psychiatrist decided to try him with Ab… read more
Dr. Kaushik
Dr. Kaushik
Psychiatrist
4,723 satisfied customers
My dghtr just turned 30yrs and has had psychosis demetia
My dghtr just turned 30yrs and has had psychosis demetia like symptoms for 7yrs; seems like it started when she was prescribed antipsychotics. Have had difficulty because she would get angry n violent… read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,679 satisfied customers
As I dictate this message as a last resort for first
As I dictate this message as a last resort for first impressions are practically impossible due to technology. Furthermore, Mutual respect, trust, honor, integrity and dignity seem to be archaic ideol… read more
JohnMichaels,MS,LPC
JohnMichaels,MS,LPC
Counselor
Master\u0027s Degree
171 satisfied customers
I had been taking risperidone for psychosis (brain injury)
Greetings. I had been taking risperidone for psychosis (brain injury) since 2009 and my condition was great. I was able to drink coffee green and black tea, though i drank decaf coffee only, i could s… read more
Dr. David
Dr. David
Radiation Oncology Attending Director
Post-Doctoral Degree
13,095 satisfied customers
My boyfriend is a 25+ year off and on meth user. He recently
My boyfriend is a 25+ year off and on meth user. He recently went on a 3 month binge and a month into it he started telling me that I worked for the federal government, put tracking devices and camera… read more
Dr. Thomas, MD
Dr. Thomas, MD
2,227 satisfied customers
One year ago I suffered from drug induced psychosis and was
.one year ago I suffered from drug induced psychosis and was hospitalised for two months. The drug that caused the psychosis was dexamphetamine, taken for ADHD. Since then I have continued to suffer w… read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,679 satisfied customers
Its my wife, she has not taken her cymbalta for several days
its my wife, she has not taken her cymbalta for several days and is now accusing me of wild things … read more
Dr. Kaushik
Dr. Kaushik
Psychiatrist
4,723 satisfied customers
My fiance is showing signs of psychosis. 53, born here but
My fiance is showing signs of psychosis. 53, born here but raised in Iraq. Taken from mother and raised by father's family. Dad never there till he was a teen, then intermittently. Alcohol abuse as a … read more
Dr. Mark
Dr. Mark
Doctoral Degree
129 satisfied customers
My mom has psychosis resulting from Parkinson medication.
My mom has psychosis resulting from Parkinson medication. she won't eat. she says she just ate or she will eat tomorrow … read more
Dr. Mark
Dr. Mark
Doctoral Degree
129 satisfied customers
I'm not sure if I'm experiencing psychosis and want to ask
I'm not sure if I'm experiencing psychosis and want to ask about it … read more
Dr. Z
Dr. Z
Psychologist
Doctoral Degree
9,633 satisfied customers
I was wondering if it's possible for to induce psychosis
Hello. I was wondering if it's possible for weed to induce psychosis like symptoms that only last the duration of being high. I recently smoked weed with a friend, which I have very little experience … read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
772 satisfied customers
According to the doctor,my brother was acute psychosis after
According to the doctor,my brother was acute psychosis after inhaling dendrite( solvent) for a continuous 3 days and 3 nights. The doctor immediately prescribed: 1. Ativan 1 mg thrice daily for 3 days… read more
Schuyler
Schuyler
1,944 satisfied customers
My 16 yo has major depressive disorder with psychosis. She
Hi. My 16 yo has major depressive disorder with psychosis. She takes 20 mg of Olanzapine, 60 mg of fluoxetine and 4 mg of melatonin and 4 mg of melatonin prolonged release. I have bipolar disorder typ… read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,679 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x