Risperdal & Feeling Anxious
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Q:  Risperdal & Feeling Anxious

Hi Dr. Phelps.

MY fiancee was diagnosed with bipolar disorder about 3 yrs ago. Since then she was put on DEpakote, Lithium and Risperdal. Last year she was daignosed with symptoms of PCOS. After reading your site extensivley, we spoke to her doctor and got her off Depakote. Since then all her symptoms have disappeared. Because we are shortly going to get married and are considering children in the future she wanted to stop going off Risperdal as well. Her psychiatrist slowly took her off and she completely stopped taking the drug about 3wks ago. For about the last 2 months we have been undergoing some small crisis in our lives and plus she has been extremely stressed with school and work. However in the last 2 weeks she has been saying that she feels anxious all the time. She says she feels so anxious that her chest would explode or something. We have been really worried as to what is happening and wondering whether her going off Risperdal has anything to do with i  t. She is currently on Lithium and Tegretol and her doctor has not increased the dose of either. If you could help that would be excellent and we would really appreciate it. I am sorry I have just used my middle name to protect her identity.

Dear V' -- 
Let's just use your initial to protect your, and her, identity a bit further..

Yes, I would think that the timing rather implicates the tapering of Risperidone as related to the onset of these symptoms.  However,  since lithium and Tegretol are clearly associated with causing abnormalities in developing fetuses, things are going to get trickier from here.  Working with a bipolar specialist who can advise you on your options for symptom control while trying to conceive a child will be very important, if you can get that.  In the short run, as you imply, a small increase in either lithium or Tegretol (if her levels are less than around 0.9 and 10, respectively) might be helpful; make sure to get current levels first, in a situation like this.  

Dr. Phelps 

 Published January, 2004


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