Psychiatry on antipsychotics: Risperidone

By Fugitive Psychiatrist: For More Info, Go Here…

Don’t try this at home.


Do not take a medication you weren’t prescribed just to see what it feels like.

I realize this makes me a hypocrite, but I am a trained physician. I prescribe medications for a living. No, doctors are not legally allowed to prescribe themselves medications, but that’s only because if we were I’d be prescribing myself Valium, most of pediatrics would be prescribing themselves stimulants (not for ADHD, for the OCPD), and the anesthesiologists would be prescribing themselves opiates. If you think that’s concerning just wait until MDMA get’s an indication. The government and the physician associations know this, and they know it looks bad, which is why they make us cajole our classmates into giving us the drugs we want. I know it’s unfair, but I didn’t make the rules.

Consider that, at the very least, I know the signs of serious negative reactions like akathisia and dystonia, and I make sure I have the meds on hand to treat them. It’s not unreasonable to assume I know more about antipsychotics and their side effects than will be conveyed to most patients by their prescriber. So although I might be able to do this safely, possibly safer than the average doctor prescribes risperidone, you cannot.

Now please, spare me the condescending comments about insulin.

Day 1: risperidone 0.5 mg at 0800 and 1 mg at 2000

I was tired and irritable all morning. I’m tired and irritable most mornings, so this was nothing new.

By 0930 I had a very mild headache. It went away with 2000 mg of Tylenol.

By 1100 I noticed something astounding: at rest, my mind was blank. I say “at rest” because I could still bring myself to exert mental effort, but the usual running series of thoughts were gone.

No ruminating about deadlines and appointments, no imaginary conversations with difficult patients, no fantasizing about fucking the one hot first-year resident, no trying to remember what groceries I need to get later, no editing manuscripts in my mind, no wondering when I am actually going to find time to re-write this stupid manuscript, and what happened to Reviewer 2 as a child that shaped him into the sadistic pedant he is today…. Nothing. Serenity. It was great.

I went through my work day more or less normally. I was in pretty a pretty good mood all day. By about 1700 I was more or less back to my normal self, which is to say, in a worse mood.

My appetite remained the same throughout the day. I ate a regular supper. I still need groceries though. I was supposed to do that tonight.

I took the second dose at 2000. It’s now 2100 and I feel sleepy. Not comatose like on Seroquel but what I imagine normal people feel like when they know it’s time for bed.

Overall this was a pleasant day. Although I did miss the new resident, this confirmed two beliefs I have about low doses of risperidone, until now based almost entirely on anecdotal evidence: it is useful for worrying/ruminating/obsessing/intrusive thoughts, and compared to many antipsychotics, it is not particularly sedating.

Day 2: risperidone 2 mg at 0800 and 2 mg at 2000

Holy fuck, am I sedated.

It’s now 10 am, and I feel like I was up all night doing something despicable. I wasn’t. I went to bed at 930 like a child. I only saw one patient this morning, and thank god she likes to talk about herself because I could barely string together a sentence. I also misspelt (misspelled?) October as “Obtober” on a script. Fortunately I caught it. I would have felt so embarrassed next time the pharmacist called to warn me about the dangers of QT prolongation.

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