Here is a letter from V. about her son and Invega- also previosly known as extended release Risperdal.
Julie,
My son has been treated for bi-polar with a mix of medications which includes Invega. This is a newer version of risperdal which is supposed to have fewer side effects. I think my son is suffering from reduced cognitive functioning, like he is in a fog. It is hard to tell because he definitely had a real drop in IQ testing (about 20 points) which the doctors thought were due to his anxiety and depression at the time of the testing, but I think it might be the meds too.
He seems “dumber” than ever and complains about it. He used to be very sharp, although he had other emotional problems which are better controlled now. Do you have any experience with invega or has anyone heard of this? He also seems to have significantly thinning hair and I suspect the 2000 mg of depakote he takes. Any ideas?
Hi V,
First of all, I am not a doctor! I always say that because I truly believe a medications specialist is our best friend in managing this illness.
To answer your question, there is no doubt that Risperdal (Risperidone) can cause fuzziness! All anti psychotics are known for this, though Abilify is supposed to have less. A friend of mine is on Zyprexa and always says it dulls her. And yet it keeps her out of the hospital and able to work part time! There is a side effect called anhedonia that is described a lack of feeling- the official definition is without emotion. I definitely get it when my meds are off. It can definitely come with depression as well. There are quite a few meds that can cause thinning hair and some cause hair to fall out in clumps. Remember, bipolar meds are chemo therapy!
Having said this, it’s wonderful that his emotions are more under control. They can cause more trouble than being dull from medications. Anxiety and depression cause memory and focus problems- they can also make you feel emotionally dull, but the ‘dumb’ feeling sounds like meds.
I suggest you talk with the medications doctor and explain that you know the meds are helping and that it’s great for your son, but he feels dulled intellectually. At least it will start a discussion. It’s important that your son knows that what he’s going through may be a normal side effect of the meds and it’s not permanent. Once he is more stable, it may be he can reduce meds with the help of his HCP. Treatment of the illness comes first- when it is more managed- it’s a good time to work on side effects. It’s a trade off!
Say hi to your son for me. It’s great that he takes his meds!
Julie
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I was reading your recent blog regarding V’s son and also information posted about Lamictal. I too am on a combination of medications, Risperdone, Lamotrigine, Diazepam and Lexapro and it is a constant balancing act. I have to balance the anxiety, memory loss, decreased cognitive function, dullness, fog, muscle cramps, hair loss and weight gain without becoming manic or depressed.
My doctor is very precise and will only adjust one medication at a time and very slow to make medications changes prior to a stressful event, especially the holidays. After dealing with this for 10 years, I now understand why. Making one change at a time has given me the ability to assess the benefits and side-effects of the each medication.
Given my background in computer information systems and systems analysis (always trying to figure out the cause and effect and “solve the problem”) I pay close attention to the changes in my life, mood and the effects of the medication.
For several years now, my doctor and counselor have told me the memory loss is due to anxiety. I understand that some of it is, however these past two months I’ve really been shutting down – I can’t remember anything, I feel like I have Alzheimer’s and ADD. I can’t follow conversations, can’t remember what I read yesterday and find it impossible to keep my schedule in order. Feeling lethargic and numb, I ask myself and my counselor if I am depressed. I feel down because I haven’t accomplished anything in the past two months, but it doesn’t feel like the depression in the past where I felt hopeless or like a failure. So what is it?
After wrapping up a huge project, dealing with family issues and winding down after the holidays, I thought I just needed rest, however the lethargy and as V says, “dumbness” kept getting worse. I finally realized I was overmedicated when my hair started falling out in clumps again. Looking back, I noted this happened when I tried depakote and lithium for a period of time and when I first started taking Lamictal. With each dosage increase of Lamicatal, the hair loss would increase until things leveled out. For insurance reasons I was forced to switch to the generic lamotrigine, but found no side effects. Now that I’ve been exercising more and loosing weight, I think the medication is too much. With my doctor’s permission, I decreased the lamotrigine and the hair loss subsided as did some of the confusion…. but not all.
As for cognitive fogginess, I agree risperdal or risperdone is a contributor. I have adjusted (increased and decreased) this medication over the past 10 years. One of the side effects that I have is the muscle cramps and stiffness in my neck and back. The most I can take now is .25mg, but do feel the benefits (controlling the drastic mood swings and emotional rollercoaster) outweigh the side-effects.
Just like bipolar, keeping your mind, body and spirit in balance is an on going process.
I am taking depakoke for the my bi-polar(clinical diagnosis was Rapid Cycling Bipolar Disorder) and Effexor for my depression. After being on the depakote since August I noticed hair thinning in January and “freaked” out. I am hoping that everthing will level out and I’ll stop seeing strands of hair coming out in my hands when washing my hair. I have gained about 10lbs but with the warmer weather I’ll be out and about walking around. I have also done changes in eating habits and diet (changing the food I eat.
I was on invega and found that it really helped my anxiety right away. I liked it overall but over the course of a year I gained 40 lbs! I finally went off and went back to taking more geodon, only at night, lamictal and ritalin in the daytime, and ativan prn. I don’t feel as good as I did on the invega but I am not gaining weight anymore. I think Invega is a good drug but just makes you really hungry. If you can control that, you’re good.
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I love this blog. I was told about it after leaving the hospital stay in which I was diagnosed. I still read it almost every day.
I wanted to just add on the medications to be sure and stay in touch with your doctor. When I was stablized and out of the hospital, I was feeling good but I did notice losing more hair. When I saw my doctor, it didn’t look bad at all (I had thick hair) so we didn’t make a change.
Then maybe a couple of weeks later I called and asked again about the hair thinning and she put me on folic acid. THEN, two weeks later I had my appointment with her and took off my hat – she immediately said we have to STOP depakote! We put me on lithium and after losing 95% of my hair, it is back, thick and now it is CURLY! Just make sure you keep checking with your doctor!
Thanks – Robin
Hi Robin,
That is great advice! Just a check in even if you feel that things are fine can prevent a lot of future trouble. I am SO glad you got your hair back. I have lost hair as well and it’s upsetting- hair is important! Julie
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