Substitute for Risperdal Consta?
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Q:  Substitute for Risperdal Consta?

Dear Dr. Phelps:

I was recently diagnosed with bipolar disorder and I currecntly take Risperdal Consta 50mg every two weeks.  The medication works wonders, but the side effects, wieght gain and male sexual problems have persisted.  Is there a substitute for this drug?  Can I take diet pills?  What about pills to help with mens sexual health?  These side effects did not wear off, and your insight would be helpful.


Dear Mr. N' -- 
You could cautiously
talk to your doctor about trying one of the "mood stabilizer" approaches which are described in the APA guidelines for the treatment of bipolar disorder and in the Texas algorithm (both described and linked from this list of mood stabilizer options).  These guidelines both start with lithium and valproate (Depakote), and also olanzapine (Zyprexa) though the latter is associated with more severe weight gain and diabetes risk than your risperidone.  And the first two are also associated with weight gain (read my description of using Depakote ER, which I still believe allows one to generally avoid weight gain if appetite increases are avoided by dose reduction).  Good luck with figuring out your options. 

Dr. Phelps

Published December, 2004


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