Q:  Near-jaw Paralysis - Result of Meds?

I was diagnosed as bipolar in 2002.
I have developed near-jaw paralysis since last February.  I have been on Risperdal since Dec. 2000 and Lithium since April 2002.  At the time I developed this chewing problem I was on 3mg of Risperdal.  I have lowered my Risperdal to 2mg since then and still experience an inability to close my mouth and grind food to a pulp and swallow it. I suspect this problem may be result of accumulation of Risperdal in my system, but my psychiatrists are clueless on this matter and are of no help at all. 
 
Could this crippling, potentially life-threatening (I lost twenty pounds in five months) condition be the result of medication I have been taking for years? I also have been taking 2mg of Benztropine a day, and have been taking Lamictal since November.  It is very difficult to chew.  I mostly eat softer foods that I can break apart with my tongue.  When I try to really chew something, I look like I'm grappling with a serious case of tardive dyskinesia, but my psychiatrists have ruled that out.

Can you help?

 

Dear Mr. B' -- 
Perhaps, if only to say that I would start by supporting your hunch that Risperidone could be involved in this (I couldn't tell from your question whether lowering the dose made any difference at all?  If it did, that would be suggestive; but if not, it would not rule the possibility of a more tardive dyskinesia kind of a phenomenon.  I hope you can find a movement disorders specialist to comment further.  In the meantime, perhaps you and your psychiatrist have been discussing alternative medication approaches you could try while this is getting figured out? 

Dr. Phelps 

Published April 2005