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What Causes Mood Instability, Seizures And OCD While On Lamictal And Risperdal?

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Posted on Sat, 27 Jun 2015
Question: I already asked this question, and paid for it, about my medical needs, and I haven't had a response to it! Please read this note to answer my question this time. I need a new specialist to answer this question-I was injured 14 years ago. I didn't have a seizure until 9 years ago, after I had a rib put into my head, when I received a bad operation that scarred a nerve. 7 years ago, I got a better pill for me, Lamictal that got rid of the seizures-I still keep taking it. I also take Risperdol, for some reason-probably since I'm disrespected for my personl wants, by other people-case manager and guardians who think I should want to be like them. They're different, and I like one of my guardians. I'm not bipolar, or schizoprenic, and I don't act like epilectic, my seizures weren't too bad, they don't run in the family, and I never had to lay down. I'm on Risperdol for a matter of this situation that I'm in. I want to see a cognitive theripist, for my OCD where I have to go over things until I get them, somehow repeatedly. I think it's because I take Risperdol, since my memory is being hurt. I do have mood stability problem. What type of pill should I be taking to correct my situation-hopefully it won't make me gain weight, or lose sexual desire. Please tell me the name or possibly the closest one's name for my needs.



doctor
Answered by Dr. Shubham Mehta (2 hours later)
Brief Answer:
dose increment of lamictal or oxcarbazepine.

Detailed Answer:
Hello
Welcome to HCM.
I have gone through your query thoroughly and understand your concerns.

You have been taking Lamictal post-operatively for seizure control and doing well after you sustained head-injury.

Risperidone is an antipsychotic which is primarily indicated for schizophrenia or bipolar disorder. It is also used off-label for behavioral disturbances after head-injury.

Risperidone can affect cognition and thus cause memory issues.
If you feel that your OCD has developed after starting risperidone, discontinuing the drug will help.

If your seizures are controlled on lamictal but you still have mood issues, I would suggest a dose increment of lamictal for mood stabilization rather than starting another drug.
The reason being that almost all mood-stabilisers cause weight gain.

However, if another drug has to be considered, oxcarbazepine can be used as it has least propensity to cause weight gain after lamictal.

Another mood stabiliser which can cause weight loss is topiramate. But, I would not advise to use topiramate for two reasons:
1. It is the third line mood stabilizer.
2. It can precipitate behavioral problems in predisposed individuals and can cause neuropathic pain.

You should definitely seek for a therapist for OCD.
Kindly discuss these issues with your doctor. Drug/dose change should only be considered under your treating doctor's supervision.

Hope these suggestions help you.

I wish you well.
Take care.
Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (2 hours later)
I've just gotta say--I'm lucky to have you!!! Now, I hope my neuro, and phyciatrist will agreed with you!!!

Do you think I still might take Metformin, or Gacrenia Cambogia w/colon cleanser-Meftformin sounds the best, if I take a different weight gaining pill in addition for regaining my health along with the Lamictal? Is there a way to get sexual feelings-like Vibryd, I believe that's the one I can take-should I get into a boyfriend, or something else-even vitamins or food?

I read that oxcarbazepine can make you loose your memory. Of course, I need something better than that.
doctor
Answered by Dr. Shubham Mehta (1 hour later)
Brief Answer:
Metformin is the most suitable choice for weight loss.

Detailed Answer:
Happy to help you.

Metformin is the most suitable choice for drug induced weight gain in my opinion.

I would not suggest you viibryd. There are some claims that it does not affect sexual life and cause weight loss. But my personal opinion is that it does cause sexual dysfunction and even weight gain.

The best thing to get back to sexual feelings is to fall in a relationship. No drugs can increase libido. Some food like chocolates, almonds are known to increase libido. You can take those instead of medicines.

I would like to tell you that ALL psychotropics (be it lamictal, oxcarbazepine, topiramate or SSRIs) can affect memory.

But then, considering drugs and their side effects in relative terms, oxcarbazepine and lamictal cause least memory impairment and weight gain.
I personally have good experience in my patients with these drugs.

Kindly discuss this with your doctor.

If you wish, you can always approach me directly by visiting my profile for any of your health-related queries at your convenience.

I wish you well.

Take care.
Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (6 hours later)
Is there anyway that my neurologist, phyciatrist, Dr. Wright, contact you for your help? I can pay for that visit. If so, please give me the name and contact phone number for your visit--to be forwarded to Dr. Manilla, and Dr. Wright? At least we spoke to each other, by writing each other I should say. I live in Kinston, NC, and I'd like to be your customer in person. Do you provide your business in this area?
doctor
Answered by Dr. Shubham Mehta (4 hours later)
Brief Answer:
happy to help.

Detailed Answer:
Sorry for the late reply dear.

I belong to XXXXXXX and practice as a consultant here.

You can contact me here anytime directly by visiting my profile on healthcare magic.
You can also find my facebook profile link and other details in my profile.

I will be happy to help.

You can take a print-out of whatever we discuss and take to your doctor for further discussion.

Hope you found my suggestions in our earlier discussions to be helpful.

Expecting a positive feedback from you.

I wish you well.

Take care.
Thanks.

Dr. Shubham Mehta, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (15 hours later)
Hi Mr. Mehtah,
I just was told by my one guardian, that I was allergic to Tegertiol, and this ox. pill that you recommended contains tegretal ( I don't know how to spell it!). So now we have to find another good one, like these ox. results. My guardian is impressed with your knowledge-this can be rare, so we might get my Drs. advised that your meds. will work. I think that they might be full of themselves.
So, we do need my guardians' knowledge-she's smart that will advise them to give me your prescription.
Sincerely,
XXXX

By the way, I'm taking the maximum level of Lamictal. Also, maybe you've noticed that I was hit by a van, while working on the side of a street, but this man was using his tunnel vision looking at a tar truck that I was going to back onto the street at the airport in PA, USA. I went flying through the air 45 feet. I injured alot of the body-along with the brain.
doctor
Answered by Dr. Shubham Mehta (1 hour later)
Brief Answer:
avoid oxcarbazepine.

Detailed Answer:
If you are allergic to tegrital, oxcarbazepine would not be suitable for you.

You are taking maximum dose of lamictal.

In that case, I can think of another two drugs which are used 'off-label' as mood stabilisers:
1. Neurontin (gabapentin): it does not cause weight gain but can cause sedation.

2. Keppra (Levetiracetam): Primarily an anti-epileptic but has been found to useful as mood stabiliser in some cases. Negligible side effects. No weight gain, no sexual side effects.

I hope these drugs work for you.
Kindly discuss this with your doctor.

Feel free to ask further.
Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (51 minutes later)
I had Neurontin, but I wouldn't take it because it made me too tired. The side effects for Keppra don't look too good. I'd rather take walnuts and almonds, like you stated for sex, and your weight gain meds., not too much necessary I hope, and go for a different seizure control-hopefully, and pretty good memory, and to others-mood stability pills. Ya see, some things put everybody in a bad mood, but I'm not allowed to feel that way!
doctor
Answered by Dr. Shubham Mehta (7 minutes later)
Brief Answer:
ocassional mood swings are normal.

Detailed Answer:
In my practical experience, I have not seen any major side effect of keppra.

Theoretically, internet may show a long list of side effects. But the practical experience is different.

Occasional mood swings are normal.
Why you are not allowed to feel bad? This is a normal emotion.

If you are having good seizure control with lamotrigine, there is no need of another drug.

Its better to try relaxation exercises like deep breathing and meditation than to take medicines for mood stability.

Take care.
Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (3 minutes later)
By the way, you can see that my memory isn't too good. I meant to say "chocolate" instead of walnuts. It's a good thing that I love chocolate!
doctor
Answered by Dr. Shubham Mehta (7 minutes later)
Brief Answer:
may be a slip of tongue.

Detailed Answer:
That could be just a slip of tongue. No problems :)

I hope the chocolates will do it for you.
You love them anyhow :)
Getting into a relationship should be a good idea.

Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (17 minutes later)
Do you think that I might not need Risperdal, or any other similar drug? What do you think that I might need Risperdal for? Just mood stability? I do know that I need a cognitive therapist, to help correct my OCD.
doctor
Answered by Dr. Shubham Mehta (10 minutes later)
Brief Answer:
no indication for risperidal.

Detailed Answer:
As I told, Risperidal is used off-label to control behavioral agitation after head injury.
I do not find any such symptoms in your description.
So, in my opinion, there is no need of this drug for you.

You just have occasional mood swings.
I do not think this is an indication for risperidal.
The unnecessary use will lead to weight gain and memory problems, which you are already experiencing.

Lamotrigine should be enough for you.

Kindly discuss this with your doctor.

Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta (11 minutes later)
I would really like to send you a check or a gift card for your attention. You definely deserve that. Let me know how much it cost for an appointment with you.

Is there a special Doctor needed for the assistance to control behavior agitation, or will that be taken care by a cognitive therapist?
doctor
Answered by Dr. Shubham Mehta (5 hours later)
Brief Answer:
a cognitive therapist will help.

Detailed Answer:
You are most welcome.

I am happy that you found my suggestions helpful.

I usually charge 500 rupees for every session.

Yes, a cognitive therapist can help you in behavioral agitation as well.

I will be thankful if you can give high star ratings after closing the discussion if you have no more queries.

You can always ask a direct query in future by visiting my profile, at your convenience.

I wish you good health.
Take care.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Shubham Mehta

Psychiatrist

Practicing since :2008

Answered : 2144 Questions

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What Causes Mood Instability, Seizures And OCD While On Lamictal And Risperdal?

Brief Answer: dose increment of lamictal or oxcarbazepine. Detailed Answer: Hello Welcome to HCM. I have gone through your query thoroughly and understand your concerns. You have been taking Lamictal post-operatively for seizure control and doing well after you sustained head-injury. Risperidone is an antipsychotic which is primarily indicated for schizophrenia or bipolar disorder. It is also used off-label for behavioral disturbances after head-injury. Risperidone can affect cognition and thus cause memory issues. If you feel that your OCD has developed after starting risperidone, discontinuing the drug will help. If your seizures are controlled on lamictal but you still have mood issues, I would suggest a dose increment of lamictal for mood stabilization rather than starting another drug. The reason being that almost all mood-stabilisers cause weight gain. However, if another drug has to be considered, oxcarbazepine can be used as it has least propensity to cause weight gain after lamictal. Another mood stabiliser which can cause weight loss is topiramate. But, I would not advise to use topiramate for two reasons: 1. It is the third line mood stabilizer. 2. It can precipitate behavioral problems in predisposed individuals and can cause neuropathic pain. You should definitely seek for a therapist for OCD. Kindly discuss these issues with your doctor. Drug/dose change should only be considered under your treating doctor's supervision. Hope these suggestions help you. I wish you well. Take care. Thanks.