These are known in the meds business as "atypical antiphycotics". Their primary use is for Schizophrenia. HOWEVER: Although these drugs are NOT approved by the FDA or Health Canada for treatment of depression, many docs are prescribing these as companion drugs to traditional SSRIs (Celexa, Lexapro, Prozac, Paxil, Zoloft, etc.) This is quaintly called "off label" use: the prescribing of a drug intended for resolution of some other condition.
I got interested in these because I was prescribed Risperidone as an adjunct to Welbutrin XL. Soon after taking Risperidone I began to experience "retrograde ejaculation" (a condition where semen does not exit as usual, instead the body ejaculates into the badder, and semen exits the body as part of urine). Needless to say, that was the end of taking Risperidone for me. (I found a reference to this bizarre side effect on the drug manufacturer's (Johnson & Johnson) official label, listed as "Ejaculatory failure" (the FDA label site for Risperidone: and also in the wikipedia citation for risperidone This is also discussed in the American Journal of Phychiatry.
I'm a little ticked that my Dr. is prescribing a med that is "off label" (Read: Not approved for what he is giving it to me for). The dose of Risperidone for Schizophrenia is 4mg., the dose used off label as an SSRI companion is 1 or 1.5 mg. I got further disturbed when I read that a review of seven studies investigating the use of atypical antiphycotics as companions to SSRIs found that there was no benefit at all from this off label use. The study review was conducted by none other than the US Department of Health and Human Services (I don't think there is a more credible body).
So here's my dilemma: I discussed this side effect with my Dr., whose response was to cut my dose from 1.5mg to 1mg. This had no impact on my depression or the retrograde ejaculation (which continued unabated). So, I have stopped taking Risperidone. Should I tell my Dr. I refuse to take this, or let him think I'm on board (keep things smooth)? I'm afraid to challenge him on the use of it at all (given that the use is off label, not to mention the US H&HS report), or should I bring this up? Would I be seen as a 'problem' patient? Perhaps I'm dead wrong on this (the part about the ineffectiveness). I just can't help getting the feeling that Johnson & Johnson drug reps have promoted this off label use to juice sales, and I'm out $$$ and normal orgasms so they can make a few more bucks. My Dr's attitude is a little arrogant, and he is a powerful person in his profession (heads up the Phychiatry Dept at the only mental health ward in the area [population 500,000]).
I'd be interested in feedback from anyone, professionals who monitor this board are welcome.