tryingtohelp: Tapering Haldol

[Tryingtohelp]

Hello I am concerned about my wife. She is to reduce haldol shot by one half. I have been on psychotropic drugs myself and know it is not so easy to get off of them.

 

I found a web site of a clinic -facility that does drug withdrawal. This clinic is in another state. It does not seem possible to be able to go and also my wife is really afraid of being hospitalized, it is her most undesirable place to be to say the least. But after writing the clinic and asking for information about tapering off haldol one of the staff wrote me back and said that he/she did not recommend tapering off haldol at home. And if done at home then they recommend daily contact with doctor if necessary. I was impressed with the clinic because they do a whole approach Diet vitamin and various supportive therapy like counseling and that sort of thing .

 

I also tried to go to the Pharmacy that gives my wife the haldol shot they did not have any any thing. 

 

I do not know for sure all the best ways to deal with this taper.

 

I think that basically the haldol is a dopamine antagonist I think that means it suppresses dopamine in the brain. My wife does lots of activities that I think produce dopamine. These activities are smoking cigarettes, eating sweets, drinking coffee. Weight gain is a concern. My wife ties to spend time on her exercise bike. and does really good in that respect.

 

SO does  anybody have any direct advise I tried as I did to look through the resources page on this  web site and all but so far I have not found anything that I could try. Thanks  

Edited October 23, 2016 by scallywag
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[Tryingtohelp]

Well as Tuesday approaches and the new tapeed dose if the haldol shot is to be 50%I am freaking out I do not want my wife to suffer I do not want to suffer because of her getting really sick again I found this 

 

Discontinuation of therapy: 

The manufacturer and the American Psychiatric Association (APA), Canadian Psychiatric Association (CPA), and World Federation of Societies of Biological Psychiatry (WFSBP) guidelines recommend gradually tapering antipsychotics to avoid withdrawal symptoms and minimize the risk of relapse (APA [Lehman 2004]; Cerovecki 2013; CPA [Addington 2005]; WFSBP [Hasan 2012]); risk for withdrawal symptoms may be highest with highly anti-cholinergic or dopaminergic antipsychotics (Cerovecki 2013).

 

When stopping antipsychotic therapy in patients with schizophrenia, the CPA guidelines recommend a gradual taper over 6 to 24 months, and the APA guidelines recommend reducing the dose by 10% each month (APA [Lehman 2004]; CPA [Addington 2005]).

 

Continuing anti-parkinsonism agents for a brief period after discontinuation may prevent withdrawal symptoms (Cerovecki 2013).

 

When switching antipsychotics, 3 strategies have been suggested: cross-titration (gradually discontinuing the first antipsychotic while gradually increasing the new antipsychotic), overlap and taper (maintaining the dose of the first antipsychotic while gradually increasing the new antipsychotic, then tapering the first antipsychotic), and abrupt change (abruptly discontinuing the first antipsychotic and either increasing the new antipsychotic gradually or starting it at a treatment dose).

 

Evidence supporting ideal switch strategies and taper rates is limited, and results are conflicting (Cerovecki 2013; Remington 2005).

 

And then I found that Surviving Antidepressants also reccomends taper of 10% too

Edited October 23, 2016 by scallywag
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[scallywag]

tth -- Welcome to Surviving Antidepressants (SA)

 

I've moved your post to the Introductions Forum so that more people will see your question. This is YOUR introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.

 

I've looked for half-life information about Haldol (haloperidol) and found that for the decanoate (long-acting injectable form) half-life is 21 days. That means that 21 days after the dose, 50% of the drug has been eliminated and 50% remains; 42 days after the dose, 25% remains. Because of this long half-life, Haldol *could* be considered "self-tapering."

 

If you are still concerned about potential withdrawal symptoms, you may have difficulty getting a 10% reduction for two reasons:

• The pharmacy won't change the dose unless they get a new or updated prescription from the prescribing doctor.
• The medication comes in standard size vials and the pharmacy employee who administers the shot may be authorized or licensed to deliver ONLY the standard doses.

Can you and/or your wife contact the doctor to request a scrip for 90% of previous dose?

Can you confirm with the pharmacy that they can adminster (give the shot) a non-standard dose?

 

The quotation you've posted seems to be referring to tablets or capsule formulations taken by mouth, not the long-acting injected forms of neuroleptics.

[Tryingtohelp]

Well thank you for your reply My wife is having side effects from the drugs she is taking. She had really bad results after being on risperdal for 12 years plus then being taken off of the risperdal all at once. Cold turkey. My wife is having some side effects currently but she is stable and doing very well mentally. My wife wants to get off the haldol right now. I do not want her to suffer I do not want her to do 50% taper but that is what the Doctor presently is prescribing  

 

I am not able to figure out how to call and talk to doctor without being in some kind of situation like not good or something. I spoke with my wife's Guardian last night and brought up some of the really bad times my wife my wife suffered through and how sick my wife was and how powerless I was to help her when she was so sick. My wife's Guardian is going to call one of the hospital administrators who has helped in the past when my wife was committed inpatient and then got better.

 

Tuesday is approaching I am very concerned and frightened I do not want to have to go through that terrible stuff again. I called a hot line night before last I was so upset. My wife's Guardian said it was her role to do doctor stuff I do not know if she is really going to follow through. So I may at least call clinic and tell the nurse how I feel. 

Edited October 25, 2016 by scallywag
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[scallywag]

I'm terribly sorry that you and your wife are in this situation. The fact that neither your wife nor you have legal authority to make decisions for her health is a significant limitation. To address this situation you need either

• to get professional legal advice
  -- or --
• to persuade your wife's Guardian of what you believe is the best course of action.

Surviving Antidepressants (SA) is a site for providing information to people who want to come off their prescribed psychiatric medications and have the capacity to do so. We don't and can't provide legal advice.

 

I wish I could help you. All that I can think to suggest is that you start investigating what is required for your wife to re-assume legal authority for making decisions about her health.

[Skeeter]

Trying to help,

Below are some links I found on withdrawing from Haldol/haloperidol. I hope they offer some answers and some help. Here is some additional information I learned while researching:

As you are probably aware, Haldol is not a curative medication, it is just supposed to help keep the symptoms of the underlying illness under control. So, what can happen upon discontinuation/tapering, is that any symptoms the med was controlling, the underlying signs and symptoms, probably will come back as she tapers off of the medication. On top of that, getting used to less and less of the med being in the system can cause its own signs and symptoms/side effects, that may or may not be normal for your wife while her body gets used to the lower doses of the medication and for a while after she is off of the medication until everything normalizes. So be aware that some of the things you notice her doing may be temporary, or they may not.

 

These links below provide more information about what to expect from discontinuing the medication alone, not including what other symptoms may return. I do hope that your wife does okay. I hope this information will help you know what is normal to expect during tapering:

 

http://www.drugsdb.com/rx/haldol/haldol-withdrawal/

http://schizophrenia.emedtv.com/haldol/haldol-withdrawal.html

http://mentalhealthdaily.com/2014/04/16/can-withdrawal-from-antipsychotics-cause-psychosis/ (great info!!)

 

This last link provides an excellent argument for getting your wife off of Haldol!

http://mentalhealthdaily.com/2015/07/03/antipsychotics-and-brain-damage-shrinkage-volume-loss/

 

Now, this is just my personal opinion here. You must seek the opinion of a lawyer for legal advice If she is doing okay on her meds, and is able to make perfect sense because of the meds, the time to petition to have you (or someone else) be her guardian (if she wants that), is NOW, before the onset of symptoms from cutting the dose of this med sets in. It may mean she needs to be on he regular dose for a while longer, but if she does not like/does not want to keep her current medical guardian, and wants someone else, it has to be done while your wife can speak for herself. I hope that makes sense. I have not been in this position myself, but have talked to patients and friends who did deal with this type of issue. Now from everything I have read in researching this for you, she may show some temporary symptoms that ae not part of her illness, but ae just part of the withdrawal process. If she sees a doctor during this time, they will assume, most likely that it is her original symptoms coming back, as that happens quite regularly, according to every article I have read on the subject. This is why if you and her medical guardian do not see eye to eye, and your wife wants someone else, it has to be done right away. This way her wishes can be followed to the letter if they are not being followed now. This again, is not legal advice only my personal opinion. You would have to consult with a lawyer to find out what you need to do if she wans a new medical guardian. I am sorry that you are not being included in decisions. It must be very frustrating.

Best of luck to you both,

Skeeter