Risperdal aka risperidone, an atypical antipsychotic often prescribed off-label as a "shut-up" pill for whatever, comes in these forms:
from Risperdal Official FDA Information
- Risperdal® Tablets are available in 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg.
- Risperdal® Oral Solution is available in a 1 mg/mL strength.
- Risperdal® M-TAB® Orally Disintegrating Tablets are available in 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg. The range of available dosages and existence of the liquid makes slow tapering relatively easy.
The psychoactive effect is due to risperidone plus its active metabolite paliperidone (9-hydroxy-Risperidone).
Following oral administration of solution or tablet, mean peak plasma concentrations of Risperidone occurred at about 1 hour. Peak concentrations of 9-hydroxyRisperidone occurred at about 3 hours in extensive metabolizers, and 17 hours in poor metabolizers.....
The pharmacokinetics of Risperidone and 9-hydroxyRisperidone combined, after single and multiple doses, were similar in extensive and poor metabolizers, with an overall mean elimination half-life of about 20 hours.
Also see the journal article Howland, 2010 Potential adverse effects of discontinuing psychotropic drugs. Part 3: Antipsychotic, dopaminergic, and mood-stabilizing drugs. http://survivinganti...ndpost__p__7840
Abrupt discontinuation of antipsychotic drugs in patients with schizophrenia is associated with earlier, and often more severe, illness episodes than are seen with gradual discontinuation. Antipsychotic drugs can cause various abnormal motor syndromes, but abruptly stopping them has been associated with the seemingly paradoxical development of similar motor syndromes, such as withdrawal dyskinesias, parkinsonian symptoms, dystonias, and neuroleptic malignant syndrome.
Dopamine-releasing and dopamine-agonist drugs are used to treat some of the motor syndromes caused by antipsychotic drugs, but their abrupt discontinuation can also be associated with abnormal syndromes. When antipsychotic drugs, lithium, or certain anticonvulsant drugs are used for treatment of bipolar disorder, rapid versus gradual discontinuation is more likely to lead to greater mood instability and manic relapse.
If necessary, these medications should be gradually tapered to minimize all types of adverse discontinuation effects. Patients should be educated about the possible adverse effects of abrupt medication discontinuation.
As with other psychiatric drugs, do not taper Risperdal by taking a dose every other day! This causes a fluctuating level of the drug in your nervous system and can make you very sick.
A conservative taper is a drop of 10% from the previous dosage every few weeks. Some people find they can go faster and some people find they have to go slower -- they can only tolerate decreases of a fraction of a milligram at a time. See Why taper by 10% of my dosage?
Cutting up the tablets with a pill splitter
This can work, but if you are sensitive to small variations in dosage, cutting up pills is not very exact. For more exact doses, weigh fragments with an electronic digital scale.
Keep the pieces you don't use in a clean pill bottle labeled with the dosage for future use.
Use an electronic digital jeweler's scale to weigh small amounts
If you are sensitive to dosage changes, you may wish to be more precise in your measurements so you can taper at a measured rate. A digital scale, which can be bought for about $30, is useful. Instructions here.
Have risperidone made into smaller dosage capsules by a compounding pharmacy
Compounding pharmacies can crush the tablets and put the powder into smaller capsules by weight. You will need a doctor's prescription for this telling the pharmacy exactly how much to put in a capsule and how many capsules to make.
Use the Risperdal liquid solution
Titrating using a liquid is very good for very small measured decreases in dosage, allowing more precise measurements.
from Risperdal Official FDA Information
Risperdal® Oral Solution can be administered directly from the calibrated pipette, or can be mixed with a beverage prior to administration. Risperdal® Oral Solution is compatible in the following beverages: water, coffee, orange juice, and low-fat milk; it is NOT compatible with either cola or tea.
If you mix it with liquid to titrate, you may find you need to slightly adjust the dose up or down. Those adjustments would be by tenths or even hundredths of a milligram.
For tips about using an oral syringe for doses of liquid medication, see http://survivinganti...ring-techniques
Use a tiny 1mL syringe to measure dosages less than 1mg, to hundredths of a milligram.
Edited by Altostrata, 31 January 2014 - 04:59 PM.