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Tips for tapering off Risperdal (risperidone)


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#1 Altostrata

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Posted 02 February 2012 - 02:41 PM

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.
  • Plus, from http://www.drugs.com...dal-consta.html, Risperdal Consta injections of 12.5 mg, 25 mg, 37.5 mg, or 50 mg risperidone every 2 weeks

http://www.drugs.com...isperidone.html
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.

To minimize the risk of withdrawal symptoms, we recommend a conservative taper of 10% from the previous dosage every few weeks. The amount of the decrease keeps getting smaller. 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?
 
Very careful tapering is necessary when you have had psychotic symptoms. Such symptoms can appear as withdrawal symptoms; that will cause you to become diagnosed as relapsed and re-medicated. Read Psychiatrist: Some patients are better off without antipsychotics...
 
Tapering off injectable Risperdal Consta
Risperdal may be administered via injection every 2 weeks. This form is called Risperdal Consta. It comes in a range of dosages: 12.5 mg, 25 mg, 37.5 mg, or 50 mg.
 
One can taper the injections simply by reducing the amount of liquid injected. This is probably the safest way to go off Risperdal Consta -- but it requires the cooperation of a doctor.
 
If you wish to switch to the tablet form to taper (see below), the following is important http://www.drugs.com...onsta.html#S2.8 :
 

Pharmacokinetics
Absorption
After a single intramuscular (gluteal) injection of RISPERDAL® CONSTA®, there is a small initial release of the drug (< 1% of the dose), followed by a lag time of 3 weeks. The main release of the drug starts from 3 weeks onward, is maintained from 4 to 6 weeks, and subsides by 7 weeks following the intramuscular (IM) injection. Therefore, oral antipsychotic supplementation should be given during the first 3 weeks of treatment with RISPERDAL® CONSTA® to maintain therapeutic levels until the main release of risperidone from the injection site has begun [see Dosage and Administration (2)]. Following single doses of RISPERDAL® CONSTA®, the pharmacokinetics of risperidone, 9-hydroxyrisperidone (the major metabolite), and risperidone plus 9-hydroxyrisperidone were linear in the dosing range of 12.5 mg to 50 mg.
 
The combination of the release profile and the dosage regimen (IM injections every 2 weeks) of RISPERDAL® CONSTA® results in sustained therapeutic concentrations. Steady-state plasma concentrations are reached after 4 injections and are maintained for 4 to 6 weeks after the last injection....
 
Excretion
....The apparent half-life of risperidone plus 9-hydroxyrisperidone following RISPERDAL® CONSTA® administration is 3 to 6 days, and is associated with a monoexponential decline in plasma concentrations. This half-life of 3–6 days is related to the erosion of the microspheres and subsequent absorption of risperidone. The clearance of risperidone and risperidone plus 9-hydroxyrisperidone was 13.7 L/h and 5.0 L/h in extensive CYP 2D6 metabolizers, and 3.3 L/h and 3.2 L/h in poor CYP 2D6 metabolizers, respectively. No accumulation of risperidone was observed during long-term use (up to 12 months) in patients treated every 2 weeks with 25 mg or 50 mg RISPERDAL® CONSTA®. The elimination phase is complete approximately 7 to 8 weeks after the last injection....

 
If you are switching from the injection to the extended-release tablets, you need to be careful about the overlap -- you could be taking a high dose if you have recently had an injection and you add tablets. Probably the safest time to make the switch to a lower-dosage daily tablet would be in the 5th week, when the injection is wearing off.
 
This reference, from the UK Psychiatric Pharmacy Group (now College of Mental Health Pharmacy), is the only one I could find regarding switching from the Consta injection to a risperidone tablet:
 
http://www.ukppg.org...idance-avon.rtf

It takes about 6 weeks following an injection for the levels in the blood to fall below a sub-therapeutic level. Switching a patient to an oral preparation should be started about 5 weeks after the final injection. The manufacturer suggests starting at a dose of 2mg/day of risperidone and gradually increasing if necessary according to response over the following week.

 

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.

See http://survivinganti...-and-elsewhere/

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.

 

Using a combination of tablets and liquid

Rather than switch directly to an all-liquid dose, you may wish to take part of your dose in liquid and part in tablets, gradually converting to all-liquid as you get to lower dosages. This can be very convenient and reduce any problems switching from one form of the drug to another.


Edited by Altostrata, 10 June 2015 - 10:23 AM.
updated

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#2 vaseadude

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Posted 25 May 2012 - 07:03 AM

Hi there, I switched from risperdal injections to oral solution and I am having a lot of side effects. What I want to know is, in case the symptoms get too severe (and I really hope they will get better!) what should one do, if there is no 'higher dose' to go back to? If I switched from injection to same dose oral? I really want to feel empowered that I know what to do in case smt bad happens. Again I hope it doesnt, but i want to have a soft pillow below just in case. Muchas Gracias! :rolleyes:

APR.10.2012 - Switched from 25mg Risperidone LAI shots (taken for over 3 years) to an oral solution of 2 mg.
JUN.09.2012 - 1.8 mg Risperdal, JUN.24.2012 - 1.9 mg (added up a bit bcos of symptoms), AUG.28.2012 - 1.82mg, SEP.26.2012 - 1.73 mg, JAN.18.2013 - 1.64 mg, FEB.26.2013 - 1.56  ...holded for 4 months....  then tapered from SEP.2013  quite consistently for a year to 1.00 (on FEB.3.2014),

 MAR.7 - 0.9, APR.17 - 0.93,  MAY.7 - 1ml

may 10 - was checked by a chinese doc, who prescribed 5htp and paciflora.

didnt take risperidone for some days,

15 may - took 1.6  in the morning instead of evening once

back to 1ml

30 may - again 1.6

 


#3 Altostrata

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Posted 25 May 2012 - 08:11 AM

vaseadude, did you phone Janssen http://www.risperdal....com/contact-us 1-800-JANSSEN (1-800-526-7736), 9 AM to 5 PM (EST), Monday through Friday. to find out the equivalencies between the depot injections and oral solution? What did they say?
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#4 vaseadude

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Posted 27 May 2012 - 11:41 AM

I wish I thought about contacting them at the time I switched... That could have been a good idea. I am also in Europe, and the number is an US number. But the question still remains. It does not matter to what dose I switched, I just wanted to know if there is just a general practice to follow in the case of switching from injection to oral and in the case symptoms are too severe (which at the moment are still tolerable,so this is NOT an emergency, just a precaution).

APR.10.2012 - Switched from 25mg Risperidone LAI shots (taken for over 3 years) to an oral solution of 2 mg.
JUN.09.2012 - 1.8 mg Risperdal, JUN.24.2012 - 1.9 mg (added up a bit bcos of symptoms), AUG.28.2012 - 1.82mg, SEP.26.2012 - 1.73 mg, JAN.18.2013 - 1.64 mg, FEB.26.2013 - 1.56  ...holded for 4 months....  then tapered from SEP.2013  quite consistently for a year to 1.00 (on FEB.3.2014),

 MAR.7 - 0.9, APR.17 - 0.93,  MAY.7 - 1ml

may 10 - was checked by a chinese doc, who prescribed 5htp and paciflora.

didnt take risperidone for some days,

15 may - took 1.6  in the morning instead of evening once

back to 1ml

30 may - again 1.6

 


#5 GiaK

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Posted 27 May 2012 - 02:42 PM

See here:

http://books.google....ridone.&f=false

"For risperidone, 25 mg long-acting preparation is equivalent to about 2 to 3 mg oral risperidone. Because these conversions are only approximate, individual dosage adjustments will have to be made..."

you're on a lower dose of what they've estimated...you might want to add 1/2 a mg and see how you do...or even a quarter...you can play with it and see...since you've been on a lower dose for a while just a tiny up-dose might help out a lot...once you're stable you can start the withdrawal.
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I took a bit over 6 years to do it. Finished on Feb 9 2010. I'm still recovering from iatrogenesis.

#6 vaseadude

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Posted 28 May 2012 - 02:17 AM

WOw, GiaK, thanks so much for finding this info! This forum is the bomb! :) Seriously, your sharing is invaluable! But since I'm stil a noob concerning meds adjustments, isnt .5ml too big of an increase? shouldn't it be increased gradually, with a 10% max increase? Or it doesnt apply to this? Merci!

APR.10.2012 - Switched from 25mg Risperidone LAI shots (taken for over 3 years) to an oral solution of 2 mg.
JUN.09.2012 - 1.8 mg Risperdal, JUN.24.2012 - 1.9 mg (added up a bit bcos of symptoms), AUG.28.2012 - 1.82mg, SEP.26.2012 - 1.73 mg, JAN.18.2013 - 1.64 mg, FEB.26.2013 - 1.56  ...holded for 4 months....  then tapered from SEP.2013  quite consistently for a year to 1.00 (on FEB.3.2014),

 MAR.7 - 0.9, APR.17 - 0.93,  MAY.7 - 1ml

may 10 - was checked by a chinese doc, who prescribed 5htp and paciflora.

didnt take risperidone for some days,

15 may - took 1.6  in the morning instead of evening once

back to 1ml

30 may - again 1.6

 


#7 GiaK

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Posted 28 May 2012 - 02:45 AM

there are certainly arguments to be made either way...I was simply thinking of getting you stable...and basing my recommendation on*MY* remembered felt body sense of what it was like to be on risperdal... that really isn't the best way to give advice to someone else, though....you got me! still I think that being that you're on 2 mg anything less than .25 will be negligible at this point... when we go off drugs .25 can turn into a whole lot of drug...but not so much when still on a lot I"m not sure I'm making any sense... anyway...add a bit of drug...figure out what makes sense for you...and yes, the least amount to get you stable is the way to go.
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You can also find the feed on twitter @BeyondMeds

I withdrew from a cocktail of 6 psychiatric drugs that included every class of psych drug.

I took a bit over 6 years to do it. Finished on Feb 9 2010. I'm still recovering from iatrogenesis.

#8 vaseadude

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Posted 28 May 2012 - 03:38 AM

I do have several symptoms cycling like fatigue, depression and anxiety, sometimes its hard, but as a whole its tolerable. So I think I should just wait a little longer on the current dose and see if my stability increases and the 'good waves' are longer and more stable. After all, I have already been on 2mg for over a month and a half. It should stabilize more Im guessing, as Im better than I was at the beginning. I just wanted to know what to do in the case that you switch to oral form and you cannot go back to a higher dose, but I found the answer thanx to you, I can, if it gets worse, increase the dose. Thanks again GiaK! Best wishes!

APR.10.2012 - Switched from 25mg Risperidone LAI shots (taken for over 3 years) to an oral solution of 2 mg.
JUN.09.2012 - 1.8 mg Risperdal, JUN.24.2012 - 1.9 mg (added up a bit bcos of symptoms), AUG.28.2012 - 1.82mg, SEP.26.2012 - 1.73 mg, JAN.18.2013 - 1.64 mg, FEB.26.2013 - 1.56  ...holded for 4 months....  then tapered from SEP.2013  quite consistently for a year to 1.00 (on FEB.3.2014),

 MAR.7 - 0.9, APR.17 - 0.93,  MAY.7 - 1ml

may 10 - was checked by a chinese doc, who prescribed 5htp and paciflora.

didnt take risperidone for some days,

15 may - took 1.6  in the morning instead of evening once

back to 1ml

30 may - again 1.6

 


#9 Altostrata

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Posted 28 May 2012 - 11:51 AM

It sounds to me, vaseadude, that maybe the 2mg dose was a little too low for you, and you are experiencing withdrawal symptoms from the switch. If you decide to increase, I'd sneak it up by very small amounts, such as .10mg. The deficit could be very small, no need to overdo a correction.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#10 Altostrata

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Posted 22 January 2013 - 09:42 AM

From official FDA information http://www.drugs.com.../risperdal.html

Warnings and Precautions

....
Neuroleptic Malignant Syndrome

Antipsychotic drugs including Risperdal® can cause a potentially fatal symptom complex referred to as Neuroleptic Malignant Syndrome (NMS). Clinical manifestations of NMS include hyperpyrexia, muscle rigidity, altered mental status, and autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis, and cardiac dysrhythmia). Additional signs may include elevated creatine phosphokinase (CPK), myoglobinuria, rhabdomyolysis, and acute renal failure.

The diagnostic evaluation of patients with this syndrome is complicated. In arriving at a diagnosis, it is important to identify cases in which the clinical presentation includes both serious medical illness (e.g., pneumonia, systemic infection, etc.) and untreated or inadequately treated extrapyramidal signs and symptoms (EPS). Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever, and primary central nervous system pathology.

The management of NMS should include: (1) immediate discontinuation of antipsychotic drugs and other drugs not essential to concurrent therapy; (2) intensive symptomatic treatment and medical monitoring; and (3) treatment of any concomitant serious medical problems for which specific treatments are available. There is no general agreement about specific pharmacological treatment regimens for uncomplicated NMS.

If a patient requires antipsychotic drug treatment after recovery from NMS, the potential reintroduction of drug therapy should be carefully considered. The patient should be carefully monitored, since recurrences of NMS have been reported.

Tardive Dyskinesia

A syndrome of potentially irreversible, involuntary, dyskinetic movements may develop in patients treated with antipsychotic drugs. The risk of developing tardive dyskinesia and the likelihood that it will become irreversible are believed to increase as the duration of treatment and the total cumulative dose of antipsychotic drugs administered to the patient increase. However, the syndrome can develop, although much less commonly, after relatively brief treatment periods at low doses.

There is no known treatment for established cases of tardive dyskinesia, although the syndrome may remit, partially or completely, if antipsychotic treatment is withdrawn. Antipsychotic treatment, itself, however, may suppress (or partially suppress) the signs and symptoms of the syndrome and thereby may possibly mask the underlying process. The effect that symptomatic suppression has upon the long-term course of the syndrome is unknown.

Given these considerations, prescribe Risperdal® in a manner that is most likely to minimize the occurrence of tardive dyskinesia. Chronic antipsychotic treatment should generally be reserved for patients who suffer from a chronic illness that: (1) is known to respond to antipsychotic drugs, and (2) for whom alternative, equally effective, but potentially less harmful treatments are not available or appropriate. In patients who do require chronic treatment, the smallest dose and the shortest duration of treatment producing a satisfactory clinical response should be sought. The need for continued treatment should be reassessed periodically.

If signs and symptoms of tardive dyskinesia appear in a patient treated with Risperdal®, consider drug discontinuation. However, some patients may require treatment with Risperdal® despite the presence of the syndrome.

Metabolic Changes

​Atypical antipsychotic drugs have been associated with metabolic changes that may increase cardiovascular/cerebrovascular risk. These metabolic changes include hyperglycemia, dyslipidemia, and body weight gain. While all of the drugs in the class have been shown to produce some metabolic changes, each drug has its own specific risk profile.

Hyperglycemia and Diabetes Mellitus

Hyperglycemia and diabetes mellitus, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, have been reported in patients treated with atypical antipsychotics including Risperdal®. Assessment of the relationship between atypical antipsychotic use and glucose abnormalities is complicated by the possibility of an increased background risk of diabetes mellitus in patients with schizophrenia and the increasing incidence of diabetes mellitus in the general population. Given these confounders, the relationship between atypical antipsychotic use and hyperglycemia-related adverse events is not completely understood. However, epidemiological studies suggest an increased risk of treatment-emergent hyperglycemia-related adverse events in patients treated with the atypical antipsychotics. Precise risk estimates for hyperglycemia-related adverse events in patients treated with atypical antipsychotics are not available.

Patients with an established diagnosis of diabetes mellitus who are started on atypical antipsychotics, including Risperdal®, should be monitored regularly for worsening of glucose control. Patients with risk factors for diabetes mellitus (e.g., obesity, family history of diabetes) who are starting treatment with atypical antipsychotics, including Risperdal®, should undergo fasting blood glucose testing at the beginning of treatment and periodically during treatment. Any patient treated with atypical antipsychotics, including Risperdal®, should be monitored for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness. Patients who develop symptoms of hyperglycemia during treatment with atypical antipsychotics, including Risperdal®, should undergo fasting blood glucose testing. In some cases, hyperglycemia has resolved when the atypical antipsychotic, including Risperdal®, was discontinued; however, some patients required continuation of anti-diabetic treatment despite discontinuation of Risperdal®....


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#11 Newhope

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Posted 03 October 2013 - 09:34 AM

Hi GiaK,

 

I'm a new user of this forum and saw your post about risperidone. I was medicated with risperidone 2mg and now I'm treating with another pdoc which is trying to help me in stop the medications. As he is an Orthomolecular too, he's treating me before to reduce it. I sugested him to use oral risperidone and he said after we can do the reductions with it.

And I read your post when this citation makes relations between kinds of risperidone. What I know is the existence of liquid and tablet risperidone. My doubt is what does it mean long-acting preparation and oral risperidone? To me liquid and tablet are oral. It's because I'm don't know this terms very well. I'm from Brasil.

 

My another doubt is: 1 ml of liquid risperidone and 1 mg tablet are the same?

 

Thanks

 

 

See here: http://books.google....ridone.&f=false "For risperidone, 25 mg long-acting preparation is equivalent to about 2 to 3 mg oral risperidone. Because these conversions are only approximate, individual dosage adjustments will have to be made..." you're on a lower dose of what they've estimated...you might want to add 1/2 a mg and see how you do...or even a quarter...you can play with it and see...since you've been on a lower dose for a while just a tiny up-dose might help out a lot...once you're stable you can start the withdrawal.


07/30/2013 Risperidone 2mg (tablet)

11/03/2013 Risperidone 1mg (tablet)

01/24/2014 stopped taking Risperidone

 

http://survivinganti...pe-risperidone/


#12 Altostrata

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Posted 03 October 2013 - 10:53 AM

The long-acting risperidone is the injectable type -- the depot injection. If you're not getting injected Risperdal, the equivalency GiaK mentions does not apply to your dosing.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#13 Newhope

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Posted 03 October 2013 - 04:38 PM

Thanks a lot Administrator,

 

Now I understood very well, it's not really my case. I talked to another pdoc and asked him if he already had stopped someone's treatment with risperidone. He said affirmatively and his method, according him, was exchange it by another medicine wich is easier to leave.

 

I let it open here if there are someone who knows this field of knowledge. Would be this method better than taking liquid risperidone and reducing gradually it?


07/30/2013 Risperidone 2mg (tablet)

11/03/2013 Risperidone 1mg (tablet)

01/24/2014 stopped taking Risperidone

 

http://survivinganti...pe-risperidone/


#14 Altostrata

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Posted 03 October 2013 - 04:47 PM

Switching drugs is a higher risk method than direct tapering. Sometimes the switch doesn't work and you get withdrawal syndrome.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#15 Newhope

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Posted 03 October 2013 - 04:47 PM

Or if someone had already stopped by this means. I have two pdocs to choose. One of them is advocating this one and another is going through the liquid risperidone and gradually stopping it. What I have been seeing here is that the last takes a lot of time and apparently suffering.


07/30/2013 Risperidone 2mg (tablet)

11/03/2013 Risperidone 1mg (tablet)

01/24/2014 stopped taking Risperidone

 

http://survivinganti...pe-risperidone/


#16 Altostrata

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Posted 03 October 2013 - 04:52 PM

Both methods could take a lot of time. Switching drugs does not make tapering quicker. I would use the liquid risperidone to taper.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#17 Newhope

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Posted 03 October 2013 - 04:57 PM

It makes sense Administrator, perharps stay on liquid is a better solution.


07/30/2013 Risperidone 2mg (tablet)

11/03/2013 Risperidone 1mg (tablet)

01/24/2014 stopped taking Risperidone

 

http://survivinganti...pe-risperidone/


#18 Altostrata

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Posted 03 October 2013 - 05:03 PM

Gradual reductions are supposed to reduce withdrawal symptoms. Please see this topic about tapering risperidone http://survivinganti...al-risperidone/


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#19 Newhope

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Posted 03 October 2013 - 05:54 PM

I'm taking tablets made by Janssen. Now the Orthomolecular pdoc prescribed the same dose by a pharmacy compound production. Are there some danger of withdrawal symptoms because of it or switching tablets by liquid with same dosage or even taking the same amount but medicines from different brands?


07/30/2013 Risperidone 2mg (tablet)

11/03/2013 Risperidone 1mg (tablet)

01/24/2014 stopped taking Risperidone

 

http://survivinganti...pe-risperidone/


#20 Karma

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Posted 03 October 2013 - 06:00 PM

Yes, there is some possibility that you could suffer symptoms when changing from tablets to liquid or vise versa.  The best advise is to switch to the equivalent dose and give it a little time before continuing your taper. 

 

Karma


2007 @ 375 mg Effexor - 11/29/2011 - 43.75 mg Effexor (regular) & 1 mg Xanax & 200 mg Gabapentin
Xanax taper: 3/11/12 - 0.9375 mg, 3/25/12 - 0.875 mg, 4/6/12 - 0.8125 mg, 4/18/12 - 0.75 mg - hold
Effexor taper: 1/29/12 - 40.625 mg, 4/29/12 - 39.875 mg, 5/11/12 - Switched to liquid Effexor, 5/25/12 - 38 mg, 7/6/12 - 35 mg, 8/17/12 - 32 mg, 9/14/12 - 30 mg, 10/19/12 - 28 mg, 11/9/12 - 26 mg, 11/30/12 - 24 mg, 01/14/13 - 22 mg. 02/25/13 - 20.8 mg, 03/18/13 - 19.2 mg, 4/15/13 - 17.6 mg, 8/10/13 - 16.4 mg, 9/7/13 - 15.2 mg, 10/19/13 - 14 mg, 1/15/14 - 13.2 mg, 3/1/2014 - 12.6 mg, 5/4/14 - 12 mg, 8/1/14 - 11.4 mg, 8/29/14 - 10.8 mg; 10/14/14 - 10.2 mg; 12/15/14 - 10 mg, 1/11/15 - 9.5 mg, 2/8/15 - 9 mg, 3/21/15 - 8.5 mg, 5/1/15 - 8 mg, 6/9/15 - 7.5 mg, 7/8/15 - 7 mg, 8/22/15 - 6.5 mg

I am not a medical professional - this is not medical advice. My suggestions are based on personal experience, reading, observation and anecdotal information posted by other sufferers


#21 Newhope

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Posted 03 October 2013 - 06:02 PM

So nice this recommended topic Administrator, many precious informations. Thx for the valuable tip Karma.


07/30/2013 Risperidone 2mg (tablet)

11/03/2013 Risperidone 1mg (tablet)

01/24/2014 stopped taking Risperidone

 

http://survivinganti...pe-risperidone/


#22 Newhope

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Posted 03 October 2013 - 06:25 PM

Along the tapering process, do you feel withdrawal symptoms? If sometimes, when? How long does it last?


07/30/2013 Risperidone 2mg (tablet)

11/03/2013 Risperidone 1mg (tablet)

01/24/2014 stopped taking Risperidone

 

http://survivinganti...pe-risperidone/


#23 Altostrata

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Posted 04 October 2013 - 07:42 AM

If you feel withdrawal symptoms, they are a sign you're going too fast.

 

Newhope, please start a topic for yourself in the Introductions forum so we can get to know you and you can record your progress.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#24 Newhope

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Posted 04 October 2013 - 01:41 PM

Ok, good idea Administrator.


07/30/2013 Risperidone 2mg (tablet)

11/03/2013 Risperidone 1mg (tablet)

01/24/2014 stopped taking Risperidone

 

http://survivinganti...pe-risperidone/


#25 rispmed

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Posted 06 September 2014 - 11:29 AM

this info is helpful...



#26 Earthworm

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Posted 07 October 2014 - 02:38 PM

I'm thinking of trying to reduce my 1mg dose. I've been on this drug for 6.5 years. Got on it so I could sleep, and still rely on it to sleep every night. No supplements were able to make me sleep, nor Benadryl. Pretty strong insomnia that requires a drug to give me sleep.

 

For a short time, I was on 2mg and even 4mg, but for the past many years its been 1mg every night.

 

I know there is risk of tardive dyskinisia when reducing dosage, and I'm worried about that. My doctor said I would have to remove Risperidone totally if that starts, but then I would need something else to sleep with, and I dunno if I would be able to find anything that works.

 

I'm not gonna be tapering my Citalopram, because my body has become really destabilized after experiencing 3 crashes.

 

I'm wondering if anyone tried tapering Risperidone, and how you did it and what you experienced.


-On SSRI's since April 2006.
-December 2007: discontinuation and WD start.
-February 2008: SSRI reinstatement: improvement, yet destabilization remains.
-Currently taking: 25mg Citalopram, 0.94mg Risperidone (for insomnia).
-Current symptoms: OCD, social anxiety, insomnia, agitation in legs, weight gain, muscle fatigue, poor skin healing.


#27 PurpleHaze

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Posted 06 November 2014 - 11:00 AM

Thank you for posting this I found it very helpful.

 

Peace.


PTSD, PANIC DISORDER

Prozac, Ativan and Risperidone 2mg. 

About to start tapering down off the Risperidone.


#28 supersloth

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Posted 26 November 2014 - 12:48 PM

I'm currently doing this using a microgram scale and cutting the 0.25mg tablets. In addition I have the 1mg tablets.
I'm lucky that I found a psychotherapist supporting me. It is very helpful to have someone to speak to who can see me from outside and give a good description of how he perceives me.
Also I'm dealing with intense feelings, which I need speak about to my therapist.

Concerning the question what I experienced during withdrawal, the biggest thing for me were intense emotions that were suppressed before. I'd like to add here, that I already had an impulsive, partly obsessive and instable personality before taking R.
For the process of withdrawal, I tried to follow the "listen to your body" taper plan, which works well.
Yet there are withdrawal symptoms like increased sensitivity, nervousness, bad memory (which also can occur when continuing the drug), bad sleep, low appetite and different bodily symptoms.
Meditation currently does a lot for me.
I'd like to read about your experience... :)

Edited by supersloth, 26 November 2014 - 01:03 PM.


#29 Altostrata

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Posted 28 November 2014 - 04:33 PM

Hello, supersloth. Please start a topic for yourself in the Introductions forum and introduce yourself to the community.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#30 Risperdrawlin

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Posted 16 January 2015 - 05:00 PM

***I meant to post this on about Dec 27, 2014 but accidentally posted in the wrong thread***

 

Hi,

 

I hope we are able to relate and help each other out. I'm currently coming off Risperdal and am down to 0.375 mg from 2 mg. The compounding pharmacy said they should have the liquid form ready in three or four days, so I will probably cut my dose to 0.32 mg. I have been on 0.375 mg for about three weeks and have mostly stabilized, I think. Before 0.375 mg, I had been cutting by .125 mg per week from .75 mg. So .75 mg for one week, then .625 for a week, then .5 for a week, then .375 for a week, then I tried .25 but was not able to cope and so went back up to .375, which I am on now.

 

I have also experienced trouble with my memory coming off Risperdal. I also enjoy talking with my therapist and getting feedback. Also also, I think I'm learning how to deal with feelings. When I came off the Risperdal too fast (I went from 1 mg to 0) I experienced just a lot of emotion with not much meaning. 

 

I also might have had an obsessive and somewhat unstable personality before taking Risperdal, though I don't appear all that impulsive. On Risperdal I appear calm, I think, and on the higher dose I appeared flat. I think right now I appear somewhat flat. Going from 2 mg to 0.375 brought my affect back.

 

Meditation is also immensely helpful for me. 


Was taking: 2 mg Risperdal

50 mg Lamictal

100 mg Zoloft

 

Currently taking:

0 mg Risperdal

3.125 mg Lamictal

100 mg Zoloft

 

Trying to come off all psychiatric medication eventually

 

My intro thread: http://survivinganti...ion-eventually/


#31 Risperdrawlin

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Posted 16 January 2015 - 05:06 PM

I'm still on 0.375 mg per night and have been taking it for about 6 weeks now. 

 

I certainly feel different than I did a month ago. I guess I'm more "stable". I'm a little more flat. My head feels like a cinderblock. I feel like everyday I wake up and feel "on" Risperdal a little more. I am able to think and interact differently than I could a month ago. I'm able to judge, analyze, and pick things apart more. 

 

If anyone who has tapered off of Risperdal successfully is reading this, can you give me any insight into what I or the average person might be like off the drug?

 

Thanks!


Was taking: 2 mg Risperdal

50 mg Lamictal

100 mg Zoloft

 

Currently taking:

0 mg Risperdal

3.125 mg Lamictal

100 mg Zoloft

 

Trying to come off all psychiatric medication eventually

 

My intro thread: http://survivinganti...ion-eventually/


#32 Altostrata

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Posted 16 January 2015 - 05:42 PM

My guess is you'll be able to think even more clearly, and you will not feel like your head is a cinderblock.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#33 Risperdrawlin

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Posted 16 January 2015 - 06:46 PM

Haha


Was taking: 2 mg Risperdal

50 mg Lamictal

100 mg Zoloft

 

Currently taking:

0 mg Risperdal

3.125 mg Lamictal

100 mg Zoloft

 

Trying to come off all psychiatric medication eventually

 

My intro thread: http://survivinganti...ion-eventually/


#34 Altostrata

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Posted 17 January 2015 - 02:54 PM

Apologies for the little joke.
 
What we see is that people who have had psychotic symptoms prior to taking drugs may develop them as withdrawal symptoms unless they taper very, very slowly. Dr. Sandra Steingard has used this method to wean patients off antipsychotics like Risperdal, see
Psychiatrist: Some patients are better off without antipsychotic drugs

 

Other people have been prescribed Risperdal for random reasons. Contrary to drug company advertising, it (and other antipsychotics) are not effective for "depression," alone or as "augmentation" to antidepressants.

 

Other than withdrawal symptoms, these people are back to their old selves off Risperdal.

 

Often antipsychotics are prescribed to counter or mask adverse effects of antidepressants, particularly the activating effects (anxiety, jitters, pacing, akathisia, sleeplessness, etc.). In these situations, if the person goes off the antipsychotic, the adverse effects of the antidepressant might become apparent again.

 

This is why we suggest going off the more activating drug first; in an antidepressant-antipsychotic combination, that would be the antidepressant. One could reduce the antidepressant part-way, then work on reducing the antipsychotic.

 

Antipsychotics tend to make people dopey and sluggish, so reducing them tends to give people more focus and energy.

 

You may wish to start a topic in the Symptoms forum to ask how people felt when they were off antipsychotics such as Risperdal.


Edited by Altostrata, 19 January 2015 - 06:22 PM.
updated

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

#35 Risperdrawlin

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Posted 19 January 2015 - 06:17 PM

No worries Altostrata. Thanks for the info. If you have any more information like this about Risperdal (antipsychotics tend to make people dopey and sluggish, etc) I would love to hear it. FYI I never actually had psychotic symptoms, I think. I think the closest thing I had to a psychotic symptom was seeing a series of rapidly flickering images in my head in bed one night early in my stay in a mental hospital (possibly my first or second night). In the hospital I was diagnosed bipolar with psychotic features. I've never had a manic episode and I've never hallucinated. I do sometimes see something move out of the corner of my eye and look and not know what it was, or something like that, or think I hear something and find out nothing happened, but I don't think I experience these any more than the average person. I don't hear voices or have visions of things that are not actually in front of me. Sometimes I may misperceive an object if it's dark and the shadows make it look like something else. I think I may have been on Trazodone when I had that experience of the flickering images. You could say I was behaving strangely when I went into the hospital, but that was because of ideas I had that I was sort of purposely experimenting with. Other than my slightly strange behavior and the flickering images I reported, I can't think of anything else hospital staff or my psychologist could have observed that would have warranted a diagnosis of any psychotic features.

 

Thanks for the suggestion about starting a new thread about what I might be like off Risperdal, I think I might do that.


Was taking: 2 mg Risperdal

50 mg Lamictal

100 mg Zoloft

 

Currently taking:

0 mg Risperdal

3.125 mg Lamictal

100 mg Zoloft

 

Trying to come off all psychiatric medication eventually

 

My intro thread: http://survivinganti...ion-eventually/


#36 Altostrata

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Posted 19 January 2015 - 06:23 PM

The side effects of antipsychotics are well-known and listed in the package inserts. All may be found on Drugs.com under Professional Information.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.