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DoctorMussyWasHere

Taper in the case of very short duration since starting

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DoctorMussyWasHere

Quick general question: What is the advice in the case of someone who has only been on 2.5mg Risperidone for a week?

 

The conundrum is if they do a standard 10% / 3 week taper it'll take almost a year to reach 0.5mg, or two years to reach 0.05mg.

During this time the duration may outweigh the risk of doing a much faster taper now.

 

I am anticipating actually advising someone, and hopefully they won't delay much longer in asking for the schedule which may change the longer they're on it.

So generally speaking I'm curious about the sliding scale of relative risks and tapering advice in this regard.

 

At the lowest extreme someone who has only taken it once could probably safely stop cold turkey, or something approaching it, the next day, right?

At the other end, at what point does the 10% / 3 week guideline become applicable?

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scallywag

Before taking the risperidone, has this person taken any psychiatric or neuroactive medications?  If they were "psych drug naive" before the risperidone, they might try discontinuing in 25% steps while closely monitoring symptoms. Why was risperidone prescribed?

 

Edit:  After only a week, someone might try a 50% reduction for a week, then cut that in half to 25% of full dose for a week. As you probably know, these things aren't predictable. There's no way of knowing right now who can just stop after a brief exposure, who can get away with a fast taper, and who needs a slow taper.

Edited by scallywag

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DoctorMussyWasHere

Hi Scallywag,

 

They were "naive" / clean before starting the risperidone as far as I know.

They are anti-meds generally-speaking, but I will ask them to make sure.

 

They have been diagnosed with borderline personality disorder.

Disorders aside, the set of behaviours that cause distress in them and in others are in the gamut of BPD.

The person is female, around 60 years of age.

 

They booked themselves into a local psychiatric hospital.

I'm guessing the hospital prescribed risperidone because they prescribe it for everything.

 

Just checking if I've got this correct:

A linear (straight) taper, not logarithmic (curved, never ending).

25% of starting dose

in 3 steps 75%, 50%, 25%

each step lasting 3 weeks?

 

They were advised to ask me for tapering help, not that I'm an expert..

They will contact me at some point,  but I can't offer my help preemptively because there are triggers around this topic.

 

I guess their delay will require a revised strategy, depending on how long they wait, in which case I can post here.

 

Thanks for advising

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mammaP

Someone who has never taken them before could, as Scally says, cut 50% for a few days then off.  The longer on it the longer the taper. The 10% rule doesn't apply here because it is only a week. Hope Tiggy is doing well.

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DoctorMussyWasHere

I saw your edit, scallywag. Thanks, understood.

 

hi mammaP,  I hope you are well..

 

I hope it's only a week. My knowledge is based on a 3rd person account.

She's been in there as a voluntary submission for a bit longer than that - maybe two, or even three weeks.

 

So the risperidone could have been started earlier than a week ago, but I'll make sure I know before suggesting anything.

The risperidone certainly isn't helping - no surprises there.

 

I'm updating Tiggy's thread now.

 

thank you..

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