Violetsi10 Posted February 27, 2018 Share Posted February 27, 2018 Hello, I am currently having monthly Xeplion (paliperidone) intramuscular injections at the dose of 50mg per month. I have been taking Xeplion for the last 3 years or so with the exception that I tried to cut down and stop with the Ok to try from my psychiatrist but I knew at the time very little if anything about withdrawal and was told nothing and it did not go that well at the end. I first started at the dose of 75mg per month, now I am on 50mg. I would like to cut down and stop (gradually) with a plan but I don't know of any psychiatrists/doctors that are very supportive, understanding and educated about going along with with this and being able to help ease with the prescriptions etc without judging me too much also.. I don't know what is the best way and things to say to my current psychiatrist for him to understand and give me another "chance" again without judging me too much if I decide to stay with him for the time being. Thank you. I have been having Xeplion (paliperidone) intramuscular injections per month for the last 3 years or so. I started on the dose of 75mg per month, now I am on 50mg. I did try to cut down and stop the medication with the ok to try of my doctor but I knew at the time very little if anything about withdrawal and was told nothing and it did not go that well at the end. Before all of this, I have taken psych drugs (mainly antipsychotics, I think) but never for very long periods of time and I did not have any trouble stopping them. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Moderator Emeritus Gridley Posted February 27, 2018 Moderator Emeritus Share Posted February 27, 2018 (edited) Hello, Violetsi10, and welcome to SA. To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly. Any drugs prior to 24 months ago can just be listed with start and stop years. Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. Please leave out symptoms and diagnoses. A list is easier to understand than one or multiple paragraphs. Link to Account Settings – Create or Edit a signature. At Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases. The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs. Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops. To get you started, and familiarized with the protocols followed by SA, I am linking a few topics so that you have a better understanding of what is recommended here. Before you begin tapering what you need to know Why taper by 10% of my dosage? Brain Remodelling What is Withdrawal Syndrome? Glenmullen’s withdrawal symptom list. I'm not familiar with Xeplion, but I read it comes in loaded syringes of 25mg, 50mg, 75mg, 100mg and 150mg. A reduction from your current 50mg to 25mg would be far too much. The links above on Brain Remodeling and Why taper at 10% of my dosage explain that the brain needs to have the drug reduced slowly so it can get used to the new dose. A drop from 50mg to 25mg would be a shock to your central nervous system and would very probably cause significant withdrawal symptoms. Is it possible to get Xeplion in other doses? For example, our advice would be to taper your 50mg dose by 10%, which would be 45mg. From what I read, you get the intramuscular shot once a month. So the next month's dose would be 10% of 45mg, which would be 40.5 or 41mg. Could a compounding pharmacy make these doses for you? You said your psychiatrists are not cooperative. Do you think your psychiatrist would write prescriptions for these doses. Or could your doctor give you 45mg of the 50mg injection? These two links give tips on how to talk to your doctor: How do you talk to a doctor about tapering and withdrawal?What should I expect from my doctor about withdrawal symptoms? 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 hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but I am glad that you found us. Edited February 27, 2018 by Gridley Gridley Introduction Lexapro 20 mg since 2004. Begin Brassmonkey Slide Taper Jan. 2017. End 2017 year 1 of taper at 9.25mg End 2018 year 2 of taper at 4.1mg End 2019 year 3 of taper at 1.0mg Oct. 30, 2020 Jump to zero from 0.025mg. Current dose: 0.000mg 3 year, 10 month taper is 100% complete. Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg Valium Feb. 2021, begin 10%/4 week taper of 18.75mg Valium End 2021 year 1 of Valium taper at 6mg End 2022 year 2 of Valium taper at 2.75mg End 2023 year 3 of Valium taper at 1mg Jan. 24, 2024: Hold at 1mg and shift to Imipramine taper. Taper is 95% complete. Imipramine 75 mg daily since 1986. Jan.-Sept. 2016 tapered to 14.4mg March 22, 2022: Begin 10%/4 week taper Aug. 5, 2022: hold at 9.5mg and shift to Valium taper Jan. 24, 2024: Resume Imipramine taper. Current dose as of Aug 26: 4.0mg Taper is 95% complete. Supplements: multiple, quercetin, omega-3, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg, iron, serrapeptase, nattokinase, L-Glutamine, milk thistle, choline I am not a medical professional and this is not medical advice. It is information based on my own experience as well as that of other members who have survived these drugs. Link to comment
Violetsi10 Posted February 27, 2018 Author Share Posted February 27, 2018 (edited) Hi, I have previously not felt like I have experienced any problem from cutting down from 50mg to 25mg, I felt the problems coming some time after stopping completely from 25mg in the past. I am thinking maybe that switching to a pill form of the equivalent dosage that I am/will be on may be more simple. I am thinking to simplify things, do you know what would be the nearest equivalent(s) to Xeplion in pill form that could be available for me which would probably be more simple to cut the doses down by 10% etc? Thank you. Edited February 27, 2018 by Violetsi10 Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Violetsi10 Posted February 27, 2018 Author Share Posted February 27, 2018 Hello, I don't think that it is possible to get Xeplion in other doses and I don't know if my psychiatrist would write prescriptions for these doses but I think it sounds much too complicated in my situation. I would like to be able to taper off gradually but securely without too many complications from my doctor. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Violetsi10 Posted February 27, 2018 Author Share Posted February 27, 2018 Hi, I have previously not felt like I have experienced any problem from cutting down from 50mg to 25mg, I felt the problems coming some time after stopping completely from 25mg in the past. I am thinking maybe that switching to a pill form of the equivalent dosage that I am/will be on may be more simple. I am thinking to simplify things, do you know what would be the nearest equivalent(s) to Xeplion in pill form that could be available for me which would probably be more simple to cut the doses down by 10% etc? Thank you. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Moderator Emeritus ChessieCat Posted February 28, 2018 Moderator Emeritus Share Posted February 28, 2018 (edited) 6 hours ago, Gridley said: We are a site for tapering drugs and as a matter of policy do not recommend drugs. I do encourage you to find a way to taper at 10%. I think Gridley may have misinterpreted your post. Please ensure you read Post #1 of this topic carefully tips-for-tapering-off-invega-paliperidone Here are a couple of excerpts from Post #1: "Tapering off Invega extended-release tabletsThe range of dosages available in the tablets suggests one might step down using a combination of tablets. For example, to taper from 12 mg/day, one might get a prescription filled for 9mg and 1.5mg tablets, for a reduction to 10.5mg/day." AND "To taper from small amounts of Invega, one might switch to risperidone liquid. Taper by switching to risperidone liquid Paliperidone is a close relative of risperidone, being it is an active metabolite of risperidone, according to http://www.drugs.com/pro/risperidone.html Titrating a liquid is very good for very small measured decreases in dosage, allowing more precise measurements. from Risperdal Official FDA Information Quote 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 want to do this, be sure to read Tips for tapering off Risperdal (risperidone)" Edited February 28, 2018 by ChessieCat * NO LONGER ACTIVE on SA * MISSION ACCOMPLISHED: (6 year taper) 0mg Pristiq on 13th November 2021 ADs since ~1992: 25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq: 50mg 2012, 100mg beg 2013 (Serotonin Toxicity) Tapering from Oct 2015 - 13 Nov 2021 LAST DOSE 0.0025mg Post 0 updates start here My tapering program My Intro (goes to tapering graph) VIDEO: Antidepressant Withdrawal Syndrome and its Management Link to comment
Moderator Emeritus manymoretodays Posted February 28, 2018 Moderator Emeritus Share Posted February 28, 2018 (edited) Hi Violeti10, Lots of information for you to digest. And welcome aboard! Have you been on the extended release pill form of Xeplion/paliperidone prior to the monthly injections? Or at anytime since 2014? Any other medications at this time? And it does appear that Xeplion is the brand name for paliperidone in France. Invega, as ChessieCat mentions is another brand name for paliperidone that is used in the U.S. I just thought I would clarify a bit, hope you don't mind. I think that you will have to consider working with a prescriber, after reading and digesting all of the above, to get switched over to an oral form(taken by mouth) of your present monthly injections. Before any tapering can begin. Do take into account some of the thoughts and information(links included) that ChessieCat compiled for you above. And do refer back to some of the basics linked by Gridley as well........such as "Before you begin tapering......." and "Why taper by 10%"..............as well as the other very important topics in that list. I hope you can find a prescriber or doctor that, even if not familiar with our protocols, is willing to understand and be educated, and supportive. Unfortunately, that can sometimes be challenging. It looks like Gridley had some informative links for you on this as well. How to talk to your doctor and what to expect. On 2/27/2018 at 9:41 AM, Violetsi10 said: I would like to cut down and stop (gradually) with a plan but I don't know of any psychiatrists/doctors that are very supportive, understanding and educated about going along with with this and being able to help ease with the prescriptions etc without judging me too much also.. I don't know what is the best way and things to say to my current psychiatrist for him to understand and give me another "chance" again without judging me too much if I decide to stay with him for the time being. Welcome again! And do keep us posted here. And ask questions as they arise. Love, peace, healing/inrecovery, and growth, manymoretodays Edited March 1, 2018 by manymoretodays grammar Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks. Started with psycho meds/psychiatric care circa 1988. In retrospect, and on contemplation, situational overwhelm. Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time). 5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014) 12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs. My last psycho med ever! Tapered @ 10% every 4 weeks, sometimes 2 weeks to 2016 Dec 16, medication free!! Longer signature post here, with current supplements. Herb and alcohol free since 5/15/2016. And.....I quit smoking 11/2021. Lapsed. Redo of quit smoking 9/28/2022, and again finally 5/25/24. Can you say Hallelujah?(took me long enough)💜 None of my posts are intended as medical advice. Please discuss any decisions about your medical care with a knowledgeable medical provider. My success story: Blue skies ahead, clear sailing Link to comment
Violetsi10 Posted February 28, 2018 Author Share Posted February 28, 2018 Hi, No, I have not been on any other medications since 2014 apart from I don't know if it's worth mentioning that I take vitamin c for some time and more recently some other supplements. Thank you for the welcoming etc. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Moderator Emeritus Gridley Posted February 28, 2018 Moderator Emeritus Share Posted February 28, 2018 (edited) Regarding supplements, we don't recommend a lot of them on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. Magnesium, nature's calcium channel blocker Omega-3 fatty acids (fish oil) Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems. Be cautious with B vitamins. While it is often a first response to stress to take a B-Complex, in withdrawal it can be overstimulating. Hypersensitive to B Vitamin or B-Complex Edited February 28, 2018 by Gridley Gridley Introduction Lexapro 20 mg since 2004. Begin Brassmonkey Slide Taper Jan. 2017. End 2017 year 1 of taper at 9.25mg End 2018 year 2 of taper at 4.1mg End 2019 year 3 of taper at 1.0mg Oct. 30, 2020 Jump to zero from 0.025mg. Current dose: 0.000mg 3 year, 10 month taper is 100% complete. Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg Valium Feb. 2021, begin 10%/4 week taper of 18.75mg Valium End 2021 year 1 of Valium taper at 6mg End 2022 year 2 of Valium taper at 2.75mg End 2023 year 3 of Valium taper at 1mg Jan. 24, 2024: Hold at 1mg and shift to Imipramine taper. Taper is 95% complete. Imipramine 75 mg daily since 1986. Jan.-Sept. 2016 tapered to 14.4mg March 22, 2022: Begin 10%/4 week taper Aug. 5, 2022: hold at 9.5mg and shift to Valium taper Jan. 24, 2024: Resume Imipramine taper. Current dose as of Aug 26: 4.0mg Taper is 95% complete. Supplements: multiple, quercetin, omega-3, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg, iron, serrapeptase, nattokinase, L-Glutamine, milk thistle, choline I am not a medical professional and this is not medical advice. It is information based on my own experience as well as that of other members who have survived these drugs. Link to comment
Violetsi10 Posted March 1, 2018 Author Share Posted March 1, 2018 Hi, Thanks everyone for all the information. I will take the time to read carefully all of the above and I will try to find a way to talk with my psychiatrist about everything that I can from step to step cut down etc to help ease with cutting down and everything. It's not always easy to talk with my psychiatrist with the kind of authority and ideas that he has, he could understand things differently.. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Violetsi10 Posted March 1, 2018 Author Share Posted March 1, 2018 Hi, I'm not saying that it will definately be useful, or not, but if anybody could post a brief list of documents (professional, official or not) that are linked to this problem that maybe I would be able to show or translate for my psychiatrist some time in the future that he may think credible and therefore help him to understand more about withdrawal etc without me seeming like I'm saying that I know more than him or anything. Thank you. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Moderator Emeritus manymoretodays Posted March 2, 2018 Moderator Emeritus Share Posted March 2, 2018 Hi Violetsi10, If I were you I wouldn't be getting your hopes up real high that you will convince your psychiatrist of W/D, it's existence, and tapering different from how he/she usually approaches it. Oftentimes they go with the information that they get from the drug makers/manufacturers and some short term studies. Do you just see this one psychiatrist as far as doctors go? I don't know if GP's(general practioners) do the injections. Do you? You might be able to find another doctor, if your present one won't take time to listen or look at new information from a "patient". You can use your search engine to find many things on your computer as well and then print off. To find on this site........use your search engine and then the topic followed by survivingantidepressants.org. If I run across anything new.......I'd be happy to share. Are you or have you read at all on other sites? Or books? Why do you want to come off of medications mainly? What are your thoughts on "Mental Illness"? I can refer you to sites and books that I have found in agreement, with my philosophy and present understanding, if you'd like. Really important now....... is also firming up on coping skills and self management. As I'm guessing........you already experienced some significant changes, behavior and thinking..........when having rapidly decreased before..........and may experience some of this, hopefully more manageable, when tapering again. Okay.....all for today. Love, peace, healing/inrecovery, and growth, manymoretodays Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks. Started with psycho meds/psychiatric care circa 1988. In retrospect, and on contemplation, situational overwhelm. Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time). 5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014) 12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs. My last psycho med ever! Tapered @ 10% every 4 weeks, sometimes 2 weeks to 2016 Dec 16, medication free!! Longer signature post here, with current supplements. Herb and alcohol free since 5/15/2016. And.....I quit smoking 11/2021. Lapsed. Redo of quit smoking 9/28/2022, and again finally 5/25/24. Can you say Hallelujah?(took me long enough)💜 None of my posts are intended as medical advice. Please discuss any decisions about your medical care with a knowledgeable medical provider. My success story: Blue skies ahead, clear sailing Link to comment
Moderator Emeritus Gridley Posted March 2, 2018 Moderator Emeritus Share Posted March 2, 2018 I think manymoretodays is probably right about not getting your hopes up that you'll convince your psychiatrist of anything. But, for what it's worth, this post by one of our moderators, Rhiannon, gives an excellent explanation of how psychiatric drugs affect the brain and the necessity of a slow taper. I provided it to you in my first post to you. Brain Remodelling Gridley Introduction Lexapro 20 mg since 2004. Begin Brassmonkey Slide Taper Jan. 2017. End 2017 year 1 of taper at 9.25mg End 2018 year 2 of taper at 4.1mg End 2019 year 3 of taper at 1.0mg Oct. 30, 2020 Jump to zero from 0.025mg. Current dose: 0.000mg 3 year, 10 month taper is 100% complete. Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg Valium Feb. 2021, begin 10%/4 week taper of 18.75mg Valium End 2021 year 1 of Valium taper at 6mg End 2022 year 2 of Valium taper at 2.75mg End 2023 year 3 of Valium taper at 1mg Jan. 24, 2024: Hold at 1mg and shift to Imipramine taper. Taper is 95% complete. Imipramine 75 mg daily since 1986. Jan.-Sept. 2016 tapered to 14.4mg March 22, 2022: Begin 10%/4 week taper Aug. 5, 2022: hold at 9.5mg and shift to Valium taper Jan. 24, 2024: Resume Imipramine taper. Current dose as of Aug 26: 4.0mg Taper is 95% complete. Supplements: multiple, quercetin, omega-3, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg, iron, serrapeptase, nattokinase, L-Glutamine, milk thistle, choline I am not a medical professional and this is not medical advice. It is information based on my own experience as well as that of other members who have survived these drugs. Link to comment
Administrator Altostrata Posted March 3, 2018 Administrator Share Posted March 3, 2018 Welcome, Violet. Please read Tips for tapering off Risperdal (risperidone) Invega Sustenna is an injection like Xeplion. A smart doctor can figure out how to make a smaller injection amount. 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. Link to comment
Violetsi10 Posted March 3, 2018 Author Share Posted March 3, 2018 Hi, Yes I just see this one doctor as far as doctors go. The injections are done by a nurse who usually comes to do it at home but there is the option of going to the nurses cabinet to have it done also. My GP did once try to contact my psychiatrist to talk about me stopping the medication and that I shouldn't be on it all my life etc but did not have any luck contacting him. My father is supportive of me stopping even if it didn't go that well last time I tried at a reasonably rapid pace, I think he understands more things now as well. It really mainly started for me when I was hospitalised "involuntarily" they said because at first I mildly refused and then I accepted, several years ago, I stayed there a few months and during that time and after they had me going to this "day hospital" where they were quite controlling like in the hospital. I took the initiative to find a psychiatrist outside of the day hospital and hospital as the other option was to see the main psychiatrist in the day hospital who is linked to that hospital as well and as I said before, they were quite controlling. After, I was finally "granted" to stop going to the day hospital with my demand and the main psychiatrist at the day hospital that I had to see for this to happen, left a recorded message in front of me for my psychiatrist.. I have read some things and articles on other sites and some parts of books as well. I would mainly like to come off medications because I don't like how they make me feel and I have read a lot about the dangers of them and also the side effects. I do not wish to specify my thoughts on "mental illness" but yes I would be interested to see things that you have found in agreement with your present understanding, if that's ok. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Violetsi10 Posted March 4, 2018 Author Share Posted March 4, 2018 Violetsi said: "I have read some things and articles on other sites and some parts of books as well. I would mainly like to come off medications because I don't like how they make me feel and I have read a lot about the dangers of them and also the side effects. I do not wish to specify my thoughts on "mental illness" but yes I would be interested to see things that you have found in agreement with your present understanding, if that's ok." Violetsi Edited: I have read some things and articles on other sites and some parts of books as well for example books by Szasz, R.D Laing, Will Hall, Breggin etc. I would mainly like to come off medications because I don't like how they make me feel with the side effects etc and I don't think it does me any good long term and I have read a lot about the dangers of them and also the side effects. I do not wish to specify my thoughts on "mental illness" but I think that I probably have a similar understanding to on this website compared to much of what you will find in the mainstream etc. Yes I would be interested to see things that you have found in agreement with your present understanding, if that's ok. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Moderator Emeritus manymoretodays Posted March 4, 2018 Moderator Emeritus Share Posted March 4, 2018 Hi Violets, How are you doing with the reading? Links by both ChessieCat and Altostrata are going to prove to be really helpful in your understanding and decision making. As well as sharing ideas with a provider who can help you begin a taper. Oftentimes.........it can be best to talk about wanting to get to the lowest dose possible of medication, rather than going medication free........with providers/prescribers. And yes, I hear you as far as the concerns with long term usage of medications. I'll leave you with a link to a site that sure helped me a lot, with a wealth of information and viewpoints: https://beyondmeds.com/2017/11/06/site-retired-ive-retired/ Just use the top drop down menus and hopefully you can find some comfort and like minds in your reading/and or listening. Love, peace, healing/inrecovery, and growth, manymoretodays Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks. Started with psycho meds/psychiatric care circa 1988. In retrospect, and on contemplation, situational overwhelm. Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time). 5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014) 12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs. My last psycho med ever! Tapered @ 10% every 4 weeks, sometimes 2 weeks to 2016 Dec 16, medication free!! Longer signature post here, with current supplements. Herb and alcohol free since 5/15/2016. And.....I quit smoking 11/2021. Lapsed. Redo of quit smoking 9/28/2022, and again finally 5/25/24. Can you say Hallelujah?(took me long enough)💜 None of my posts are intended as medical advice. Please discuss any decisions about your medical care with a knowledgeable medical provider. My success story: Blue skies ahead, clear sailing Link to comment
Violetsi10 Posted March 5, 2018 Author Share Posted March 5, 2018 Hi, I am advancing with the reading little by little, but soon should be able to have read it all. One thing is that I don't have much support from most of my family apart from my father who does his best at his age, the rest of my family would probably aggravate and worsen things and the situation. I don't see this part of my family that often but they could come and see me when they wish and anything that they don't understand that is not "normal" enough to their ideal, they would probably try to take control of the situation by going through medical "authorities", and they tend to exagerate to certain extents about how I am and they percieve me. I don't think that they are very open to understanding anything new and probably do not really want to. (One of the phrases of one of my close family was I think that if ever you tried to stop the medication I think you should have a Professional doctor taking care of you and checking up on you as if I am completely unable to do anything for myself and I understand the kind of understanding of doctor they mean and the checking up part too ) Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Moderator Emeritus manymoretodays Posted March 7, 2018 Moderator Emeritus Share Posted March 7, 2018 (edited) Good job then Violet. On the reading of the nuts and bolts of tapering your paliperidone injection, and then hopefully crossing over to an oral form. "I have read some things and articles on other sites and some parts of books as well for example books by Szasz, R.D Laing, Will Hall, Breggin etc." I have not read Szasz at all. I will take a look. Yes, on the family........I understand and it's not too uncommon for them to want a quick fix for a loved one, and sometimes secondary to whatever struggles you may have had........it does seem like they just expect more of the same. My family, while not coming around completely.......seem to........at least........at this point in time...... respect my decision. To come off medication/drugs. So there is that. They look to me for "natural alternatives" or want to try what I try now......full circle I guess. Anyway, not always our best support as far as talking about this stuff. And mine is now better........my family that is. My sister in law is a now retired PHD psychologist who just came for a visit recently with my dear brother. She reads a lot of fiction now...... And gives my brother lot's of chores.......ah, family. But where would we be without them? I'd like to just advocate for others now and/or ease their struggles. I don't think I can give speeches.......at least not yet. It's so political and complicated. Still learning where I fit best or how I may best help in this regard. Look around the site when you get a chance. I don't know why but I bet you would enjoy reading one of our moderators journal/introduction, as I have..... Quite the remarkable recovery/healing journey so here is a link and a toast(of tea) to Shep: http://survivingantidepressants.org/topic/7419-☼-sheps-journey/ Please ask any questions as they arise and well, be well. Love, peace, healing/inrecovery, and growth, mmt Edited March 7, 2018 by manymoretodays Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks. Started with psycho meds/psychiatric care circa 1988. In retrospect, and on contemplation, situational overwhelm. Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time). 5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014) 12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs. My last psycho med ever! Tapered @ 10% every 4 weeks, sometimes 2 weeks to 2016 Dec 16, medication free!! Longer signature post here, with current supplements. Herb and alcohol free since 5/15/2016. And.....I quit smoking 11/2021. Lapsed. Redo of quit smoking 9/28/2022, and again finally 5/25/24. Can you say Hallelujah?(took me long enough)💜 None of my posts are intended as medical advice. Please discuss any decisions about your medical care with a knowledgeable medical provider. My success story: Blue skies ahead, clear sailing Link to comment
Violetsi10 Posted March 30, 2018 Author Share Posted March 30, 2018 Hi, I am now currently on 25mg since early March, I couldn't really find another way to reduce dosage for the moment but I do plan when I go to taper more on finding another way before reducing gradually and stopping most probably switching to an oral form. I am just going to wait a bit so that everything gets as stable as possible before proceeding and of course I will have to plan and find a way to talk with the doctor about the doing the rest... At the moment I am feeling pretty okay and I will get round to reading all of the rest of what you have given me to read as I have not yet read all but I have read some. Thank you. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Moderator Emeritus manymoretodays Posted March 31, 2018 Moderator Emeritus Share Posted March 31, 2018 (edited) Hi Violet, Very happy to see your update. And understandable. Plenty of time now to read and digest the information, and get/hold on to stability before any further switches of dosage forms or dosages. I'm certainly leaning towards having you stay put with your current dosage and dosage form for several months...........more than 3 months even. And I.......haven't gotten to reading Szasz yet........oh, how time flies sometimes. I wonder if you have a printer for your computer? And if so, if you could print out Dr. Joseph Glenmullens symptom list? You could also opt to do an online spreadsheet if that is an easier format for you to use. http://survivingantidepressants.org/topic/2390-dr-joseph-glenmullens-withdrawal-symptom-checklist My idea is.........to see if you see any trends in W/D issues over each months time, on a regular basis, even while your Xeplion(paliperidone) injections are monthly and at the same dosage. It might help us later as well. Let me know what you think or are able to do. Meanwhile, I am hoping you are experiencing Spring and that general lift that often comes with that for me anyway. If not........I'll send some..........right here, right now via the internet. And I'm joking as well as just sending healing thoughts and intentions. Love, peace, healing/inrecovery, and growth, manymoretodays Edited March 31, 2018 by manymoretodays spacing Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks. Started with psycho meds/psychiatric care circa 1988. In retrospect, and on contemplation, situational overwhelm. Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time). 5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014) 12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs. My last psycho med ever! Tapered @ 10% every 4 weeks, sometimes 2 weeks to 2016 Dec 16, medication free!! Longer signature post here, with current supplements. Herb and alcohol free since 5/15/2016. And.....I quit smoking 11/2021. Lapsed. Redo of quit smoking 9/28/2022, and again finally 5/25/24. Can you say Hallelujah?(took me long enough)💜 None of my posts are intended as medical advice. Please discuss any decisions about your medical care with a knowledgeable medical provider. My success story: Blue skies ahead, clear sailing Link to comment
Violetsi10 Posted March 31, 2018 Author Share Posted March 31, 2018 Hi, Yes I think that is an interesting idea and I will try that . I hope you have a good spring as well. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Violetsi10 Posted April 28, 2018 Author Share Posted April 28, 2018 Hi, Could someone inform me as to what is the equivalent dosage of Xeplion 25mg (paliperidone, monthly intramuscular injection) 25mg in other oral forms of antipsychotics for example Risperidone oral liquid solution (RISPERDAL 1 mg/ml, solution buvable?) and some other common pills like maybe Risperdal etc.. and at the same time give me the exact origin of their information? Thanks. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Moderator Emeritus manymoretodays Posted April 29, 2018 Moderator Emeritus Share Posted April 29, 2018 (edited) Hi Violet, So that's what you decided on then? To try and switch over to oral risperidone? Yesterday I looked through some of the more relevant links already provided and........honestly, still can't conclude what exactly would be the equivalent dosage of your injectable paliperidone(which is like Invega Sustenna injections here in the U.S.) to an oral form of risperidone. It's complicated. Paliperidone is an active metabolite of risperidone. http://survivingantidepressants.org/topic/7101-tips-for-tapering-off-invega-paliperidone/ ^ this one seems the most informative but not definitive as far as dose equivalencies. Are you able to open all the links given from France? It looks like the sources are given......most of them in the U.S. I searched around and all that came up was switching from oral forms to injectable, not the reverse. The complicated part is........at least I think it is........is that the way the injectable forms(keeping up that blood level of the active ingredient) work are probably going to differ somewhat once you switch to even the nearest equivalent dose of risperidone. So.......you might encounter some symptoms. Have you noted any trends in symptoms during this past month? And been able to find/use coping skills? From what I can understand.......it does seem that even with the long acting injection the daily dosage(or active metabolite) might vary a bit, especially towards the end of the month. So, also just to recap.........you'll be coming up on your 3rd month now of the decrease to 25mg. of paliperidone, correct? When do you see your prescriber again and can you ask if he/she would be willing to switch you to an oral equivalent in another month or so(preferably liquid)? Do you have access to any pharmacists that might be able to help? Pharmacists here in the U.S. are the ones who package up the medications. Love, and peace, and healing and growth, mmt ........and afterthoughts with a hug.........that this may take some time to figure out so my encouragement to be patient and that when you have further information that you do your best to stay at an equivalent dose for awhile.........I just don't want to see a repeat of what has happened before when you went from the 25mg. of injectable to zero. I'm just going to include a couple of other links for you to look at........most especially the first posts in both of them. http://survivingantidepressants.org/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/ http://survivingantidepressants.org/topic/1008-before-you-begin-tapering-what-you-need-to-know/ Edited April 29, 2018 by manymoretodays afterthoughts Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks. Started with psycho meds/psychiatric care circa 1988. In retrospect, and on contemplation, situational overwhelm. Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time). 5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014) 12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs. My last psycho med ever! Tapered @ 10% every 4 weeks, sometimes 2 weeks to 2016 Dec 16, medication free!! Longer signature post here, with current supplements. Herb and alcohol free since 5/15/2016. And.....I quit smoking 11/2021. Lapsed. Redo of quit smoking 9/28/2022, and again finally 5/25/24. Can you say Hallelujah?(took me long enough)💜 None of my posts are intended as medical advice. Please discuss any decisions about your medical care with a knowledgeable medical provider. My success story: Blue skies ahead, clear sailing Link to comment
Violetsi10 Posted April 29, 2018 Author Share Posted April 29, 2018 Hi, I would just like to calculate and plan my options a bit in advance. I havn't really been able to identify definitely any (w/d) symptoms, but I will try more and keep trying.. I think I am coping quite well, (there is often quite a lot of noise in the evening and night in the area where I live and occasionnally I find a bit disturbing and sometimes I find it hard to get to sleep but I found ways of coping thus making it less of a problem. Yes, I plan to ask about switching to an oral (preferably liquid) form probably in a couple of months or so, maybe slightly sooner. I think I can say that I agree with you about staying on an equivalent dose for a while after I have switched form. Thanks. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Administrator Altostrata Posted April 29, 2018 Administrator Share Posted April 29, 2018 Violet, the injection will naturally fade out over the month. At the end of the month, there's smaller amount of the paliperidone left in your body. That would be a good time to switch to a lower dosage in tablet form. See Tips for tapering off Risperdal (risperidone) In the US, any doctor can prescribe these drugs, it doesn't have to be a psychiatrist. If you don't like this psychiatrist, are you obligated to continue to see him? 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. Link to comment
Violetsi10 Posted April 30, 2018 Author Share Posted April 30, 2018 I could find another psychiatrist and end up with a worse one. My current psychiatrist however is not particularly awful. He once said to me that I don't have to see him. On another occasion he also said that if I stopped the medication after some time I would end up unwell or in hospital. That was not long before he accepted for me to try stopping the medication to see what happened. But he did mention things of his opinion that were not very supportive or encouraging yet he is not particularly horrid. For the time being, I think I would stay with him and if ever I was considerably displeased with his ways, I could try to find another reasonable psychiatrist. But I would like to eventually become free of any follow up.. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Moderator Emeritus manymoretodays Posted May 1, 2018 Moderator Emeritus Share Posted May 1, 2018 (edited) Hey Violets10, ......and thank you to Altostrata for weighing in on the subject. Do look at that link she gave you ^. It's all feeling like "rocket science" as we sometimes say here in the states. An expression usually said in a different context......such as "it's NOT rocket science". So.......I suppose it's possible V10........that in time you might be able to convince this prescriber that you would like to do an oral form(Alto says pills/tablets). Meantime......here's a discussion that might help, as far as working with prescribers, http://survivingantidepressants.org/topic/4463-how-do-you-talk-to-a-doctor-about-tapering-and-withdrawal/ On 4/29/2018 at 2:17 PM, Violetsi10 said: I think I can say that I agree with you about staying on an equivalent dose for a while after I have switched form. .......as equivalent as possible.......it's not going to be exact. Other things you can work on now would be deciding how to eventually do some minimal reductions(10% or less) when you get to the oral form.......pill splitting, careful weighing, compounding, or liquid. This might be an opening to talk with a pharmacist(?chemist). Happy M'aidez......hope I got that right......I shall dance around a May pole somewhere now. Love, peace, healing, and growth, mmt Edited May 1, 2018 by manymoretodays Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks. Started with psycho meds/psychiatric care circa 1988. In retrospect, and on contemplation, situational overwhelm. Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time). 5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014) 12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs. My last psycho med ever! Tapered @ 10% every 4 weeks, sometimes 2 weeks to 2016 Dec 16, medication free!! Longer signature post here, with current supplements. Herb and alcohol free since 5/15/2016. And.....I quit smoking 11/2021. Lapsed. Redo of quit smoking 9/28/2022, and again finally 5/25/24. Can you say Hallelujah?(took me long enough)💜 None of my posts are intended as medical advice. Please discuss any decisions about your medical care with a knowledgeable medical provider. My success story: Blue skies ahead, clear sailing Link to comment
Moderator Emeritus manymoretodays Posted May 7, 2018 Moderator Emeritus Share Posted May 7, 2018 (edited) Hi Violets, Well here is one.......an article I found published in 2012. I'll copy 2 items out of it that gave me further clarity......... and then give you the link as well. Extractions from the article are in black. In the literature, paliperidone doses are sometimes expressed as milligram equivalents (mEq) of paliperidone. Therefore, 25, 50, 75, 100, and 150 mEq paliperidone palmitate are equivalent to 39, 78, 117, 156, and 234 mg of paliperidone palmitate, respectively. So.......your 25mg. is actually a milligram equivalent(mEQ) of 39 mg. And yay, you are on the lowest dose of the injection. And so it is the same with Xeplion as it is with Invega Sustenna(both brand names of the injectible form.......very similar from what I can glean). And then this table: Table 3 Doses of oral and injectable paliperidone needed to attain similar concentration at steady-state14 Formulation Paliperidone extended-released tablet Paliperidone palmitate long-acting injection Dosing frequency Once daily Once every 4 weeks Dose 3 mg 39–78 mg 6 mg 117 mg 12 mg 234 mg Adapted from Invega® Sustenna™ product information.3 And here is the link to the full article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3413070/ The parts that I extracted were down towards the end of the article. Just hoping it helps make it clearer for planning purposes. And will repost Alto's wisdom as well. On 4/29/2018 at 2:36 PM, Altostrata said: Violet, the injection will naturally fade out over the month. At the end of the month, there's smaller amount of the paliperidone left in your body. That would be a good time to switch to a lower dosage in tablet form. See Tips for tapering off Risperdal (risperidone) In the US, any doctor can prescribe these drugs, it doesn't have to be a psychiatrist. If you don't like this psychiatrist, are you obligated to continue to see him? Love, peace, healing, and growth, manymoretodays Edited May 7, 2018 by manymoretodays formatting Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks. Started with psycho meds/psychiatric care circa 1988. In retrospect, and on contemplation, situational overwhelm. Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time). 5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014) 12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs. My last psycho med ever! Tapered @ 10% every 4 weeks, sometimes 2 weeks to 2016 Dec 16, medication free!! Longer signature post here, with current supplements. Herb and alcohol free since 5/15/2016. And.....I quit smoking 11/2021. Lapsed. Redo of quit smoking 9/28/2022, and again finally 5/25/24. Can you say Hallelujah?(took me long enough)💜 None of my posts are intended as medical advice. Please discuss any decisions about your medical care with a knowledgeable medical provider. My success story: Blue skies ahead, clear sailing Link to comment
Violetsi10 Posted May 8, 2018 Author Share Posted May 8, 2018 Hi, Thank you for the information. I'm sure it will be useful. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Moderator Emeritus manymoretodays Posted May 10, 2018 Moderator Emeritus Share Posted May 10, 2018 And more. An fairly new topic that is also here, on site, in tapering. It's got some more recent stuff on AP's too. I'm studying. It's fun. http://survivingantidepressants.org/topic/17117-dose-equivalents-for-antidepressants-and-second-generation-antipsychotics/?_fromLogin=1 Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks. Started with psycho meds/psychiatric care circa 1988. In retrospect, and on contemplation, situational overwhelm. Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time). 5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014) 12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs. My last psycho med ever! Tapered @ 10% every 4 weeks, sometimes 2 weeks to 2016 Dec 16, medication free!! Longer signature post here, with current supplements. Herb and alcohol free since 5/15/2016. And.....I quit smoking 11/2021. Lapsed. Redo of quit smoking 9/28/2022, and again finally 5/25/24. Can you say Hallelujah?(took me long enough)💜 None of my posts are intended as medical advice. Please discuss any decisions about your medical care with a knowledgeable medical provider. My success story: Blue skies ahead, clear sailing Link to comment
Violetsi10 Posted July 26, 2018 Author Share Posted July 26, 2018 Hi, Regarding supplements, I would like to ask your opinion on things like Valerian and other similar things? Can they cause problems and are best to start with low doses to see reaction? Thank you. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Moderator Emeritus manymoretodays Posted August 3, 2018 Moderator Emeritus Share Posted August 3, 2018 (edited) On 2/28/2018 at 4:27 PM, Gridley said: Regarding supplements, we don't recommend a lot of them on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. Magnesium, nature's calcium channel blocker Omega-3 fatty acids (fish oil) Hi Violetsi10, Yes, you should be very cautious with supplements now. They can cause problems in sensitized nervous systems like ours. Even with the 2 mentioned above you should only introduce one at a time and start on the low end until you see how you tolerate. If you haven't already you might look into trying one, or eventually even both of the above supplements. I found Magnesium to be really calming in my more acute days of withdrawal. I still use a bit of it from time to time. Mostly in the form of Epsom salts in a bath. I've also used it orally as well and still do when the need arises............ Sometimes I still get "stressed" and my autonomic nervous system needs some help with calming. I found this topic on Valerian here on site: Valerian root There are a couple different ways that you can search here. To find topics on Valerian root, for example > go to our symptoms and self care section > at the top right there is a search box that you can type in Valerian > and it brought up this subject. I often do a search as well, by typing in survivingantidepressants.org then the subject(in this case Valerian) in my main browser, off site. Although it does look like Valerian can be antianxiety, and has helped some with sleep.............it also seems there can be great risks apparent with it's usage..........one of them being that it can cause dependencies just like psychiatric drugs.............another is that for some who are sensitized already with withdrawal........it might go paradoxical............meaning it could have the opposite effect and actually create a feeling of panic. So yes, many supplements like Valerian and others can cause problems in those of us with psych medication histories and/or withdrawal. So......my opinion would be......... not a good idea. If you were someone who had never had any psych drug in your system.........only then, I think it might be considered. If I were you I would stick to learning non drug/supplement(other than the 2 mentioned above) coping skills now..........that will serve you better I think in the long run. And there are many topics as to different techniques here to get you started: Non-drug techniques to cope The Beyondmeds site is also being updated again, and there are all kinds of non-drug coping and informative pieces to read there. ........and how are you doing overall now? Are you still maintaining on the 25 mg Xeplion injectable monthly? You are still adjusting no doubt........ to the drop back in March of this year. Love, peace, healing, and growth, mmt Edited August 3, 2018 by manymoretodays puncuation, clarity Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks. Started with psycho meds/psychiatric care circa 1988. In retrospect, and on contemplation, situational overwhelm. Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time). 5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014) 12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs. My last psycho med ever! Tapered @ 10% every 4 weeks, sometimes 2 weeks to 2016 Dec 16, medication free!! Longer signature post here, with current supplements. Herb and alcohol free since 5/15/2016. And.....I quit smoking 11/2021. Lapsed. Redo of quit smoking 9/28/2022, and again finally 5/25/24. Can you say Hallelujah?(took me long enough)💜 None of my posts are intended as medical advice. Please discuss any decisions about your medical care with a knowledgeable medical provider. My success story: Blue skies ahead, clear sailing Link to comment
Violetsi10 Posted August 4, 2018 Author Share Posted August 4, 2018 Hi, Thank you for the reply. I am ok. Yes I am still maintaining this dose. It would be reasonable to say that I am still adjusting, yes. Best. Violetsi Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Violetsi10 Posted November 19, 2018 Author Share Posted November 19, 2018 Hi, I am now currently on Risperidone tablets 1/2 a 4mg tablet / day = 2mg / day. The doctor I see also said that he is ok to switch to the liquid oral solution but he would like to see me in a meeting first. I am ok. Thanks. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
Violetsi10 Posted November 25, 2018 Author Share Posted November 25, 2018 Hi, Does anybody think that this is a reasonable cut down in dosage in account that it was changed at the end of the month? Thank you. Xeplion (paliperidone) intramuscular injections monthly)) 75mg approx.Sep 2014 - Jan 2016 ----50mg approx. Jan 2016 - Mar 2016 ----25mg approx. Apr 2016 - Jun 2016 Stopped (0mg) approx. Jun 2016 - Apr 2017 ---- 25mg approx. Apr 2017 - May 2017 ----75mg approx. May 2017 - Jun 2017 ----50mg approx. Jun 2017 - Mar 2018 ----25mg . Mar 2018 - Nov 2018 ----Risperidone tablets 1/2 4mg tablet /day = 2mg/day Nov 2018 - Jul 2019 ----Risperidone 1mg/ml oral solution - 2ml daily reducing by 0.1ml every 2 weeks until down to 1ml per day - Jul 2019 - Present Link to comment
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