Sadie1: reducing lurasidone / Latuda

[Sadie1]

Hi,

 

I am happy to know this site exists! After coming off of a couple of other antipsychotics (see below) I am finally on one that seems the lesser of evils. That being said Lurasidone is not perfect.

 

I’m on 30 mg, soon to be 20 mg of Lurasidone. I have been on 30 mg (from 40 mg) for 3 months now so I feel it is time to trial a reduction. So far I haven’t had any withdrawal symptoms, but I’m pretty sure I am a poor metabolizer of this medication, so I’m expecting a delayed withdrawal.

 

I think it will take some convincing to go down any further than 20 mg because I am on this medication for Schizophrenia which I have been newly diagnosed with, and literature with being poor metabolizers on antipsychotics is limited (I only found an article stating if you’re on Risperidone you should be on 1/4 of the recommended dose). It took enough convincing to get this far, as the normal starting dose for Schizophrenia is 40 mg. I haven’t had any hallucinations or other symptoms on 30 mg so I am hoping 3 months was long enough to go ahead and trial 20 mg.

 

Overall, I find Lurasidone the lesser of evils for antipsychotics as I am not drowsy at all, and don’t have akathisia as bad as I did on other medications. I have had some weight gain, my hair is thinning a lot, and I have a bit of akathisia in the afternoons so I’m hoping the reduction will help with this.

 

I wish I could go off of all medications, and part of me still believes that there is a possibility that my short-lived psychosis episodes were because of medication withdrawal, not schizophrenia, as I was coming off of medication both times the psychosis happened. Or, I have entertained that there is a possibility I have both Schizophrenia, AND had withdrawal psychosis. Either way the psychosis which presented as auditory hallucinations was super scary and I don’t think I want to experiment with being completely off a medication for now. If I was able to convince my psychiatrist to taper completely off of it at some point, I would probably want to be in hospital and because of the delayed withdrawals I experience, it would be quite a lengthy stay, so not ideal right now.

 

July 2020 - Feb 2021 : Risperidone

March 2021 - April 2021 : Abilify

September 2021 - March 2022 : Clopixol

March 2022 - Current : Lurasidone (Latuda)

 

 

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.

 

Can you please give us specific information in your signature about your drug history for all drugs and supplements you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only specific dates, include the day (as best you can say for example early March if you don't recall the day), drug names, and dosages of each medication decrease or increase.

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Your Drug History in Your Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

On 11/7/2022 at 6:04 PM, Sadie1 said:

I’m on 30 mg, soon to be 20 mg of Lurasidone. I have been on 30 mg (from 40 mg) for 3 months now so I feel it is time to trial a reduction.

 

We do not suggest that you reduce your Lurasidone from 30 mg to 20 mg.  This is too big of a drop, and puts you at risk for significant withdrawal syndrome, which can take a very long time to recover from.  

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Latuda/Lurasidone

 

Not only that, but you did a big drop 3 months ago, when you dropped from 40 mg to 30 mg.  And, you have done a lot of drug switches over the past 2-3 years.  Your nervous system needs lots of time to adjust to this large dose reductions.  Even if these drug switches and reductions haven't bothered you before, these things tend to be cumulative, and build up over time, and catch up with you.  It's quite a lot for your nervous system to deal with.  Are you symptom free now?  Did you have any withdrawal when you dropped from 40 to 30?  

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

 

Edited November 18, 2022 by getofflex

[Sadie1]

Thanks getofflex.

 

I have not experienced any withdrawal symptoms yet. I had a really delayed withdrawal with Abilify (almost 6 months later!) so I am not sure I am out of the woods yet.

 
My plan was if I go any lower than 20 mg, that I would get it compounded into smaller doses. From what I’ve read, it seems that people going off Latuda have a harder time after the 20 mg decrease, but I could be mistaken.

 

Have you ever heard of anyone getting such delayed withdrawals? I know meds like Abilify and Latuda have a longer half life but 6 months was quite surprising to me.

 

Thanks

 

[Sadie1]

I think I’ve found the answer to my question here:

 

 

[Thorin]

How’s it all going Sadie1?

[Sadie1]

Hi Thorin,

Thanks for checking in! So far I haven’t really experienced any withdrawals but given how late I experienced Abilify withdrawals I think it will still come. I’m also not experiencing any hallucinations or any symptoms of Schizophrenia. I am going to stay at 20 mg for at least 4-6 months to see if anything happens before considering lowering my dose. Sad to hear your last update was a window and not complete recovery but hope you’re doing better!

[Thorin]

Thanks @Sadie1 I feel the wave is slowly improving day but day. Sounds like a good plan to hold for a while. My last window was the best I’d felt in a long time but I believe I pushed myself too hard and hence the latest wave. I’ll be practising radical self care from now on and only pushing myself in little steps. Sounds like you’re doing the same thing! Good luck!

[Sadie1]

So I finally started feeling very mild withdrawal symptoms since Sunday, December 4th. I felt mildly hungover for 2 days and then brain zaps on Tuesday. I’ve started taking Magnesium since Tuesday and so far no other symptoms have come up yesterday or today, not sure if it’s a coincidence or not. Now I’m just curious if the withdrawal is from reducing my dose from 40-30 mg just over 4 months ago, or if it is from reducing 30-20 mg just over a month ago. I guess I’ll see what happens in a few months in March, if I go into withdrawal then, I have more than a 4 month delay in withdrawal with Lurasidone.

[Sadie1]

Now that I have been on 20 mg of Latuda for 3 months, I am going down to 15 mg.

Other than very mild withdrawal symptoms in early and late December I have not experienced anything else so I feel fairly safe moving down to 15 mg. I know that the recommendation here is to go down by 10%, but since I tolerated the previous decreases from 40 mg to 30 mg and 30 mg to 20 mg I’m hoping this is okay.

It takes me nearly 4-5 months to feel a difference in the dose reduction so I believe even though I’m now on 15 mg, the concentration in my body is over 15 times the actual amount, so closer to 200 mg. I could be wrong about this, but if I’m continuously metabolizing the drug out in 4-5 months that is definitely poor metabolism.

 

[itcanalwayschange]

Hi Sadie1,

 

How are you getting on?

I am currently on Cariprazine but will be switching to Latuda.