Jean77: Hello, I've been diagnosed with psychosis and put on antipsychotics and antidepressants

[Jean77]

Hello, my name is Jean and I'm a 29 year old graphic designer from Ljubljana, Slovenia. I got involved in a bad relationship and 0,5 years into the relationship in January of 2022 I couldn't sleep for 7 days bcs I was constantly overthinking about why this relationship is not working out and then I attacked my father and got hospitalised. I got diagnosed with acute psychosis with very good prognosis. I've been put on Zypreza 20mg, Rxulti (brexpiprazole) 3mg, Zooloft 200mg and Lorazepam 3mg for three weeks. I had a real hard time weaning of Lorazepam even tho I was on it for just 3 weeks, Zooloft was added bcs I was feeling anxious at the hospital. My decision at the time was that I'm gonna listen to doctors and just take the meds, I was afraid. I've tappered of Zyprexa because I developed gynecomastia and my doctor increased Rxulti to 4mg. I've succesfully tappered of Zooloft and this year I was tapering Rxulti from 4mg to 0mg - with guidance of my psychiatrist I've tapered it 1mg per month, so in 4 months I was completely off. 

The relationship was still going on but we we're in these on and off cycles and after I fully quit my medication I did 800mg of MDMA in one night and then 3 months later when my gf broke up with me and next day called the cops for help bcs I was saying strange things so I was forcibly hospitalised again and put on medication again. My new dose from the hospital in October was: Rxulti 3mg, Rispardal 3mg, Rivotril 0,5mg, Ascentra (Zooloft) 75mg.

While I had some auditory hallucinations after not sleeping for a very long time they diagnosed me with schizoprenia which I think its total bullsh*t bcs nobody spoke to me at the hospital they were just increasing the dosage of meds. Its been 2 months since I left the hospital and after weaning the benzos I'm getting back to my self slowly. I've already removed Rivotril, and decreased Rispardal from 3mg to 1mg. I've spoke with my psychiatrist and told him that in the last 3 years I've struggled on meds and I wanna get back to the place of feeling and thinking where I was before I was taking meds, and he surprisingly agreed that I can wean of all meds. One thing that I am worried about is the rate of tapering bcs from what I am reading online it's way slower than what my psychiatrist reccomeds. WIth Rispardal he just said I can stop taking it when I was at 2mg and I've told him it's better to go slow and he said oh yea you can go to 1mg and then off.

The realtionship has ended and I decided to move on, I'm keeping up with my job - I have a sole propretorship and I work as a contractor which is challenging bcs I'm doing creative work while being on antipsychotics.

I do feel lots of restlessness and inability to be still for a longer period of time, my thoughts and emotions still feel numbed out which is probably still from the medication. I've tapred off antipsychotics before pretty quickly without noticing any extreme withdrawal but I got hospitalised again, my question is what would you suggest. My plan was to first taper of antipsychotics and then taper of AD bcs I do feel like AD is helping me keep up a bit at the moment.

[Jane318]

Greetings @Jean77, and welcome to SA!  We are a community of volunteers providing peer support in the tapering of psychiatric medications and their associated withdrawal syndromes. 

 

Thank you for completing your drug signature.

 

I am sorry for all you have suffered these last few years - and I am amazed at how far you have come, how you have overcome these horrible experiences!  Many kudos to you for making the decision to move on with your life and all the hard work required to keep up with a demanding profession! You demonstrate the commitment and determination to get off these harmful drugs for good.

 

On 12/8/2024 at 4:45 AM, Jean77 said:

I do feel lots of restlessness and inability to be still for a longer period of time, my thoughts and emotions still feel numbed out which is probably still from the medication.

While it is impossible to rule out other causes, these drugs are known to produce multiple side effects including a numbing of thoughts and emotions.  Further, since you are taking multiple drugs, there may well be drug interactions at play as well.  I encourage you to check your drug interactions at https://www.drugs.com/drug_interactions.html.  This shows a major interaction between brexpiprazole (Rexulti) and sertraline (Zoloft), with symptoms that include restlessness, and a moderate interaction between resperidone and sertraline.

 

On 12/8/2024 at 4:45 AM, Jean77 said:

I've tapred off antipsychotics before pretty quickly without noticing any extreme withdrawal but I got hospitalised again, my question is what would you suggest. My plan was to first taper of antipsychotics and then taper of AD bcs I do feel like AD is helping me keep up a bit at the moment.

It sometimes becomes harder to taper off a drug each successive time.  This is not to discourage you, but just to make you aware that tapering may be a bit more difficult this time, even if you have been able to get off a drug with ease before.

 

As to which drug to taper first, please read: Taking multiple psych drugs? Which drug to taper first?  As you see from this post, there are no hard and fast rules.  Based on your narrative, drug history, and potential drug interactions, however, I would agree that it makes sense for you to taper off the APs first, then the Zoloft.  

 

Please note that your drug history reveals multiple drugs and several fast tapers.  This makes it especially important for you to taper these last three drugs carefully and sufficiently slowly to keep withdrawal symptoms in check.  Here at SA, we recommend the hyperbolic taper method, which you can read about here:  Why taper by 10% of my dosage?  The 10% always refer to the prior dose, so, with hyperbolic tapering, the reductions get smaller and smaller each month, for example a 10% hyperbolic taper from 10 mg looks like this: 9mg, 8.1mg, 7.3mg, etc. Importantly, if you develop unpleasant side effects from tapering, halt the taper, give yourself time to settle, and once stable, taper more slowly and by smaller amounts moving forward. The experience of others suggests that the lower you go in dose, the slower you need to go with tapering.  Those that taper too quickly often develop very unpleasant withdrawal symptoms. This Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) is a helpful summary of what many experience.  

 

Before you begin to taper, please carefully read:

 

Before you begin tapering - what you need to know

Important topics in the Tapering forum and FAQ

Tips for tapering off Risperdal (risperidone) (We do not have a page for Rexulti, but the 10% taper method still applies).

Tips for tapering Zoloft (sertraline)

 

As you taper, and even in protracted withdrawal, it is very normal to have periods where you feel better, and periods where you feel terrible.  This is what we call the windows and waves pattern of stabilization.  This is actually a good sign of healing!  Read more about windows and waves here:   The Windows and Waves Pattern of Stabilization

 

 

It’s important to keep tabs on your symptoms and adjust your taper amount and schedule as needed.  This will help you identify your windows and waves and reveal your progress, which is encouragement we need! 

You can use the following list of typical withdrawal symptoms to track the severity of your symptoms over time:  Daily Checklist of Antidepressant Withdrawal Symptoms (PDF).  You may choose to also track your foods and activities to identify things that trigger symptoms as well. 

 

There are things you can do to help your nervous system recover as you taper.   Eat a balanced, whole foods diet, stay well hydrated, engage in gentle exercise, and get adequate rest/sleep.  Avoid all neurologically active substances, like caffeine, alcohol, nicotine and recreational drugs- these are like pouring gasoline on a fire for your symptoms.  Avoid adding any further psychiatric medications to deal with your withdrawal from psych meds- the effects of these meds on a destabilized nervous system is unpredictable, and taking something else could make you worse.

 

 

We recommend only two supplements here - magnesium (glycinate is a good form) 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) 

 

This is your introduction topic.  Each member gets one intro topic- please post updates and questions here, in this thread.

 

I look forward to following your journey, and helping out in any way I can.  Best wishes.

[Yesyes123]

On 12/8/2024 at 9:45 AM, Jean77 said:

While I had some auditory hallucinations after not sleeping for a very long time they diagnosed me with schizoprenia which I think its total bullsh*t bcs nobody spoke to me at the hospital they were just increasing the dosage of meds.

They will throw diagnoses at anyone who shows any kind of abnormal behavior. Your problems clearly seem to stem from lack of sleep and drug use, I wouldn’t give any diagnosis too much attention.

[Jean77]

thanks for the long post, I've found many things helpful.

I've only been on Rispardal for 3 months and I've already reduced it to 1mg. I started to notice restlessness when I went to 1mg. Now I'm gonna stay at 1mg till I stabilise and then reduce but I wanted to then go to 0,5mg and then off but what you're suggesting is that I taper the remaining portion of Rispardal by 10% in this fashion:
0,9 mg, 0,81 mg, 0,73 mg, 0,66 mg, 0,59 mg, 0,53 mg etc. ?

At this rate it will take me 3 years to tapper all of my medication for good. It's frustrating that I have to wait 3 years till I'll be able to feel like my normal self again and I want to get there quicker. 

Would an alternative be somewhere in between lets say: 1mg, 0,75mg, 0,5mg, 0,25mg, 0mg also be a good option or you always swore with the hyperbolic tapering? Or can I decrease multiple medications at the same time?

[Jean77]

14 hours ago, Yesyes123 said:

They will throw diagnoses at anyone who shows any kind of abnormal behavior. Your problems clearly seem to stem from lack of sleep and drug use, I wouldn’t give any diagnosis too much attention.

 

The two times I seemed to have psychosis was after not sleeping for longer periods of time, I did have delusions and my thinking was irrational but I've never heared voices talking to me. I'm not focusing to much on diagnosis bcs I've seen them throw differenet ones all the time. My main objective is that I wanna feel like myself again and not take these antipsychotics as I feel really numbed out and unable to think on them.

[Jane318]

5 hours ago, Jean77 said:

I've only been on Rispardal for 3 months and I've already reduced it to 1mg. I started to notice restlessness when I went to 1mg. Now I'm gonna stay at 1mg till I stabilise and then reduce but I wanted to then go to 0,5mg and then off but what you're suggesting is that I taper the remaining portion of Rispardal by 10% in this fashion:
0,9 mg, 0,81 mg, 0,73 mg, 0,66 mg, 0,59 mg, 0,53 mg etc. ?
At this rate it will take me 3 years to tapper all of my medication for good. It's frustrating that I have to wait 3 years till I'll be able to feel like my normal self again and I want to get there quicker. 

 

It only takes a 2 to 4 weeks for our bodies to become dependent upon these powerful drugs.  SA experience has shown that a slow 10% (max) hyperbolic taper is the safest way to get off these drugs while keeping withdrawal symptoms in check.  Going to quickly is a bad idea for all of these drugs, but especially so for APs.  I hope you carefully read: Tips for tapering off Risperdal (risperidone), including the links.

 

That said, you may be able to cut perhaps every three weeks instead of every four, but only if you are carefully monitoring your symptoms.  Your "jumping to zero" point is when your dose is sufficiently low that you no longer feel a difference after a cut. This can be different for everyone.  But in general, is a lower dose than many practitioners will say.  I am fairly confident in stating that 0.5 mg is too high to jump to zero.  If you did 10% per month you would be at 0.282 at the end of year 1, 0.08 mg at the end of year 2, and 0.23mg at the end of year 3. 

 

When to end the taper and jump to zero?

 

5 hours ago, Jean77 said:

Would an alternative be somewhere in between lets say: 1mg, 0,75mg, 0,5mg, 0,25mg, 0mg also be a good option or you always swore with the hyperbolic tapering?

This is a linear taper, which SA does not recommend.   Please read:  Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration

 

5 hours ago, Jean77 said:

Or can I decrease multiple medications at the same time?

While some have done this, SA does not recommend it due to its multiplied complexity and greater risks.  You might read Rhiannon's story:  Rhiannon's intro (by Rhi)

[Yesyes123]

6 hours ago, Jean77 said:

what you're suggesting is that I taper the remaining portion of Rispardal by 10% in this fashion:
0,9 mg, 0,81 mg, 0,73 mg, 0,66 mg, 0,59 mg, 0,53 mg etc. ?

Yes, that is what we recommend here.

 

Some people may be able to go faster but it’s not worth your well being to try and see if you are one of those people.

 

7 hours ago, Jean77 said:

At this rate it will take me 3 years to tapper all of my medication for good. It's frustrating that I have to wait 3 years till I'll be able to feel like my normal self again and I want to get there quicker. 

It will not take 3 years for you to feel like your normal self, once you are stable you will feel better even if still on small doses of your drugs. Then you can taper off much easier