PPPPP9: Getting off Risperdal, how rough is it and how did you feel after the final cut?

[ppppp9]

Good sage advice Scallywag.  Thank you.  I'll see how I'm doing before considering a further reduction.  At the moment I feel good but will post if that should change.  Take care.

[Miko789]

Hi pppppp,

 

I would suggest you taper first the effexor finish with that and then taper off the risperdal. One drug at a time like scally says. I agrree that effexor is tricky and has withdrawal symptoms so dropping one bead at a time is what you should do.not sure if 1 bead/day is good enough, i think is too fast. You should hold on for at least 6 weeks before next cut

About the feeling of spacey and pressure in head I have it too, not sure if its the risperdal or the antidepressant. seroxat

 

 

Keep us informed

Miko

[blazesboylan]

Tonight my head feels heavy like it wants to have a big headache but can't.

 

Hi Ppppp9,

 

I hope that you are doing well. I spotted the above and I was just wondering if you have experienced it again? I have had pressure in my head, just like you describe, for roughly two years now. I think that it started when I made my first attempt at tapering. It varies in intensity but it's worst at night. I was even sent for an MRI brain scan to see if there was something causing it.

 

I used to take risperidone by the way but I switched to olanzapine 9 months ago. I am trying to taper the olanzapine now. I am finding that the Effexor is more of a challenge though.

[ppppp9]

 

Tonight my head feels heavy like it wants to have a big headache but can't.

 

Hi Ppppp9,

 

I hope that you are doing well. I spotted the above and I was just wondering if you have experienced it again? I have had pressure in my head, just like you describe, for roughly two years now. I think that it started when I made my first attempt at tapering. It varies in intensity but it's worst at night. I was even sent for an MRI brain scan to see if there was something causing it.

 

I used to take risperidone by the way but I switched to olanzapine 9 months ago. I am trying to taper the olanzapine now. I am finding that the Effexor is more of a challenge though.

 

Hi blazesboylan.  It's a funny thing.  I had never been on more than 75 mgs. Effexor and with the tapering off that med over the past 3 years I'd say I've done exceptionally well.  I did drop a few beads several weeks ago and had a little head pressure.  The original pressure I felt in February 2016 I think was due to the drop in the Risperdal, maybe too much of a cut or too close to the last drop.  I'm now down to 4 beads of Effexor and have felt great over the past several days, no w/d symptoms, no anxiety and sleep is good.  I'm going to hold off dropping anymore on the Effexor until I've completed my taper off Risperdal and then I'll hold on that for some time before finishing up with the Effexor.  At 4 beads it's of no consequence to wait until the right time approaches.  Head pressure is a mystery to me.  Don't really know what it means or what prompts it.  Take care.

[blazesboylan]

Hello,

 

I don't really know what the pressure is about either but as I was saying I'd imagine that it is a withdrawal symptom. It's not too bad this evening anyhow.

 

The best of luck to you with your tapering anyway. It sounds as if you are doing very well. I have quite a long way to go on the Effexor front although I have come a long way also. 300 mg to 80 mg.

 

Have a nice weekend too. 

[ppppp9]

Can someone please explain what a half-life is and what it really means and what relevance it is on tapering etc.?  

[scallywag]

PPPPP9: Wikipedia's page on biological half-life.

 

Quick answer: the time it takes for your body to metabolize or eliminate 50% of the dose. 

 

Risperdal has a half-life of 20 hours. This means that after

• 20 hours the body has eliminated 50% and there's 50% remaining
• 40 hours the body has eliminated 50% of previous level and there's now 25 % remaining
• 60 hours the body has eliminated 50% of previous level and there's now 12.5 % remaining

The impact of this is mostly about "inter-dose" withdrawal. On a drug with a longer half-life there's more wiggle room on timing.  Effexor is a task master with its half-life of 4 hours -- after 12 hours, there's 12.5% remaining.  If someone is taking the immediate release version, they can start to feel w/d symptoms if they're late for the next dose, even by an hour.

[ppppp9]

Very good explanation Scallywag, thank you.  I'm struggling with which of the two I should finish tapering first, the Risperdal or Effexor.  Miko says Effexor. Seeing that I'm on such a small amount of each, does it really matter??   If Effexor, how do I taper from 4 beads, 1 bead off and hold at 3 till I feel good but not less than 6-8 months before another drop and then what?  I sure appreciate all the guidance I'm receiving.  It gives me strength!

[ppppp9]

Scallywag, getting back to half-life.  I take the Risperdal at night and usually after 20 hours I actually feel much better, my mind feels clearer.   During the day sometimes between 12-3pm I feel a bit out of sorts, spacey just not completely normal.  I take the Effexor in the morning.  What would that be?

[mammaP]

Hi P, I tapered effexor and found the last 4 beads troublesome because you can't cut less than 25% .  There are ways around it. One is to get immediate rel;ease tablets and make a liquid yourself, you will find instructions in the tapering forum, it is a sticky topic near the top of the page. 

 

In the UK liquid effexor is available, I asked the pharmacist, who gave me a note of the brand and dosage (ml per mg), I took that to my doctor and he gave me the script with much reluctance and mumbling about it being ridiculous and I should just stop, but I got the script  Sadly I had an allergic reaction to the liquid and went back to 4 beads.  I managed eventually to get to 3 by taking 4 smaller ones then going to 3 larger ones. From 3 I took the 3 largest  beads every day and they got progressively smaller. At the end I threw away the teeny tiny ones and went to the 2 largest beads, then to 1, I stopped when the beads were so tiny they can't possibly have had any active ingredient left, the beads are coated with a film that makes them slow release. 

 

I would hold for a while now just to give your brain a rest if you are having some withdrawal symptoms. Once you are stable  you can start again. 

[ppppp9]

Hi mammaP,  That's a GREAT take on how to taper off the beads.  I can't ask for anything different because my pdoc doesn't know I'm tapering.  It didn't even occur to me that the beads were different sizes but now that I think about it they are.  I am feeling some w/d from the drop to 4 beads.  I think I'm in week 3.  I may have unknowingly been mixing smaller ones with bigger ones too thus the w/d symptoms.  I will work towards the 4 smaller ones daily and hold on that until I feel very good and then drop to 3 larger ones daily and then at the right time drop to 2 larger ones etc.  Thanks so much.  You've explained this very well!  Should I work on the Effexor and then do the Risperdal after I've finished the Effexor?  If so, how much time after finishing the Effexor should I give before finishing with my taper of the Risperdal?  That's a tough question but am in no rush!

[ppppp9]

I discovered something with the Effexor beads.  With a thin serrated knife I was able to   cut a bead in a perfect half which is great  because I'll end up with a more precise and smaller dose reduction.

[mammaP]

Have you counted how many beads are in the capsule P? Mine at the end  had 400, can't remember the brand now. Effexor brand I had sometimes had what looked more like chips than beads, more irregular with many different sizes.  Some people have said theirs have beads that are about 1mg. Another one I had was 2 tablets inside a capsule!  If you cut the beads you will lose the slow release and get the dose in one hit, which will wear off long before the next dose is due. 

It is hard to find the biggest when they all look so similar, I used a magnifying glass, lol.  I took out my muesli for breakfast today and as usual all the big stuff was at the top and the seeds at the bottom,.  That made me think about effexor beads. An experiment for you, get a bigger capsule, I would empty a supplement capsule, it's just an experiment.  Pour the beads into one half, pop the top back on and just tap it while it is vertical. Remove the top gently and the bigger ones will be at the top. My muesli didn't mix when I shook the box from side to side, the big bits came to the surface, it's the same when baking pastry. Rub fat into flour and shake the bowl to bring lumps to the top.  Might work,I  haven't any left to try it or I would, always up for an experiment   . 

[ppppp9]

Thank you mammaP.  All makes sense.  I will tap to see what stays on top and will get a magnifying glass too.  I'll post again if I'm experiencing w/d symptoms.  All the best.

[ppppp9]

I did my last cut on Effexor early June, have felt great since the week following.  I won't be cutting out another bead until around September 1st.  I feel good and don't feel a need to rush this.  My sleep is good and I have no anxiety.  Hopefully, this pattern continues but who knows as it's supposed to get more difficult the lower you go.

[Altostrata]

ppppp9, how are you doing?

[ppppp9]

Hi Altostrata.  Thank you soooo much for asking!  I'm doing remarkably well.  When I read alot of the posts on this site it concerns me that I'm doing as well as I am so far.  Doesn't seem right although I've decided on taking a very conservative approach to the tapering.  I've discovered in all that I've read since I discovered SA to be good to myself and to be very very careful and safe.  I dropped a bead September 1st, had a mild sensation for about a week in doing that but have since evened out.  This seems to be my pattern with each drop.  I'll hold at this probably until the New Year and then drop another bead.  I took the inspiration from mama... and have been reducing beads in the order of largest first for a period, then a bit smaller until finally  the tiniest ones and hold on that for a period.  When I do my drop, I then take the next largest and the pattern continues.  Fortunately for me, I don't have an underlying issue with the Effexor which would necessitate my getting off of it quickly.  I just want off.  I'm so grateful that I feel good.  It could very well be that the other meds I'm still on are cushioning the blow so to speak while I taper off Effexor.  I won't be weaning off the Trazodone until I've completed the Effexor and then Risperdal taper.  I'm holding on my last drop of the Risperdal at about .25 mgs., have been since May 1st.  I don't think I should cut on that again until the Effexor is free and clear of my system although I do admit I'm tempted to do a slice of it soon to bring me further along in my taper of it.

 

I'm not looking forward to my taper off the Trazodone.  It'll be painstakingly long and difficult I expect but again, I'll take the safe route and do my taper over a long period of time to minimize or avoid w/d symptoms. 

 

The magnesium I'm taking provides a wonderful calming effect at night and promotes sleep.  I'm not at all anxious and my sleep is still good.  Remarkable really considering the extremely low dose of Effexor I'm on and equally low dose of Risperdal.

 

My biggest concern is that while it's great that I've spent the years doing a very slow and gradual taper can I still get hit with w/d symptoms when I finally jump off the last dose even though I'll be very careful not to do that until the time is right?  Your advice is appreciated! 

 

There is so much wisdom, support and understanding on this site that I would be so lost and inept at this whole process without the wealth of information I've been able to absorb from here.   I feel so thankful for having found SA!

[Altostrata]

You are so welcome!

 

Don't worry about dropping off the last dose. It could be no more difficult than reducing a bead.

 

Please do visit and tell us how you're doing. Your taper is going as it should, that will be encouraging to many people.

[jmncrr]

ppppp9,

 

I too am tapering risperidone, but i have quite a ways to go. I see from reading the thread that it took you roughly 8 months to taper from .5 to.25 mg.

 

How were the withdrawals during that period? Were you still experiencing nausea, and how long did it last? Were there any other withdrawals.

 

Thanks  and good luck

[ppppp9]

Hi jmncrr,

 

That drop in February resulted in a few mild w/d symptoms, a bit of nausea, head tension and mild windows and waves which subsided after a few weeks.   Since then, I've not any w/d symptoms with the other reductions.  I think I experienced the initial symptoms because I had cut too much and too close together to the drop prior.  You've not been on it long at all so if you experience w/d symptoms at this point, they should only be residual and not last long.  I think a 5% reduction a week is quite fast though.  I'd definitely take the last phase slow and easy to ease out of the drug comfortably.  Best of luck!