jmncrr: tapering risperidone

[jmncrr]

 

It can take time for w/d symptoms to appear. Another member posted noticing that w/d symptoms appeared 10 days or more after reducing dose of a neuroleptic medication ("anti-psychotic").

Doesn't withdrawal vary from one person to the next though?

 

My main worry is getting anxiety or depression. I can handle nausea, brain zaps or other symptoms. I am on two AD's, and i think from what i have read on Mental Health Daily is that they can mask withdrawal, and probably protect me from anxiety and depression.

 

In success stories on this website, there is someone who tapered two AP's 10% every two weeks all the way to the end with success, but was on an ssri during taper.

 

Let me hear opinions on this.

Thanks for all the support

[jmncrr]

Should i be making reductions every two weeks instead of every week. Ive asked this once and was told to continue like i was 5% every week, because it was working for me, but now i wonder if i should be making cuts every couple of weeks instead. Any feedback would be appreciated.

 

Thank you

[ChessieCat]

The BrassMonkey Slide

 

"This entails doing 4 cuts of 2.5% a week for 4 weeks and then holding an additional 2 weeks."

 

BrassMonkey has been doing a slow taper but has included 2 week holding periods.

 

You need to listen to your body, not keep to a schedule.  Only you know how you feel and whether or when it will be time to hold/slow down.  If you keep notes on paper, you may be able to see a pattern that you aren't able to from memory alone.

 

Recently I held for 3 months mid taper to give my brain a chance to catch up if it needed it.

[jmncrr]

I am making cuts weekly at 5%.  I have had no withdrawals through my taper so far at that speed. My question is should i keep at the pace and frequency, or extend it to cuts every 2 weeks at 10%?

 

Scallywag said that withdrawals can hit at 10 to 16 days after a cut with antipsychotics, which made me question my pace and frequency.

 

I cant really listen to my body yet, because i have not had any withdrawals.

[ChessieCat]

Unfortunately there is no way to know when, or even if, a person will experience withdrawal symptoms, and what those symptoms will be, so this is a question that cannot be answered by anyone.

 

The problem is that once you experience withdrawal symptoms you either have to suffer them or updose.  It is better not to experience them in the first instance, or at least keep them to a minimum and bearable.  I have seen members here who joined 2-4 years ago and if they had gone slower and steadier in their taper they would most likely be off their drug by now.  Instead they seem to be in a worse place than they were when they joined.  Some of them have ended up on an additional drug which then has to be tapered also.

 

Once you destabilise your CNS (central nervous system) by changing doses (for instance if you end up with unbearable withdrawal symptoms and updose) it can sometimes be hard to get stabilised again.  You might be able to get away with it the first few times, but because the effect is cumulative, there may come a time when updosing lands you in a worse condition.  It's better to go slowly and steadily all the way along than risk the unbearable suffering that can result.

[jmncrr]

So in your opinion i should slow it down. Should i be tapering 10% every few weeks like this website says for risperidone? It does say some can go faster, and some have to go slower. So far i have been able to go faster.

 

 

Some of them have ended up on an additional drug which then has to be tapered also.

 

I have read that other psychiatric drugs can mask withdrawal. Is it possible that the two AD's i am on are doing just that? Possibly depression and anxiety, since that is what they are prescribed for.

[scallywag]

It would be a good idea to hold at a dose for a month or so. That way you'll allow some time for you CNS to catch up. We've seen people scamper quickly down in dose with no problems only to be hit hard at a low dose or when they're fully off. The point of making small reductions slowly is to minimize the risk of withdrawal symptoms. Doing smallish reductions rapidly uses only half of the solution.

[jmncrr]

So basically your saying i have been going too fast.

 

Can i wait to hold until i have reached 1 mg, which would basically be 1/3 of my original dose? At that point hold for a month, and resume at a slower pace.

 

Should i hold now for a month, and then resume at a slower pace? I really would like to continue like i am until 1 mg.

 

Ive read that with 20% of original dose left is when you should slow down. I plan to do that before 20% to be safe.

 

Should i be making cuts every two weeks at 10% instead of weekly at 5%? I have asked this once before, and was told to continue like i was, since it was working for me, but with withdrawal taking 10+ days to occur like you said, maybe i should change that.

 

Is there something to being on other psychiatric meds and helping withdrawal? Just wanting that to be confirmed here.

 

Thanks again for all the support

[KarenB]

If you're unsure, a hold is a good way to reassure yourself. 

 

To help people avoid unnecessary harm, we recommend only tapering by 10% per month.  Some people can taper faster, but this needs to be your decision.  We can't recommend it as it could prove to be bad advice for some members. 

 

From Taking multiple psych drugs: 
 

"Brakes" may temper withdrawal symptoms

The most common and significant antidepressant withdrawal symptoms are nervous system activations (indicating a too-fast taper): hyper-alerting, sleeplessness, abnormal anxiety, agitation, etc.

Withdrawal sleeplessness is a symptom you want to avoid. It makes tapering much harder and post-withdrawal syndrome more difficult to recover from.

If you reduce the accelerator while taking a sedating drug, the sedating drug may help alleviate the activation of withdrawal. You may plan to taper the sedating drug later.

BUT -- Don't add a "brake" to your cocktail to prepare for withdrawal
Do not increase your risk of neurological damage by increasing your polypharmacy. Adding drugs may conflict with a drug you're already taking.

The sedating drugs also will need tapering, and can incur a withdrawal syndrome of their own.

[jmncrr]

How come some people are able to withdraw from medication more quickly than others?

 

Someone in success stories withdrew from two anti- psychotics in just ten months with no problem, one right after the other. I wonder if i could do that, for i have had no problems so far with my slow taper.

 

The longer i am on this anti-psychotic, the longer it may take to get off of it in the long run, because the longer you are on them the harder they are to get off of. My doctor didn't think twice about withdrawing me from risperidone in just 4-8 weeks. While that may be a little to fast, i sure would like to speed it up if i could.

 

I think the fact that i am still on two antidepressants while tapering risperidone, has numbed my central nervous system to withdrawals so far.

 

Any thoughts?

[KarenB]

There are multiple factors which determine how fast any given person can withdraw.  Number of drugs taken, length of time taken, personal history of trauma and stress, presence of PTSD, general health, life circumstances, personal 'robustness', ability to manage w/d and learn and implement helpful tools .. the list is probably endless.

 

You could copy another person's tapering regimen and get totally different results. 

[jmncrr]

 

There are multiple factors which determine how fast any given person can withdraw.  Number of drugs taken,

 

So the fact that i am on Two AD's, are probably playing a factor in my withdrawal from Risperidone?

 

I was expecting some anxiety or insomnia by now, and i have had nothing. I am able to move faster than what Tips for tapering Risperidone recommend.

 

I just don"t know if i should push it any faster or not, for i know the longer i am on it, the harder it could be to get off in the end.

 

Any feedback is much appreciated

[jmncrr]

Do other psychiatric drugs play a factor in withdrawal from another drug, by masking withdrawal symptoms?

 

I just would like to confirm that here, and if this explains my easy withdrawal so far, for i am on two other psychiatric drugs currently besides risperidone.

 

Any thoughts

 

Thank you

[jmncrr]

Any ideas as to why i am having an easy withdrawal so far from risperidone?

 

My sleep is better than ever. In fact it seems harder to get out of bed after each drop in dose. No anxiety, but that might be due to the fact i am on other meds.

 

I am sure as i get lower in dosage i will have to slow it down, but so far so good. Ive increased it from 5% a week to 6% a week three weeks ago, and have not had any problems, but i dont plan to increase it anymore.

[jmncrr]

I would like to know if i am tapering too fast, and do i need to slow it down? Do i have a body that is just not very sensitive to withdrawals?

 

I want to avoid withdrawals, and maybe should be following the tapering guidelines here. The guideline do say some can go faster, and some have to go slower than 10% every few weeks.

 

I just know the longer your on a psychiatric drug the harder it is to come off, and if it takes a long time it would seems it would be harder in the end, or is that not the case.

 

Thank you for any response

[scallywag]

Anything we tell you about why you're not having withdrawal symptoms would be a guess. Enjoy the good fortune or genetics that give you this relatively easy experience.

[jmncrr]

I realize it is guesswork as to why i am not withdrawing from risperidone, but i dont mind some opinions as to why i am not.

 

So far i have gotten genetics, and other medications i am taking.

 

I guess some people just have an easier time with it, but my luck could run out when i get to lower dosages, which is why i might slow it down under 1mg.

 

My heart goes out to whomever is suffering withdrawal right now.

[jmncrr]

I know i mentioned slowing it down, but i am tempted to speed it up since i have not experienced any problems so far, and i am desperate to get off it.

 

I am worried the longer i am on it, the harder it will be to come off it in the end.

 

Will being on it another two years or so tapering,  not make a difference in my withdrawal process?

[ChessieCat]

"Will being on it another two years or so tapering,  not make a difference in my withdrawal process?"

 

In response to your question:  "I would like to know if i am tapering too fast, and do i need to slow it down? Do i have a body that is just not very sensitive to withdrawals?"

 

Scallywag said:  "Anything we tell you about why you're not having withdrawal symptoms would be a guess."

 

The same goes for your new question quoted above in bold.  Nobody can say what might or might not happen.  Your guess is as good as anybody else's.

 

Focussing on things to which there are no answers can cause a lot of unnecessary worry and stress.  I suggest you check out the links in this post, especially Acceptance.

 

It's not unusual for members here to be fixated on particular things.  Check out these topics:  OCD Obsessive Thoughts, Compulsive Behaviours, Neuro Emotions, Health anxiety, hypochondria, and obsession with symptoms (in your case, lack of symptoms), Fear, terror, panic, and anxiety

[scallywag]

I've re-read your thread in its entirety.  I've mentioned that you should consider holding at a dose for a period of a month; I would strongly encourage you to do hold at your current dose just to be sure that your CNS has adapted to your sequential dose changes.  With neuroleptic (anti-psychotic) medications, the reactions and symptoms sometimes don't show up with only short periods between dose reductions.

[jmncrr]

Thanks ChessieCat for the new links. I will look into CBT. I am experiencing some anxiety about not having withdrawals, and anticipating them just seems to make it worse.

 

The reason i posed the question about tapering for years is, i would only assume that a 2+ year taper would make it harder in the end because one would be on the medication longer, but maybe its just ones body adapting to decreases slowly, and that would not be a factor.

 

Any thoughts on that

 

I do not understand how my Dr. can look me in the eye, and say i would not get withdrawals from a 4 to 8 week taper.

 

Are there people who can taper that quick and be just fine?

 

Is it a minority who suffer bad withdrawals, or do the majority of people suffer if they taper as fast as my Dr. wants to?

 

Thanks for all the support

[jmncrr]

 

With neuroleptic (anti-psychotic) medications, the reactions and symptoms sometimes don't show up with only short periods between dose reductions.

 

Thanks Scallywag for the response.

 

I will definitely consider holding at my current dose for a month.

 

Since symptoms don't show up with only short periods between dose reductions, should i be making my reductions every two weeks from now on?

 

Thanks for the support

[jmncrr]

Is it a minority who suffer bad withdrawals, or do the majority of people suffer if they taper as fast as my Dr. wants to?

 

Since symptoms don't show up with only short periods between dose reductions, should i be making my reductions every two weeks from now on?

[jmncrr]

Do the majority of people suffer bad withdrawals, if they taper over a two month period, or is that in the minority?

[scallywag]

jm: You have asked a variation of this question several times previously.

 

The only answer that we can give is that there is little to no reliable information from scientific research studies about

• what factors affect intensity, frequency, duration of withdrawal symptoms
• what % of people experience symptoms.

Continuing to let thoughts about this occupy your thinking may be a waste of your obvious intelligence and energy.

[jmncrr]

 

Continuing to let thoughts about this occupy your thinking may be a waste of your obvious intelligence and energy.

 

Your right scallywag...you wont hear it from me again.

 

I am just feeling anxious , and don't understand how some can have such a hard time, and others don't. It only makes me think i can go faster, but i don't want to pay a price, for that reason i wont.

[jmncrr]

Should i be making my reductions bi-weekly instead of weakly. Ive had no problems with the weekly cuts so far, but sometimes withdrawals can take 10+ days to emerge.

 

Any idea as to why i have had such good luck so far with my taper?

 

Thank you

[jmncrr]

I know i have been told to hold for a month, but when i resume tapering should i taper 10% every two weeks instead of weekly reductions, because of delayed withdrawal?

[stan]

Should i be making my reductions bi-weekly instead of weakly. Ive had no problems with the weekly cuts so far, but sometimes withdrawals can take 10+ days to emerge.

 

Any idea as to why i have had such good luck so far with my taper?

 

Thank you

hi,

 

you are not lucky...

 

it is because you are taking several different drugs, so taper one is covered by the other

when you will taper the last you will feel the difference,

[jmncrr]

Thanks for the advice on holding, but i am basically doing what the tips for tapering risperidone say. It says some can go faster than 10% every few (three) weeks. I have basically been doing 5% every week, which is the same thing as 10% every two weeks.

 

Initially i was told to just leave it like i am doing with weekly smaller cuts, but now i wonder.

 

My question is since there is sometimes a delay in withdrawal symptoms, should i be making reductions every two weeks instead of weekly?

[AliG]

I would hold for a good while and let your CNS catch up.  Then , perhaps taper much more slowly.

http://The slowness of slow tapers

 

We advise the 10 % taper method. Please reread: You are going too fast .

Why taper by 10% of my dosage? 

 

http://survivingantidepressants.org/index.php?/topic/3949-stabilizing-after-a-reduction-what-does-that-mean/

 

Ali

[jmncrr]

 I don't feel i am going too fast, for that guideline says some can go faster than 10% every three weeks. I think i will wait and hold at 1mg. I will then have reduced my original dosage by 66%. A good time to slow down.

 

At that time i will make reductions every 10 days instead of every 7 days. So basically it will be 10% reduction every three weeks like the tips on tapering risperidone says.

 

My question was should i spread out my reductions now like 10% every two weeks instead of 5% a week?

 

Plus i think the two AD's i take, and will taper next, are masking withdrawal from the risperidone.

 

Any thoughts

 

Thanks

[jmncrr]

I think i am going to get the oral solution of risperidone, and start taking .5mg/ml, about a 1/3 of my dose. I will take the rest in tablet form letting my body get use to the liquid form slowly, and when i get to .5mg/ml i will start using liquid titration.

 

My question is are there any concerns i should have about introducing the liquid? Ive read that the liquid can sometimes be less than the tablet form at same dose.

Is this true?

 

Any feedback or suggestions is appreciated

 

Thank you

[Miko789]

  Hi Jmncrr

 

to answer your question

yes the A/D (seroxat) helps with the tapering of the antipsychotic to avoid anxiety depression and fatigue. Are you taking seroxat also?do not stop if you are.Are you taking oral tablet or long acting injection? I think its easier with injectable to taper.

Do you pay for  the meds? or your health insurance pays?

 

thanks

[jmncrr]

I do take Paxil at 20mg (tablet), and i continue to take it.  I will taper it second.  I also take 300mg of wellbutrin.

 

I get my meds through the Veterans Administration, so they are free.

 

Thanks

[jmncrr]

Are there are there any concerns i should have about introducing the liquid form of Risperidone? Ive read that the liquid can sometimes be less than the tablet form at same dose.

Is this true?