LuiB: tapering off Invega Sustenna and other drugs

[Altostrata]

No, I'm sorry, I wish they were everywhere.

[LuiB]

Hello Altostrata

 

I found a list of facilities that are more holistic in the way they deal with mental illness. 

 

Check out https://artausa.org

 

Also books by Emma Bragdon

 

Stanislav Grof's Spiritual Emergency is very interesting. 

[LuiB]

I am now wondering if stopping Invega Sustenna depot shot abruptly is a good idea given the fact that I don't think anything was wrong with me before the drug was adhered and the possibility that I am more mature now and can handle my responsibilities more appropriately (having learned the pitfalls of the justice system). 

[Altostrata]

Lui, the Invega Sustenna depot injection wears off over time. You cannot quit it abruptly, it will be in your system until it wears off.

 

Please review this topic for our discussions about potential ways to more gradually go off Invega.

 

You're still taking 1050mg lithium and 1500mg Divaloproex sodium? Have you been getting regular kidney and liver function tests?

[LuiB]

I meant, with the invega depot, to stop it abruptly as oppososed to tapering off gradually. (not take the next shot due). 

 

I am no longer taking lithium and divalporex sodium. 

[Jgarza7]

How are you doing now luiB? I’m suffering from the withdrawals of invega sustena. 

[LuiB]

22 minutes ago, Jgarza7 said:

How are you doing now luiB? I’m suffering from the withdrawals of invega sustena. 

 

Yeah, I know what you mean. I spent about a year tapering off and spent 1.5 years off of it. Emotionally doing well after the withdrawal effects subsided but I got in trouble with the law and drove myself to homelessness. 

 

I got cought in the mental health system and got back on the 150mg depot shot. Had 2 shots already after the 2 month long hospital stay and next shot I get should be only 100mg.

 

Im just looking to stabilize at this point until I have a solid support system. 

 

I have an acupuncturist that I see weekly, a naturopath that I visit monthly and a transpersonal Psychotherapist that I just started seeing recently and will also be visiting him once a week. 

 

How am I doing? I'm on too high of a dose for my liking. Feeling heavy and slow and suppressed. 

 

Like I said, I'll probably be on the drugs for a little while just lowering the dose at some point to 75mg or even 50mg.

 

I don't like the way things are, gets better at times and feel like it sucks that I got put on it once again. 

 

But until I have a solid support system and a plan, I'm not sure what else to do other than just wait and be patient. 

 

How's it going with you? 

[Jgarza7]

Well, my psychiatrist recommended me to try invega sustenna because I have PTSD from the war in iraq. So I tried it and it was the worst mistake of my life. I had  side effects from getting injected so I stop taking it. Now I’m dealing with the withdrawals and I’m not myself anymore. I stop doing the things I love and I feel stupid. I researched what it does to the brain and it blocks dopamine and serotonin receptors. I’m trying to find help from anyone who has stop taking this drug and recovered. I’m wondering if I will ever be myself again. 

[LuiB]

How many shots have you taken? 

[Jgarza7]

It was 2 injections. The 234 and the loading dose 156. My last injection was December 10 2018

[LuiB]

Yeah, I would suggest that you take part in some form of activities to get back to yourself. 

 

I'm not sure how your mental state of mind is and/or how motivated you are, however meditating and exercising along with a healthy diet are ways to recuperate. 

 

Taking a proactive approach to your wellbeing are some ways that might help you feel better. 

 

I try to do some of those things myself. I know that running outside helps me to feel great, and mentioning that to you reminds me of that. 

 

Just gotta build up the motivation to start doing it consistently. 

 

For now I depend on pushups everyday. Gets my energies flowing and hormones pumping which all help to gain wellbeing. 

 

Good Luck and remember to take good care of yourself. 

[Jgarza7]

Thank you for replying. I just feel this drug has messed with my brain and I’m not myself. I feel disconnected from reality. I also heard the drug has very long half lifes. I don’t want to feel like this forever. I was just wandering if you recovered from these injections or are you still on them. 

 

Goodnight

[LuiB]

My pleasure 🙂

 

Yeah I got off and they forced me back on them through a court order. 

 

I was just mentioning some things that you could do - that I do or Atleast try to do to help recovery. 

 

Goodnight

[LuiB]

I have been tapering off Invega Sustenna. The depot shot comes in 150, 100, 75, 50 and I think 25 mg. 

I started again in Nov. 2018 and was put on 150mg. March and April 2019 I took only 100mg each and May and June I was down to 75mg.

 

If the next dose in July is 50mg then that would be a 33% reduction which I think is much. 

 

That is why I am thinking of switching to Risperidone so I could potentially have an easier Taper with the pill Form and micro tapering with the liquid Form. Combining both for starters. 

 

I was wondering if anyone would have an idea of what I can expect (in withdrawal etc) with such a move. 

 

Your input is greatly appreciated. 

 

Moderator: I'm not sure if this post should go here or in the Invega Sustenna tapering thread. (moved to intro topic)

 

Edited June 15, 2019 by ChessieCat
added note

[ChessieCat]

I suggest you read through Post #1 of the tips for tapering Invega Sustenna.  There is mention of tablets being available.  And also changing to risperidone.

 

tips-for-tapering-off-invega-paliperidone

 

[LuiB]

I was wondering what does of risperidone one should switch over to from Invega Sustenna 75ml.

 

www.switchrx.ca mentions 4 to 6 mg. However, it gives the same dose no matter what dose of paliperidone you put in. 

 

Any suggestions? 

[Altostrata]

On 6/15/2019 at 1:55 AM, LuiB said:

I have been tapering off Invega Sustenna. The depot shot comes in 150, 100, 75, 50 and I think 25 mg. 

I started again in Nov. 2018 and was put on 150mg. March and April 2019 I took only 100mg each and May and June I was down to 75mg.

 

If the next dose in July is 50mg then that would be a 33% reduction which I think is much. 

 

That is why I am thinking of switching to Risperidone so I could potentially have an easier Taper with the pill Form and micro tapering with the liquid Form. Combining both for starters. 

 

I was wondering if anyone would have an idea of what I can expect (in withdrawal etc) with such a move. 

 

Your input is greatly appreciated. 

 

Moderator: I'm not sure if this post should go here or in the Invega Sustenna tapering thread. (moved to intro topic)

 

 

Lui, how are you doing with the decreasing dosage of the injections? Have you had any problems so far?

 

Your next 50mg injection in July would be building on a very low base of the Invega Sustenna still in your system from the prior dose.

 

If you haven't had withdrawal symptoms from letting the injections wear off so far, why do you not want to continue tapering via lower-dose injections?

 

This is from Tips for tapering off Invega (paliperidone)
 

Quote

 

Injectable Invega Sustenna: Letting it wear off
Invega may be administered via injection every 4 weeks. This form is called Invega Sustenna.

 

Invega Sustenna is intended to last at "therapeutic" strength for a month, then you would get another injection to keep up the potency. Its half-life is very long -- 25 to 49 days. This means that at 25-49 days, it has worn off to half-strength in your body. It would take about 125-343 days for it to completely leave your body.

 

The blood level and side effects will be highest shortly after the injection, then wear off somewhat. Given the very long half-life, if you have gotten a single application of Invega Sustenna (often two injections close together), you must let your body gradually metabolize it to go off it. 

 

Switching to tablet form to taper injectable Invega Sustenna
If you get withdrawal symptoms while letting injectable Invega Sustenna wear off, you may need to taper more slowly. Conceivably, one might switch to a lower dosage in the tablet form about a month after the injection; tablets come in a range of dosages that make tapering easier.

 

 

 

[LuiB]

31 minutes ago, Altostrata said:

 

Lui, how are you doing with the decreasing dosage of the injections? Have you had any problems so far?

 

Your next 50mg injection in July would be building on a very low base of the Invega Sustenna still in your system from the prior dose.

 

If you haven't had withdrawal symptoms from letting the injections wear off so far, why do you not want to continue tapering via lower-dose injections?

 

This is from Tips for tapering off Invega (paliperidone)
 

 

 

 

I have had withdrawal symptoms such as severe depression that only lasted a couple of days.

 

So what you said got me thinking that it is not so bad, I could just take the 50mg in July.

 

However, what about tapering after the 50mg. The next lowest one according to my knowledge is the 25mg. Thats a 50% reduction.

 

The reason I wanted to switch was due to the ability of tapering by 10% increments that the liquid risperidone provides. (The Harm Reduction Guide Method)

 

Also from Tips for tapering off Invega (paliperidone):

 

On 9/27/2014 at 4:30 PM, Altostrata said:

 

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
 

 
If you want to do this, be sure to read Tips for tapering off Risperdal (risperidone)

 

Injectable Invega Sustenna: Letting it wear off
Invega may be administered via injection every 4 weeks. This form is called Invega Sustenna.

 

Invega Sustenna is intended to last at "therapeutic" strength for a month, then you would get another injection to keep up the potency. Its half-life is very long -- 25 to 49 days. This means that at 25-49 days, it has worn off to half-strength in your body. It would take about 125-343 days for it to completely leave your body.

 

The blood level and side effects will be highest shortly after the injection, then wear off somewhat. Given the very long half-life, if you have gotten a single application of Invega Sustenna (often two injections close together), you must let your body gradually metabolize it to go off it.

 

So I thought it would be wise to do it this way (switch to Risperidone), but now that you mention it, given the limited withdrawal I was dealing with got me thinking.

 

What is your view, on this Asltostrata?

 

Thanks for your continued help and support.

[Altostrata]

7 hours ago, LuiB said:

I have had withdrawal symptoms such as severe depression that only lasted a couple of days.

 

 

Was this at the very end of an injection period? When did this happen? Has it happened recently?

 

I would continue with the monthly injections at decreasing dosages. If you get withdrawal symptoms, then you can start adding very small daily doses of risperidone liquid. You may not get withdrawal symptoms.

 

For example, if you find you get withdrawal symptoms after your 25mg injection wears off, you might want to add 0.5mg per day (15mg per month), stabilize for a few months, then start tapering that at 10% per month -- to be safe.

 

Please let us know how you're doing.

[LuiB]

18 hours ago, Altostrata said:

 

Was this at the very end of an injection period? When did this happen? Has it happened recently?

 

I would continue with the monthly injections at decreasing dosages. If you get withdrawal symptoms, then you can start adding very small daily doses of risperidone liquid. You may not get withdrawal symptoms.

 

For example, if you find you get withdrawal symptoms after your 25mg injection wears off, you might want to add 0.5mg per day (15mg per month), stabilize for a few months, then start tapering that at 10% per month -- to be safe.

 

Please let us know how you're doing.

 

The withdrawal depression happened 3 weeks in and I hadn't realised that it is due to the withdrawal until I thought about it recently. 

 

I've been stable since my last 75ml shot in the beginning of June. 

 

I went to my GP today to discuss next dose. She doesn't feel comfortable in switching my drugs and recommended that I see a psychiatrist in order to do that (something I do not currently have). 

 

So for now, I'm getting a 50ml shot in July and will probably stay on that through August as well.

 

I also discovered that the lowest dose available is the 50ml. There is no 25ml available. 

 

Hence, while hopefully all goes well, I'd be finding a psychiatrist that will let me switch to risperidone so that I will continue my Taper with that. 

[Altostrata]

If you had withdrawal symptoms from the 100mg injection wearing off, the subsequent 75mg injection would be rectifying that.

 

Please let us know if you get withdrawal symptoms at the end of the injection cycle this time around.

 

You might tell a psychiatrist you want to be on the lowest effective dose of risperidone. They tend to like this idea. They don't want people going off their antipsychotics and ending up in the hospital. So what you're doing will make sense to a good psychiatrist (be prepared, they're hard to find), and they will understand why you would want risperidone liquid on hand to supplement the injection wearing off as you transition to a daily dose of risperidone.

 

It may very well be that the lowest effective dose of risperidone is close to or at zero for you, but it's wise to go slowly so as not to trigger withdrawal symptoms or other symptoms that could send you back to the hospital.

[LuiB]

Yes Altostrate

 

I feel that I am prepared to handle the withdrawal that may come at me when I drop the shot from 75ml to 50.

 

I am actively searching for a cooperating psychiatrist. 

 

I am also hopeful, like you mentioned, that the minimum effective dose is actually a big fat zero. 

 

I'm being more mindful to remaining in a meditative state at all times and remaining calm. 

 

Again, thanks for all your support. Would be much harder to do without you. 

[Altostrata]

You're so welcome, Lui. Be sure to take care of your sleep!

[LuiB]

Hello Altostrate

 

As mentioned and planned, I got a 50mg shot today. 

 

I am much better now. I did go through periods of intense anxiety but that has subsided greatly. 

 

I am now leading a much healthier life including daily Excercise and running, walks in the park and spending hours in Nature. 

 

All these things has greatly improved my mood and not only that but my mental and emotional wellbeing and also my spiritual wellbeing. 

 

I started to eat much healthier. Eating exclusive home cooked meals with lots of vegetables salads and organic grains. 

 

All this would not have been possible when I was zombied out on the high doses of drugs. 

 

It is astonishing how much these hospitals and psychiatrists over drug us. 

 

If you remember, two years ago I was also on a large dose of lithium and valporic acid. At one point I was also on Clonazepam until I insisted to the pdoc that I get off that (clonazepam - I got off that at an earlier stage). 

 

It is disappointing and heartbreaking these actions they take with no remorse. 

 

Anyway, I hope I am better able to tackle the withdrawal if it arises due to my more mindful approach. 

 

Oh yes, I forgot to mention that I also meditate daily and I have got a very awesome and supportive holistic transpersonal psychotherapist that I see weekly. 

 

I've got more news I'll share with you once I read your response and your take and advise going forward on all this. 

 

Thanks for being there, Altostrata. 

[LuiB]

@Altostrata

 

What should I do given that I am now on the lowest dose of Invega Sustenna - 50mg and doing well. Stable. 

 

Should I just stop taking it at one point or is that risky business?

[Altostrata]

On 7/11/2019 at 3:46 PM, LuiB said:

I am much better now. I did go through periods of intense anxiety but that has subsided greatly. 

 

Thanks for the excellent news, Lui.

 

When did you go through these periods of anxiety? Was it when your prior Invega Sustenna injection was wearing off?

 

When did you get the 50mg injection? How did you feel right after you got the 50mg injection?

 

The injection will wear off over time. If you get withdrawal symptoms as it wears off, it may be important that you get the liquid risperidone in the near future. so you can switch to a low dose of risperidone for a while and stop getting the shots.

 

Please take care not to mistake withdrawal symptoms as a return of a psychiatric condition and go to the hospital, because they likely would put you on high-dose shots again.

[LuiB]

4 minutes ago, Altostrata said:

 

Thanks for the excellent news, Lui.

 

When did you go through these periods of anxiety? Was it when your prior Invega Sustenna injection was wearing off?

 

When did you get the 50mg injection? How did you feel right after you got the 50mg injection?

 

The injection will wear off over time. If you get withdrawal symptoms as it wears off, it may be important that you get the liquid risperidone in the near future. so you can switch to a low dose of risperidone for a while and stop getting the shots.

 

Please take care not to mistake withdrawal symptoms as a return of a psychiatric condition and go to the hospital, because they likely would put you on high-dose shots again.

 

Yes, definitely excellent news @Altostrata

 

Yes, anxiety was during the prior injection wearing off. I've had them all through my higher doses of this drug and as I weaned off them. 

 

I definitely have much better coping mechanisms now. 

 

I sometimes wake up feeling anxious (my sleeping habits are great now btw) and just go out for a stroll in Nature and I feel much better. 

 

I got the 50ml on the same day I posted here, last week, July 11.

 

I was feeling good prior to and after the injection I felt fine and still feeling fine. 

 

Ofcourse problem is I still feel that I am heavily drugged but way better than any previous time I was on higher doses. 

 

I will definitely not voluntarily go to the hospital. 

 

Do you think that the best way would be to switch to risperidone? I really don't like the idea of going onto another drug now, even for tapering measure. 

 

Is it really not recommended to just stop taking the shots after some time since I'm on the lowest dose? 

 

What are you thinking now? 

[Altostrata]

I guess you could see how you do as this injection wears off. Might be a good idea to keep looking for a doctor who might prescribe if you need a low dose of risperidone as a bridge to go off at the end.

[LuiB]

On 7/17/2019 at 11:27 PM, Altostrata said:

I guess you could see how you do as this injection wears off. Might be a good idea to keep looking for a doctor who might prescribe if you need a low dose of risperidone as a bridge to go off at the end.

 

Do you know of any cases where the doctor only injects part of the drug and not the whole syringe. My pharmacist suggested I ask the doctor to do that when I asked him how he suggests I get off this drug. 

 

I will be moving to another city in September so I will be getting a new doctor once I get there and I'm hoping to find a cooperative one. 

[Altostrata]

Yes, it is possible for a doctor to inject a partial dose. You will have to discuss this with your doctor.

[LuiB]

This would be the optimum solution, wouldn't you say @Altostrata? 

[Altostrata]

If you can find a doctor to do it, progressively decreasing dosages of injections makes sense. However, you might still need a low-dose bridge in tablets if you get withdrawal symptoms when the injection wears off.

[LuiB]

@Altostrata

 

I want to stop taking the injection at some point. Some point soon. I don't want to discuss anything with any "doctor" of any kind. It seems that that label is the biggest sham of all shams. Hah, "doctor" for God sakes. 

 

Even my naturopathic "doctor" is a sham it seems. 

 

Not no pharmacist not no nothing. 

 

I feel done with this, just take my last dose or 2 max and then just quit it. 

 

I think I'm going to get the injection on my own for September, where I will be moving to a new town and give myself half the dose, and that will be the last dose I take in September. 

 

I feel I can do it and handle the withdrawal. 

 

Comments? 

 

Edit: my grandfather was a doctor, a pediatrician my uncle is a doctor and I have a cousin who is a doctor. 

 

I've gone head to head with these individuals when I was a child as doctors. Perhaps I had a feeling back then of the sterile nature of their profession very early on in my life. 

[Altostrata]

Not sure about you giving yourself an injection. How would you get the injectable liquid?

 

Just be sure to be very gradual in your dosage changes. Please let us know how you're doing.

[LuiB]

3 minutes ago, Altostrata said:

Not sure about you giving yourself an injection. How would you get the injectable liquid?

 

Just be sure to be very gradual in your dosage changes. Please let us know how you're doing.

 

Hello @Altostrata

 

The injection comes from the pharmacy all ready. I usually pick it up from the pharmacy before going to the GP and have it injected. It comes in the box ready to be adhered. 

 

In Peter Lehmann's book Coming Off Psychiatric Drugs, most of the people documented had come off their drugs cold turkey, successfully. 

 

There must be numerous people who have successfully come off their drug without tapering. 

 

I mean I am on the lowest dose, how risky can it be to just stop taking the depot? 

 

What is there to worry about, the withdrawal effects? I have had almost zero problems other than wanting to sleep a little more tapering from 75 to 50mg.

 

And I have dropped large doses such as from 150 to 100mg.

 

It seems that the only problem I have is being on the drug. The more I Taper the better I feel and the better I am. 

 

There is no need to prolong the tapering process more than is necessary. 

[Altostrata]

"Cold turkey" refers to quitting tablets without a taper. It doesn't apply to injections. As we've discussed, the injection gradually wears off. You may not get any withdrawal symptoms from this, or very minor at the very end, for a few days. Many people have done this.

 

Your experience tapering this drug may be different from your prior experiences. We cannot predict that. You'll have to see if you get withdrawal symptoms 2/3 of the way through the injection period, you may want that bridge of low-dose tablets we discussed.

 

I've never heard of anyone tapering by themselves with an injectable drug. I doubt that Peter Lehrmann has, either.