Manny78: multiple psychotropic drugs - which one first?

[Manny78]

I have trouble focusing. I can't concentrate. This doctor is going to ask a colleague to help me with the taper plan. I don't know him only what I read in the web.

[Altostrata]

How are you feeling after your reduction to 1.75mg risperidone?

 

You need to see how this reduction works for you. If 13% is too much, you'll have to reduce by smaller amounts. You can talk about this with the doctor -- but you need to see the effect of this reduction first.

 

Somebody will have to do math to calculate your reductions if you want to do it gradually.

[Manny78]

Hello Altostrata, I keep waking up in the evening,legs muscle pain,tiredeness, trouble focusing, legs restleness. 

[Manny78]

Does risperdal causes sleeping problems when you are tapering off? I can't sleep. Does the weight gain stop while you tapering or when you are off? I weigh 98 kilos, and I have a big fatty belly.I am starting to eat healthy. 

Thank you, 

 

Manny 

[Manny78]

Anyone knows about Aneurol? It contains Valium and vitamins. 

[Manny78]

Hello everyone, I am speaking with this psychiatrist about  the extrapiramidal symptoms I have. From what I have spoken with him and the descriptions he gave me, I might have tardive dystonia and akathisia. He suggests increasing the biperiden and clonazepam for the tardive distonia. I won't up me dose of klonopin 0,25mg neither biperiden 4mg because I would have to taper them and  I don't want to cause more damage to my poor brain. He suggest seeing a neurologist to rule out what I have. Possible treatment is baclofeno, vitamin B like pirodoxina 600 to 1200mg/day, or botulinic toxin.

 

Manny 

[Altostrata]

Are you now taking 1.75mg risperidone? How are you feeling from the last dosage reduction?

 

Odd that the psychiatrist focused on adding other drugs, most likely the extrapyramidal symptoms come from risperidone. What did he say about reducing risperidone?

[Manny78]

Hello Altostrata.Yes,I am at the same dose which is 1,75 mg.I started on October, 18th,and I haven t made any further reduction. At the beginning I didnt feel that bad, just legs pain,mucle pain, but now this week and past week, legs in flames, akathisia, i cant keep my legs without moving them in bed, need to pace,and movement in my torso(tardive dystonia). 

Speaking about risperidone, he said that the offending drug should be reduced if possible. In addition, he mentions to reduce risperidona, abilify and klonopin in an oral solution to reduce very slowly. His advice is for the moment to increase klonopin oral solution for a few weeks (10,10,10). This part of numbers I don't understand. I am at klonopin 0,25mg at night in tablets. I use klonopin 0,5mg and I break it in half. 

[Manny78]

I made a mistake in the last post.When  I said oral solution I wanted to say liquid drops.

[Manny78]

Hello everyone. I CANNOT find a psychiatrist to help me out with my taper. The one that I found it is too far away from where I live,and he cannot find a psychiatrist close to  me that would help with me. I will have to go to a private psychiatrist not knowing if he will help or not.Most of them,they don t.The problem I have is the label they put on me,that I am schizophrenic and I am not.

I don t have more risperidone 1mg pills. I only have  6,4, and 3 mg pills in that order,and I am taking 1,75 mg of risperidone. My idea is to use the 4mg pills and to cut them in 4 pieces to obtain 1mg trying to get as even as possible.Then, cut the 3 mgs pills in 4 pieces to get 0,75mg.My question is it possible to break the pills and obtain the dose you are on, in my case risperidone 1,75 mg,because the pills also contain  fillers?

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[Manny78]

How much in % is to cut 0,25 mg of risperidone out of 1,75mg?

[Glosmom]

HI Manny78,  

 

If you reduce 1.75 mg by .25 mg that is  a 14.28% cut.  So slightly more than the recommended 10%.  Another way to look at it is to take your 1.75mg multiplied by 85.72% = 1.50 mg.  

 

If you were to do the recommended 10 % cut that would be 1.75 mg multiplied by 90% (.90) = 1.575 mg or round up to 1.58 mg.  

Hope that helps.  Best Regards, Glosmom

[Manny78]

Thank you,Glosmom.Did your daughter taper risperidone too?? Water tritation? I decided to up my dose again, after two days on 1,5mg because I realized that I need to do a more smooth taper. My risperidone pills are not soluble in water. I tapered off for two years abilify and it was a hellish taper. I had inner aka for months. I only managed to get on 10 mg. I still have other 10 mg to taper. 

[Glosmom]

Hi Manny, Yes Glo tapered off of Risperidone.  She used the liquid form and we did not mix it in any additional fluid. We just used different syringes the lower we went.   We started with a 3 mL syringe and then went to a 1 mL syringe.   Take your time and be sure to hold.   We found that Glo had symptoms no matter how big or small we reduced in dose. They key was holding long enough until she stabilized before dropping again.   In hind sight, each hold should have been at least 2 months.  Best wishes on your tapering journey!!  Glosmom

[Manny78]

Can anyone help me to do a taper schedule? I am cutting too fast. I cut from 1,75mg to 1,5mg, six days ago.

My pills weigh 0,032mg and they are 3mg.

 

 

[brassmonkey]

Hi Manny-- how are you determining the weight of your doses and pills? Do you have scales that you are using? A pill that only weighs 0.032g is very tiny, is that right?

 

The reduction you just did would be 10%.  That is within the guidelines we use. If you did the reduction all at once it will take several weeks for the symptoms to stabilize so six days is too soon to tell if it was too big of a reduction. To come up with a reduction schedule we need to know how much you want to reduce each time.  If 10% is too much possibly 5% would work better. Please don't make any more changes until we come up with a good plan.

[Manny78]

Hello brassmonkey. I am using a digital scale. I started yesterday to cut with scale. I have diffirent pills sizes. I have 4 mg and 3mg.The ones I am using are the 3mgs,and they weigh 0,032g. Before  I was using the 4mgs pills because I was in 2mg breaking then in halves. After that, I used 2 1mg pills to get 1,75mg,which was one 1mg and 3/4 of 1mg pill. I don't have more 1mg pills. 

[Manny78]

Hi brassmonkey. I was cutting with a knive.I want to reduce 10% per month. I think cutting from 1,75mg to 1,5mg is more than 10%.I assume that cutting with the scale is not exact too because of the fillers. 

[brassmonkey]

Using a combination of the knife and the scales can be quite accurate.  The fillers are a good thing because they give you more material to work with.

 

Reducing from 1.75mgai to 1.5mgai is about 12.5% which is too much. A 10% reduction would be to 1.58mgai. (milligrams active ingredient)

 

When you weigh this on the scale, using the 3mg tablets, it would be 23.4mgpw (milligrams pill weight) The scale will read 0.023 or 0.024

 

 

[Manny78]

Hello brassmonkey.I am sorry,but I don't quite follow what you are saying. I just weighed 5 or 6 pills and the average weight was 0,032g. What I am doing or I did was crush the 5 pills and with the powder I got, I am swallowing 0,018mg which should be close to 17,5mg. I don't understand the mgpw and how it should read the scale 0,023g or 0,024g.

9 hours ago, brassmonkey said:

Using a combination of the knife and the scales can be quite accurate.  The fillers are a good thing because they give you more material to work with.

 

Reducing from 1.75mgai to 1.5mgai is about 12.5% which is too much. A 10% reduction would be to 1.58mgai. (milligrams active ingredient)

 

When you weigh this on the scale, using the 3mg tablets, it would be 23.4mgpw (milligrams pill weight) The scale will read 0.023 or 0.024

 

 

 

[brassmonkey]

Ok let's ignore what I said about the .023, .024.

 

mgpw means milligrams pill weight, which is the weight of the dose as measured on the scale

 

mgai means milligrams active ingredient, which is the strength of that dose

 

 

So you are using 3mg pills that weight .032g each.  Then each pill has a strength of 3mgai and a weight of .032gmpw.

 

Now that you are using the scales to weigh things your dose will be a lot more accurate and consistent. It will probably be a little different than what you think you were taking. If you are swallowing .018g of the powder made from 3mgai pills then your dose is actually 1.69mgai.

[Manny78]

Hello everyone. I went to the psychiatrist today. He switched me to risperidone 1mg/ml. Anyone has experience tapering with oral solution? The syringe measures up to 3ml with decrements of 0,25ml. Is that too much taper? Can I get a different syringe that measure less? I am experiencing akathisia and dystonia

Is akathisia permanent? Will my aka will get worse as I decrease? I am at 1,75mg of risperidone. 

[Manny78]

I went to the psychiatrist today with my mom. He reduced my mom Zyprexa from 15mg to 7,5mg last month. I know that is way too much. My mom cannot keep her back straight, but she also has arthrosis, discopatia, and acuñamiento de cuerpos vertebrales. Anyone went to the neurologist and diagnose you with akathisia and dystonia? That is what I have. What is the procedure to know if you are having dystonia and aka? Because I have those two. I think. 

[Manny78]

Taking ibuprofen and Cymbalta, is it SAFE? 

[Manny78]

Hello guys.I am having a very rough akathisia from discontinuation of risperidone. I have tapered by 5%,and I keep feeling worse. I am holding for a month. Should I keep tapering even if my aka is really bad?

[gdsequoia]

Hi Manny. Nice to meet you!

We have a lot in common. I, too, take Abilify, an antidepressant and biperiden. I have OCD. And I suffer from dystonia too, and muscle pains in the quadriceps.

 

On 1/24/2020 at 11:29 PM, Manny78 said:

Taking ibuprofen and Cymbalta, is it SAFE? 

I can tell you my experience. I've taken 500mg paracetamol + 30mg escitalopram every day for a week (this was 2 years ago). This gave me a gastritis flare (I hadn't had any gastritis symptoms for 20 years by then). This problem lasted a month (I treated it with PPIs and probiotics, and a mild diet).

 

So if you do that combo, you probably need to pair the ibuprofen with a PPI, or *at the very least* take it with a lot of food and very short-term.

 

Also, for me, I've been using 4 alternative-medicine solutions (golden paste, magnesium chelate and 2 others) for my various pains. They were *very* compatible with my antidepressant and with the rest of my therapy.

 

Best of luck,

gds

[Manny78]

Hi gds. Nice to meet you too. I replied you back in your thread. How bad is your dystonia?  I have contortion movements in my back,legs burning, restlessness legs and back burning. Need to get checked for movements disorder.

[gdsequoia]

My dystonia is mainly in my neck. I can keep my head upright when I'm sitting or standing at one place. But not when I'm walking.

 

The dystonia caused a complication: 2 herniated disks in my neck-region of the spine. If, at any time, I look up (with my head, not just my eyes), this gives me strong joint pains that take hours to subside. Same when I bend over in an "incorrect" way. The reason is twofold - (a) the hernias, and (b) the Abilify.

 

For the past 9 months I've been using a sort of prosthesis (my dad made it for me) to keep my head upright. I can't function without that prosthesis. It has been a godsend, as it has stopped the progression of my spinal degeneration. I can PM you a pic or vid of how I use that prosthesis, if you want.

 

Quote

legs burning, restlessness legs and back burning

I'm not sure that's dystonia. Your contortion movements, however, are dystonia IMHO.

[Manny78]

Helio everyone. anyone having a common cold during the corona virus crisis? I am feeling very sick, headache, tremors and burning legs. 

[Nocturna]

Hi Manny,

Hope the cold is gone by now!

Congratulations about tapering down the Abilify to 10 mg! Do you mind sharing some details about it, e.g. did you experience any psychotic symptoms from that (if you ever experienced those)?

Hope I'm not asking for too much. For some context, I'm diagnosed with schizo-affective disorder myself, attempted twice to go AP-free and in both occasions I went into a relapse a few months after.

[Manny78]

On 5/12/2020 at 8:15 PM, Nocturna said:

Hi Manny,

Hope the cold is gone by now!

Congratulations about tapering down the Abilify to 10 mg! Do you mind sharing some details about it, e.g. did you experience any psychotic symptoms from that (if you ever experienced those)?

Hope I'm not asking for too much. For some context, I'm diagnosed with schizo-affective disorder myself, attempted twice to go AP-free and in both occasions I went into a relapse a few months after.

Thank you Nocturna, it took me 1 year to get rid off 10 mgs of abilify.I tapered very slowly mixing a 10mg discmelt abilify pill with 10ml of water. I removed 0,2ml each time with a syringe .It was a hellish taper. I had outer akathisia and inner akathisia.I stopped at 10 mg because I couldn't keep tapering because of bad sxs.Now tapering risperdal with akathisia as the worse symptom. What is for you a schizo affective Disorder? I am diagnosed with various things like Schizotypic personality disorder and paranoid schizophrenia based on what my father told the psychiatrists when I was on a psy ward in the US. Never heard voices before antipsychotics.Wish you the best luck with your taper. Manny. 

[Altostrata]

Manny, has the tapering caused akathisia? Are you tapering too fast?

[Manny78]

Hi,Alto.Yes,I am having akathisia because of the taper of Aps. I changed my primary physician. In this country, psychiatry can harm you and nothing happens. My new gp referred me to a neurologist who wasn't very helpful.What he wrote in his notes for me doc and others was this: "what bothers him most is akathisia:restless, he cannot stop.Also, legs tremors and muscular tics.He sleeps good,even though restless legs.Diagnosis:side effects of neuroleptic medication. Anxious disorder". I NEVER HEARD OF ANXIOUS DISORDER. I am anxious because of the aka. He ordered blood work for Thyroid glands,ceruloplasmina. DEPENDING ON BLOOD RESULTS HE WILL DECIDE Symptomatic treatment, Ropinirol or klonopin at night. I FILED A COMPLAINT LETTER, and I am waiting for a reply. 

 My blood results were good according to my physician but the bilirubin is high. Total bilirubin is 2,9mg/dL, Range is from 0,2 to 1,2mg/dL. 

 

My new gp wants me to taper buy doesn't know how. He spoke with my psychiatrist who now from the suddenly agrees to taper me at his own speed like 1mg of risperidone and nothing bad happens you. I am tapering 5% or 10 percent per month. I am using oral risperdal solution. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Altostrata]

Did you get akathisia from lowering the dose?

[Manny78]

2 hours ago, Altostrata said:

Did you get akathisia from lowering the dose?

Yes, I did.Also memory problems, spaciness,thinking and forgetting what  I want to say. 

[Altostrata]

I would stop tapering, Manny. At what dose did akathisia start?