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Tips for tapering off Risperdal (risperidone)

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Risperdrawlin

Thanks for the site recommendation. It was really useful. 

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Risperdrawlin

Hi, can anyone who has come off Risperdal safely and relatively easily tell me at what dose they jumped off? I'm currently on 0.125 mg and have been for about 50 days (just over 7 weeks). Tonight I am probably going to cut to 0.0625 mg (50% cut). I am thinking I will jump off after spending a month or two at 0.03 mg or 0.01 mg depending on how I feel. What have other folks done?

 

Thanks!

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banana

Hi here's my tapering off experience:


I was on 4 mg of risperdal  after being diagnosed with psychosis, and started tapering off three months later. 


 I didnt like the drug because I felt lifeless and it was too sad for me. My psychiatrist said I would have to stay on the drug for another year to two years minimum to avoid relapse. I visited a hormone doctor who prescribed many vitamins, a gluten free diet and injections of vitamin B12 (check if you have a deficiency in this vitamin and if you are celiac, both can lead to mental unbalances even psychosis).


I visited my general practitioner and we decided to start tapering off. We decided to go onto pills to facilitate the tapering. He only gave me half the injection, and two weeks later I was meant to start with 2 mg of risperdal pills. As the consta injection stays in your system for seven weeks or so, I had a strong reaction to taking the pills. It was like an overdose, I woke up completely stiff, but alive. So, we decided against taking pills with risperdal still in my system and let the medication taper off over a seven week time period. I then took the minimum dosage of risperdal, o.5mg for two weeks, then 0.25 mg for two weeks and then completely stopped. The side effects of my dramatic withdrawal were depression, but my healthy dose of vitamins, especially Niacin and vitamin B12, exercise and a therapist twice a week kept me going. I strongly believe in this 'prescription to nutritional healing' guide, as my hormone doctor prescribed almost exactly to what this guide prescribes for schizophrenia. I was enrolled in an art class at the time, which really helped the depression withdrawal. I really hope this helps

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Miko789

Hi there, I switched from risperdal injections to oral solution and I am having a lot of side effects. What I want to know is, in case the symptoms get too severe (and I really hope they will get better!) what should one do, if there is no 'higher dose' to go back to? If I switched from injection to same dose oral? I really want to feel empowered that I know what to do in case smt bad happens. Again I hope it doesnt, but i want to have a soft pillow below just in case. Muchas Gracias! :rolleyes:

Vasedude which consta injection you did the 37,5mg or the 25mg and what dosage oral you switched at?

What kind of sideffects did you have?

thanks

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Rossho

Hi All,

 

Has anybody got any experience tapering risperdal? I am wanting to start the taper soon. I intend on doing a water titration. I am interested in the 300 ml straight taper drawing out 1ml a day to keep it simple. Now i understand that this is not practical as once you get past the first 30 days your percentage cuts become larger than 10 percent a month. how does one deal with this problem. is there an easy way, i am not good at math at all and i am very afraid. Does anyone have a simple method of tapering this drug? I use the liquid oral solution risperdal which i will be diluting into 300 ml of water and making my cuts. I am also dosing twice a day. is this enough? i am scared to up that to dosing 3 times a day as i dont want to destabalize myself right now. would this destabalize me if i did split into 3 doses per day? I think the half life is about 24 hours. Guys i am really scared and looking for an easy method of tapering. many seem to advocate the 300ml straight taper but this in my mind is a linear taper and not safe? is there something that I am missing? Please guys I am so afraid and just want off this medication. 

 

thank you...

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Rossho

Hi all. I am soon to begin a risperdal taper. I am going to dilute my 1mg dose (liquid oral solutiin) in 300 ml of water and then for the first month cut 30ml and hold. Has anyone had success tapering risperdal and would this work? I might start with a 5% cut so 15 ml the first month.  Iv been on risperdal for about 10 months. Im also dosing twice a day. Is this sufficient or should I be dosing more often?

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Rossho

Hi all,

 

I am wanting to conduct a daily microtaper for an antipsychotic medication (risperdal). However I have heard that a daily microtaper is not suitable for this kind of drug but exclusive for benzos. Apparently a cut and hold approach is more suited. Does anyone know about this or why it is? Id really like to know. Any info greatly appreciated

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Altostrata

Please read

 

I don't know where you "heard" you cannot microtaper Risperdal. It comes in a liquid and may be microtapered.

 

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Iatrogenesis

I just read this earlier in the topic:

 

Quote

What we see is that people who have had psychotic symptoms prior to taking drugs may develop them as withdrawal symptoms unless they taper very, very slowly. Dr. Sandra Steingard has used this method to wean patients off antipsychotics like Risperdal, see (...)

 

Wait, you're saying people who get prescribed APs for depression, insomnia, post-menstrual syndrome and whatever else are not going to get psychosis as a WD symptom if they are susceptible to WD and withdraw too quickly? How would that be possible? These "psychotic symptoms" and "relapses of illness" are obviously just what happens when your brain gets flooded with dopamine, I remember reading the guys who developed APs studied heroin addiction and thus associated psychosis with dopamine, but the AP WD psychosis is pretty much the same thing as heroin psychosis (what I mean is that it's the same mechanism, what the drug does to your brain, not the smaller amount of the drug not being able to help your brain) so how does that work?

 

(Or perhaps those were later Clinical Trials to back up the "APs manage psychosis" theory once the drugs already started fetching those corps a lot of money)

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Altostrata

Symptoms that look like psychotic symptoms may occur in anyone who has reduced any psychiatric drug too fast. "Psychosis" is only a description of behavior, not a disease.

 

People who have had psychotic symptoms prior to going on psychiatric drugs may be especially susceptible to having them as withdrawal symptoms; therefore, they should take particular care in tapering so as not to trigger that symptom pattern.

 

The theory that dopamine alone is responsible for any type of psychiatric symptomology is erroneous. Presuming that drugs that affect dopamine change behavior, therefore dopamine is responsible for that behavior, is just plain bad logic.

 

(Dopamine is, however, involved in tardive dyskinesia and organic disease such as Parkinson's.) See Again, chemical imbalance is a myth. Stop the lies, please.

 

 

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Iatrogenesis

Thanks for the response. I agree with you 100%. I know the chemical imbalance theory is a lot of nonesense, as I mentioned I believe the story of how APs
have been increasingly more aggressively marketed and the chemical imbalance theory was constructed well into their commercial existence is quite similar to that of the ADs,
that is first a 'miraculous discovery' was made, only afterwards clinical trials were conducted to understand the pharmacodynamics of the drugs and because those particular neurotransmitters were indentified as being
affected the most by those drugs, the corporations launched campaings to promote their new theory linking the 'disorders' that their drugs purportedly treated to those neurotransmitters the drugs threw out of balance the most.
So yes, some terrible logic.

 

I shouldn't have used the word 'obviously', my point was really that those 'psychotic symptoms' are just the WD symptoms that this drug class tends to produce in anyone, but I misunderstood your comment.
My only doubt is what role dopamine plays in the WD of this particular drug class. After all I believe they tend to produce psychosis by far the most often out of the psychiatric drug classes and they target the dopamine
pathways the most. So my idea of this is that just as in heroin, there is some link between the kind of WD, or otherwise brain damage those drugs produce and dopamine.

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carefulprayerful

What is the benefit of using the liquid form of Risperidone for tapering?  Is it just easier to measure precise amounts when the drug is in liquid form? 

 

I read that "Orally disintegrating tablets and oral solution are bioequivalent to tablets," which I presume means the half-life is the same  (https://psychopharmacologyinstitute.com/antipsychotics/risperidone/pharmacokinetics-risperidone/).  

 

Also, are there members who have successfully tapered off this drug after years of exposure to it?  I have been using Risperidone for 5 years. 

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carefulprayerful

This is the information I meant to reference at the above link (https://psychopharmacologyinstitute.com/antipsychotics/risperidone/pharmacokinetics-risperidone/):

 

Pharmacokinetics of Oral Formulations

Absorption

  • Orally disintegrating tablets and oral solution are bioequivalent to tablets.
  • Rapidly absorbed after oral administration.
  • Peak plasma levels achieved within 1 hour.
  • Linear pharmacokinetics.
  • Time to reach steady state ( between 4 and 5 half-lives for all drugs):
    • For risperidone:
      • 1 day in extensive metabolizers.
      • 5 days in poor metabolizers.
    • For 9-hydroxyrisperidone:
      • 5-6 days, measured in extensive metabolizers.
  • Food effect: risperidone can be administered with or without meals.

Excretion

  • Apparent half-life of risperidone:
    • 3 hours in extensive metabolizers
    • 20 hours in poor metabolizers
  • Apparent half-life of 9-hydroxyrisperidone:
    • 21 hours in extensive metabolizers
    • 30 hours in poor metabolizers

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Altostrata

Thanks. Information added to post #1 in this topic.

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Iatrogenesis
On 1/17/2015 at 11:54 PM, Altostrata said:

Often antipsychotics are prescribed to counter or mask adverse effects of antidepressants, particularly the activating effects (anxiety, jitters, pacing, akathisia, sleeplessness, etc.). In these situations, if the person goes off the antipsychotic, the adverse effects of the antidepressant might become apparent again.

 

This is why we suggest going off the more activating drug first; in an antidepressant-antipsychotic combination, that would be the antidepressant. One could reduce the antidepressant part-way, then work on reducing the antipsychotic.

 

Antipsychotics tend to make people dopey and sluggish, so reducing them tends to give people more focus and energy.

 

I'm sorry, but as an antipsychotic survivor I have to strongly disagree with this one piece of advice (of course I really appreciate what you guys are doing).

 

While there's no denying antidepressants are insane and destructive drugs, APs are worse. Much worse. For example, they very often tend to make a person unable to read. Your brain is so fried

you can't put the letters together. I'd had this initially very strongly, then after several years it subsided but reading never was quite comfortable or easy. My friend has been suffering form this effect very strongly ever since she started

taking them, so she pretty much can't read books, it takes an immense effort to put those letters together. And we're talking about the minimum effective dose of the drug that can do this to a person, when prescribed for psychosis, demotivation, (which is another joke, because of just how demotivating those drugs are), other things like that which are deemed 'serious' by the doctor, so for instance 2 mg Risperidone or 10 mg Olanzapine. (For depression I believe the minimum dose would be 5 mg Olanzapine - another joke by the way - and I can't say how likely that dose is to cause this effect, but it's a minimum dose, mind you)

 

Another problem, for example is tardive dyskinesia that can develop after continued use. That's unvoluntary movements of the face or limbs (that you can often see portrayed in films for example as the insane person constantly blinking). Now, this effect apparently takes a long time to develop and while I had been using the drug for a long time, the only thing I got from it was progressing tension, akathisia (which is a sort of prelude to diskinesia, that's tension in your legs, arms etc that makes you want to shake them) and at night while going to sleep sometimes a spasm in my legs. Still, it's a sign of just how much destructive this drug class is and if you do get it, it kills your social life (if it hasn't already been killed by other effects of the drug).

 

So unless perhaps the AP was prescribed to mask the akathisia/mania whatnot from the AD and you know if you get rid of the AP you will not be able to sleep or something like that because the AP is the only way you can suppress that completely disabling effect AND you can't switch the antidepressant to another one that doesn't totally disable you AND the AP dose is rather low (so definitely below the minimum effective dose for treating psychosis) I would strongly advise anyone to quit APs first. They are just overall a much more stronger poison and you want to be off them as soon as you can.

 

 

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Iatrogenesis

I wanted to add a couple of things

 

4 hours ago, Iatrogenesis said:

My friend has been suffering from this effect very strongly ever since she started taking them, so she pretty much can't read books, it takes an immense effort to put those letters together.

She's been taking Olanzapine for 10 years now. This effect is something a doctor would be likely to ask you about, because they believe whatever you "have" is causing it.

4 hours ago, Iatrogenesis said:

Another problem, for example is tardive dyskinesia that can develop after continued use. (..) Still, it's a sign of just how much destructive this drug class is and if you do get it, it kills your social life (if it hasn't already been killed by other effects of the drug). 

The idea is this stays forever and you're maimed for life, even if you manage to quit the drugs (at least I suppose so, unless quitting them properly makes such a big difference that it can heal).

4 hours ago, Iatrogenesis said:

They are just overall a much more stronger poison and you want to be off them as soon as you can.

They also have the capacity to shorten a person's lifespan considerably more. For example you can examine the stories of some famous people who had been taking the drugs for a long time for some disorder... People die, I believe, around 25-30 years prematurely and at the end they're completely burned out (while the medical literature will tell you Schizophrenia or whatever shortens your lifespan like this, which completely doesn't add up, because these people die of heart attacks etc).

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Altostrata

We agree that antipsychotics are dangerous drugs, more destructive to general health than antidepressants and just about any other type of psychiatric drug.

 

However, if a person, for example, is taking an antipsychotic to sleep because the antidepressant causes insomnia, reducing the antipsychotic first will cause the person to suffer insomnia from the antidepressant throughout the taper. Many people understandably find this intolerable.

 

Our advice stands to taper the more activating drug first. As I stated above:

13 hours ago, Iatrogenesis said:

One could reduce the antidepressant part-way, then work on reducing the antipsychotic.

 

If you are suffering adverse effects from the antipsychotic, you would go the route of harm reduction and reduce that first. Some adverse effects are so severe, they warrant a fast taper.

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Iatrogenesis

Yes, I understand you're suggesting this approach only in this particular case, although the way it's stated in this thread could leave some doubts about it.

The majority of the mods seem to have experience with tapering Antidepressants or Benzos, not Antipsychotics. Perhaps you may not fully realize just how ugly these drugs are.

 

I was lucky enough to be able to quit them over 10 months, but if somebody wanted to play it safe and taper them like you recommend here, that could be several years of tapering just one drug.

So the dyskinesia I brought up could be one concern for the person who has been taking antipsychotics for a significant amount of time, because they wouldn't like to have that develop while they were tapering off antidepressants.

As I mentioned, I believe it can be a social death sentence, because it could never go away.

 

Tapering off antipsychotics first when there's a risk of that developing would be harm reduction, but my point is that actually because antipsychotics are just so much more harmful in general, stopping them first is harm reduction as well. It's not only about some disabling "adverse efffects" that could develop, it's actually about the effects the drugs have on anybody. Having successfully quit them, but still being on antidepressants, I can say "less energy and focus" or being "dopey and sluggish" doesn't quite convey how bad the drugs are. Not being able to read is just one quite conspicuous effect, but it goes so much deeper than that. There are some websites where people "review" drugs, the worst things people will say are not an exaggeration.

 

So my point is APs should be attempted to be tapered off first at all costs, because you can't really enjoy yourself on them. They "decrease the quality of life" much more, so to speak. You have to experience it for yourself or at least see it for yourself to be able to fully realize that. Some people say they're evil, some say they steal your soul... It could sound dramatic to you, but that can give you the right picture - they're suffering. You can simply enjoy yourself much more on antidepressants, so doing it this way should be attempted at all costs, because you're saving your health and allowing yourself to enjoy a few years of your life much more, and in addition possibly decreasing the risk of developing some disabling condition like dyskinesia or diabetes.

 

 

 

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Glosmom

HI @Iatrogenesis

I really appreciate your perspective.  I am helping to taper my mentally handicapped daughter (she is 22 years old) off of risperdal, so having her tell me what she is going through is impossible.  We have to go by her behaviors and actions.  I know with all my heart there is no chance of 'getting my daughter back' until i get her off this awful risperdal.  May i ask at what dose did you 'jump to zero' ? I saw that you tapered 10 mg over 10 months which essentially is a .5 mg /month reduction for olanzapine.  Glo is on risperdal and i have read there is a 1 to 5 ratio of risperdal to olanzapine, although i know they all have differences to some degree.  She has symptoms with every decrease so we constantly  struggle with.... is it better to get her off a little faster with more sypmptoms or keep her on longer, still with symptoms, but with the antipsychotic in her system overall for a longer period of time.

 

Again, greatly appreciate your thoughts and ideas.

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Iatrogenesis
On 8/5/2018 at 5:39 PM, Glosmom said:

HI @IatrogenesisI really appreciate your perspective. 

 

Hi, Glo's mom. Thank you.

 

On 8/5/2018 at 5:39 PM, Glosmom said:

@Iatrogenesis
I am helping to taper my mentally handicapped daughter (she is 22 years old) off of risperdal, so having her tell me what she is going through is impossible.  We have to go by her behaviors and actions.  I know with all my heart there is no chance of 'getting my daughter back' until i get her off this awful risperdal.  May i ask at what dose did you 'jump to zero' ? I saw that you tapered 10 mg over 10 months which essentially is a .5 mg /month reduction for olanzapine.  Glo is on risperdal and i have read there is a 1 to 5 ratio of risperdal to olanzapine, although i know they all have differences to some degree.

 

I just dropped from 0.5 mg to 0. It was actually 0.5 mg every 2 weeks. Throughout the withdrawal, I suffered from rather mild
symptoms. There was a wave of unreasonable suspiciousness, that lasted a short time and nobody noticed - it wasn't dangerous at all compared to the full fledged
"manufactured" psychosis I had to deal with during the CT tapers (and the 3 week one). I was sometimes quite irritable, but the drug itself had made me very irritable. Apart
from that, I mostly dealt with nausea and a sort of feeling of weakness in my muscles which wasn't really particularly unpleasant.
I had a wave of pretty strong anxiety towards the very end but it lasted a few hours (this might have been after the final drop).

 

On 8/5/2018 at 5:39 PM, Glosmom said:

@Iatrogenesis

She has symptoms with every decrease so we constantly  struggle with.... is it better to get her off a little faster with more sypmptoms or keep her on longer, still with symptoms, but with the antipsychotic in her system overall for a longer period of time.

 

Again, greatly appreciate your thoughts and ideas.

 

I sadly could never advise you to speed up Glo's taper, due to several reasons. First, she's been tapering conservatively like this for quite some time now and she's come
a long way while staying in good shape. Still, you say she reacts to every drop in dose. I did not. As it's stated here, the lower doses during a taper are harder
to taper off from (hence the 10% reduction method). If you sped up her taper now, her nervous system would be probably thrown into confusion, because by now it's used
to smaller decrements.

 

Second, you're not inside her skin AND she can't articulate how she feels well. That's a very special situation that requires more caution. The best way you
can try and have an idea if the withdrawal process is working out is to listen to your body, but you can only observe Glo and try to figure out what's going on.

 

Third, there's the issue of not being able to recover from a failed withdrawal that you can read about here. That's something that I've never had any experience with
or seen any of my friends have an issue with, but I understand this can happen to people as well. I've always been able to switch between drugs and reinstate
after being in WD for a long time and the WD would disappear almost instantaneously. But it cannot be understated how lethal WD can be and not only the AP WD, just

WD from any psychiatric drug. People here write about going through Hell etc. Before I attempted this 10 month taper, I already had sufffered from 3 failed withdrawals
that were very, very bad (so they gave me the impression I was very ill). Now I'm not an extremely patient person and I don't mind taking chances. That's why I'm tapering off Prozac, not Zoloft now even though
the insomnia, fatigue, space-out it induces are quite bad, because I still prefer this process to take a year rather than several (I really want off the drug). But I already know I am able to pull it off
within that time frame if the drug's halflife is long enough.

 

The issue of half-life seems to be very important, because you can taper off drugs with a higher high-life more easily. In my experience, the 10 hours difference
between Olanzapine and Zoloft was what apparently made the Zoloft WD fail. There's a similar difference between Risperidone and Olanzapine, but I wouldn't really recommend
you to attempt to switch drugs at this point, unless the taper was going awry. Because as it's brought up here apparently some people don't tolerate switching between
drugs from the same class well, and because again you can't communicate with Glo well.

 

That a drug could be concocted that is at the same time so bad and so addictive is seriously messed up. But there's no easy way out and you've already come a long way.
You shouldn't worry about Glo developing dyskinesia or diabetes, because she hasn't been on the drug nearly long enough. Sorry I can't offer any solutions,
but you have to keep in mind how lethal withdrawal can be, I just couldn't recommend doing anything riskier in the case of your daughter, seeing as the process has been going
along fine for her.

 

In fact, I can't really recommend anyone to withdraw quicker than Breggin's method, what period of time could work for a person is an extremely individual thing

and everyone has to decide for themselves if they are willing to take a greater risk, keeping in mind all the things that are stated on these forums. My point here was only that there IS

a very significant difference between how "bad" ADs and APs are, so I strongly believe quitting APs should be a priority in almost all cases.

 

Hoping the best for Glo.

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Glosmom

Thanks so much for taking the time to offer such a thorough response @Iatrogenesis.   Those on this site are the 'voice'  of Glo for me and your words offer me perspective and remind me to be patient. I do not want to screw up the tapering progress we have already made.  Glo has never been her normal self the entire time on this drug, so there is no guarantee she will ever return to that person once she is off.  However, we don't want to take any more chances than we already have. Your thoughtful reply reminds me to go slow and take the time it takes.  Best wishes to you in your prozac tapering!! I hope you can experience as peaceful of a process as possible during that time.

 

Warmest Regards, Glosmom

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truthunter

Want to thank Risperdrawlin and Iatrogenesis for some very helpful comments. Great tapering tips and insights from both of you. Could not agree more Iatrogenesis with your sentiments on how terrible and damaging APs are and about the irony of them causing the very issues they purport to control causing people who don't understand the dynamics to blame themselves or their loved one potentially driving the taker into an indefinite period of consumption of meds that are extremely damaging mentally and psychically. It os almost a perfect crime by the drug companies and they are being enabled by the government. So wrong. Anyhow having unfortunately experienced both Risperdone and  Olanzapine I agree with Glos Mom that Risperdone drops are much more touchy. That said that it comes in liquid form is incredibly helpful for tapering and the value of the ability it gives one to fine tune dose reduction is great. Also while a longer half life could help with those initial bumps I believe that there are less bumps down the track. So, like you get it over with and less late surprise potential.I also agree with Iatrogenesis that it is better to be careful unless one is incredibly mentally strong and self aware and my experience has been that any time I push too hard to just get my kid off it backfires and we end up taking longer and sadly ingesting more of the crap. I am not religious but they are the devils drugs!You have to handle them with the care of dynamite or the whole thing can blow up on you. It's all about patience, intuition and knowledge. Every one is different so best to err on the side of caution. Baby steps are good steps. The main thing is to be stepping in the right direction. It's not a race but about reaching your destination. Thanks all for sharing.

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Iatrogenesis

Thank you! I would be optimistic, your description of her state sounds positive, she's improving. During my failed withdrawal, I was really trying to get by and cope with some really unpleasant symptoms, so nothing like the improvements you're seeing.

 

Warmest Regards

 

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Griqua

Has any of you recovered from risperdal consta? I've heared it should give permanent effects.

 

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Altostrata

Hi, truthunter. Please start an Introductions topic for yourself so we can get to know you.

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Iatrogenesis

Oh, hi, Truthunter, somehow when I was writing my last reply to Glosmom I failed to notice your post (weird, maybe it's the insomnia). I'm glad my experience could be useful to you.

 

EDIT: Oh no, now I understand your post got approved only recently.

Edited by Iatrogenesis

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