Banana121: brother's road to recovery

[Banana121]

Hello. I pray you are all doing well. I have recently been lurking on this website, looking for other people with a similiar experience as to mine.

 

I am asking for help and advice in regards to my brothers recent situation.

 

My brother had been sectioned in the beginning of this year. He came home one day and was acting different. I later realised that these were delusions. 

 

He was unwell for a week and had gotten better for a week then the following week he became unwell again but this time he was quite aggressive. He would get angry easily. He was very emotional and would get really upset sometimes over a small thing or easily irritated. I guess you could describe him as being manic at this time. He also said his heart would start beating fast randomly and he felt like he was having a panic attack. My family decided he needed to go to the hospital as he was very much out of control. 

 

He went to the hospital and was alright there but he kept walking and wouldn't sit still, he would do this at home as well, always doing some sort of exercise.

 

He got upset at the hospital and broke the fire alarm and the doctor had called the police on him. He got arrested, stayed in the cell overnight and the next day they decided to section him under the mental health act.

 

He was put on 10mg of Olanzapine at first, then he was switched to risperidone 0.5 after 2 or 3 days. With 5mg Olanzapine and up to 2 mg of Lorazepam a day as PRN. Even though it was PRN the staff said that he needed PRN everyday. He was put into seclusion a couple of times, it was horrible for the whole family, we just wanted some help, not for him to be snatched from us.

 

We finally were able to get him home after 28 days. We were given 6mg of risperidone, PRN and procycldine as his medication because his hands were shaking. At home he was good although I noticed that during the day he would get a bit hyper, say he doesn't feel good. I would then give him the lorazepam and he would calm down.

 

The nurse would visit us at home and she told me to stop using the Lorazepam and give him Olanzapine instead, if he needed it. So thats what I started doing, big mistake. As soon as I stopped the Lorazepam he became unwell, kept walking around, felt agitated, a lot of anxiety. I then used Olanzapine to calm him down. he would get like this a lot and I realised that its akathisia. I think from the risperidone. 

 

He would come upstairs at night saying he cant sleep and he needed something to help him. I thought that this was withdrawals from the Lorazepam or Olanzapine that was given to him in hospital as PRN. I then called the doctor and he said lorazepam has been out of his body for two weeks so it must be his illness returning, he told me to put his risperidone up to 7mg. I tryed doing that for 3 days but it made him feel worse. I put him back on 6mg.

 

I told the doctor that I wanted to switch from Risperidone to Olanzapine because it wasnt helping and he would feel restless half an hour after taking it.

 

The doctor told me to put him on Olanzapine 5mg and to reduce his risperidone by 2mg every 4 days. I got him down to 3mg of risperidone at this time. 

 

It was then that I found this site and saw the 10% taper method and I realised that I cant just cut off his Risperidone as he had been on it for 6 weeks already.

 

I have now got him on 2.25mg of Risperidone from yesterday but the problem is that he has also been on 3.75mg Olanzapine for a month since coming home. He is already been complaing about being stiff and he sleeps 14 hours a day and has gone quiet, he stopped making conversations and rarely laughs like he used to, since being on Olanzapine. 

 

I also suspect that he may have Seretonin Syndrome or toxication from the risperidone because he displays symptoms when i up the dose of the medication. Hypomania, restlessness and agitation.

 

I dont know what to do, I want to get him off Risperidone as it makes him agitated, his muscles twitch,  his hands used to tremor and gives him akathisia unless he has a benzo. But I also want to get him off the Olanzapine because he gets really tired during the day has stopped talking to my dad, they are so close, and I dont want him to lose his emotions forever. He cant stay on two antipsychotics. The side affects outweight the benefits.

 

Should i ask the doctor for a benzo or something to help the akathisia. Should I also taper the Olanzapine at the same time? How much percent can I taper his medication by and how often, can I taper 10% Risperidone and 10% Olanzapine?

Can i taper more often than every month? 

 

Thanks so much, if you managed to read all of this.

 

Edited March 4, 2018 by ChessieCat
reduced font

[Gridley]

Hello, Bananas121, and welcome to SA.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

• Any drugs prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• Link to Account Settings – Create or Edit a signature

As you now know, at Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops.
Before you begin tapering what you need to know

Why taper by 10% of my dosage?

What is Withdrawal Syndrome?

Glenmullen’s withdrawal symptom list.

 

We recommend tapering only one drug at a time, because if there is a problem, it would be difficult to tell which drug taper was the cause.  Generally, we recommend tapering the more activating drug first, so that the sedating drug can act as a buffer to help cushion any withdrawal symptoms.  According to your description, the more activating of the two drugs is the Rispiradone.  This link give tips on tapering off Rispiradone, including instructions on how to make nonstandard doses.

Tips for tapering off Risperdal (risperidone)

 

I would definitely not taper more than 10% every four weeks.  In fact, Many members find that the lower there dose gets, the slower they need to taper, either by reducing less than 10% or reduce by 10% and hold for longer. The brain needs time to become accustomed to the lower dosage, and experience here has shown that tapering too fast can lead to very unpleasant withdrawal symptoms and destabilization of the nervous system that can take a long time to correct.  I know you want your brother to be off these drugs as soon as possible, but slow and steady is the best approach.

 

I wouldn't recommend a benzo.  Besides very likely making your brother even more sedated, this will be another drug your brother will have to come off.  Once the Rispiradone taper gets underway, you should see a reduction in the symptoms you mention.

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community. I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but I am glad that you found us.

[rupa]

Tapering risperidone first is very wise decision.

It is an evil drug.

So many discomforts ,like restlessness,sleeplessness,agitation etc

once fully out of risperidone ,let him stabilise on olanzapine for a month or two.

Then taper slowly of olanzapine.

Once he fully out of all medication , he will be a new person.

He will know his flaws and hard learned lessons.

He will be alright.

I appreciate you very much for being a wonderful sibling to your brother.

 

Edited March 22, 2018 by ChessieCat
removed quote

[powerback]

Fairplay B to you ,your brother has a very caring sibling .you don't have to answer this ,was this episode a total random event ,what ever led it no judgment from me ,if it was from anything taken ,this will have to be looked at in the future and to use a phrase from rupa .a lesson learned it that respect .As I said no judgement what so ever .

I hope your brother gets well .

[Banana121]

On 22 March 2018 at 7:03 AM, rupa said:

Tapering risperidone first is very wise decision.

It is an evil drug.

So many discomforts ,like restlessness,sleeplessness,agitation etc

once fully out of risperidone ,let him stabilise on olanzapine for a month or two.

Then taper slowly of olanzapine.

Once he fully out of all medication , he will be a new person.

He will know his flaws and hard learned lessons.

He will be alright.

I appreciate you very much for being a wonderful sibling to your brother.

 

Thank you so much Rupa. It means a lot.

[Banana121]

On 23 March 2018 at 10:22 PM, powerback said:

Fairplay B to you ,your brother has a very caring sibling .you don't have to answer this ,was this episode a total random event ,what ever led it no judgment from me ,if it was from anything taken ,this will have to be looked at in the future and to use a phrase from rupa .a lesson learned it that respect .As I said no judgement what so ever .

I hope your brother gets well .

Thank you powerback.

[Banana121]

7 March - 2.25mg Risperidone (pill)
10 March - Stopped 3.75mg Olanzapine
11 April - 2mg Risperidone
20 April - Stopped 2mg Risperidone

 

Hello, I need some advice please. My brother went on holiday with his dad on the 10th April. Around the time of 20th of April he told my dad that he wanted to stop the medication and he stopped Risperidone.

My dad called me on the 5th May and said that my brother stopped the medication 2 weeks ago and he is fine.

 

I have noticed that my brother has stopped messaging me frequently on the 20th April and from then he has been having fatigue and is struggling to do a simple task that I ask of him to do. He is also speaking less to me on the phone, only saying short sentences or saying "ok".

 

I haven't told my dad to reinstate his medication in case he has an adverse reaction because he is still on holiday and my dad doesn't really notice his symptoms like I do.

Whenever I would reduce his dose, he would get irritated, cortisol, restlessness and fatigue.

 

He will be coming home next week and I was thinking of reinstating his medication then at maybe 0.1mg (liquid) so I can check his reaction to reinstatement. I want him to be stable and not have him take more medication in the future for when a wave comes.

 

My dad might be able to get 0.25mg pill from where they are on holiday but I'm afraid of an adverse reaction so I want to start him on less. But time for reinstatement is going.

 

It is now 3 weeks of him without medication and I wanted to ask if I should reinstate and if so, by how much? Thank you.

[Banana121]

Im not sure how to shorten this to my signature but here is a drug summarisation.

 

Jan to Feb 2018: (Sectioned) Risperidone 1mg moved up to 6mg

Procycldine 5mg twice a day Lorazepam 1 to 2mg (PRN) Olanzapine 5mg (PRN)

08 Feb 2018: Olanzapine 3.75mg 

10 Feb 2018: Risperidone 3mg 

Procycldine 5mg

16 Feb 2018: Risperidone 2.5mg

7 Mar 2018: Risperidone 2.25mg

10 Mar 2018: Stopped Olanzapine

11 Apr 2018: 2mg Risperidone, stopped Procycldine by gradually tapering.

20 Apr 2018: Stopped Risperidone 2mg

[Banana121]

CouId I please have some advice from a mod or someone who has experience with reinstatements and antipsychotics.

[SkyBlue]

Hello, Banana,

 

This is a thread about reinstatement: http://survivingantidepressants.org/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/?tab=comments#comment-33809 Please read through it, and search that thread for Risperdal and/or "antipsychotics."

 

You are right to be cautious about reinstatement. I'm not trying to scare you, just making sure you know it is an unknown, and there are no clear rules (how much exactly to reinstate, what effect it will have etc). The good news is that he seems to be in the reinstatement "window" (less than one month off). 

 

From January to February, it looks like the Ripsperdal dose was doubled, then cut in half. This can be extremely destabilizing. Doctors don't understand when they mess around with the doses so abruptly.

 

This is important: Are the symptoms you talked about (confusion, etc) new and/or extremely distressing? 

 

 

Edited May 17, 2018 by SkyBlue
added a few things

[Banana121]

18 hours ago, SkyBlue said:

Hello, Banana,

 

This is a thread about reinstatement: http://survivingantidepressants.org/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/?tab=comments#comment-33809 Please read through it, and search that thread for Risperdal and/or "antipsychotics."

 

You are right to be cautious about reinstatement. I'm not trying to scare you, just making sure you know it is an unknown, and there are no clear rules (how much exactly to reinstate, what effect it will have etc). The good news is that he seems to be in the reinstatement "window" (less than one month off). 

 

From January to February, it looks like the Ripsperdal dose was doubled, then cut in half. This can be extremely destabilizing. Doctors don't understand when they mess around with the doses so abruptly.

 

This is important: Are the symptoms you talked about (confusion, etc) new and/or extremely distressing? 

 

 

Thanks so much for replying. He is back from holiday and back to normal, I know he is in a window now. when he was on risperidone, he would be agitated and whilst I was tapering it would amplify his akathisia. I'm scared of him falling into a wave of akathisia. Im also scared of triggering an adverse reaction but I need to make a decision. The symptoms he got whilst on holiday were what he would get when I was tapering his risperidone.

[SkyBlue]

You're very welcome. I'm so glad he's in a window now. 

[rupa]

23 hours ago, Banana121 said:

Thanks so much for replying. He is back from holiday and back to normal, I know he is in a window now. when he was on risperidone, he would be agitated and whilst I was tapering it would amplify his akathisia. I'm scared of him falling into a wave of akathisia. Im also scared of triggering an adverse reaction but I need to make a decision. The symptoms he got whilst on holiday were what he would get when I was tapering his risperidone.

Hi

After stopping olanzapine and risperidone, what are his symptoms so far? What are day time symptoms and what are night time symptoms?

Please ask him and reply.

please take care of him.

He stopped at high doses what a mistake.

At present what medicines he is using?

[Banana121]

4 hours ago, rupa said:

Hi

After stopping olanzapine and risperidone, what are his symptoms so far? What are day time symptoms and what are night time symptoms?

Please ask him and reply.

please take care of him.

He stopped at high doses what a mistake.

At present what medicines he is using?

Hello rupa, right now his symptoms are fatigue, feeling hot, waking up at 4:30am, sensitive to loud sounds, Im still deciding on how much to reinstate his risperidone by.

Edited May 18, 2018 by Banana121
Forgot to write something in

[rupa]

6 hours ago, Banana121 said:

Hello rupa, right now his symptoms are fatigue, feeling hot, waking up at 4:30am, sensitive to loud sounds, Im still deciding on how much to reinstate his risperidone by.

I didn’t know I have to reinstate within 8 days (of 1 mg risperidone ,which I colturkeyed. Out of ignorance)back in 2016,by the time  I reinstated after a month it’s already late and brain settled with hypnagogia without sleep tablet and hypnopompic hallucinations with sleep tablet(olanzapine).After 2 years my damage increased with time but not subsided.

I did not understand why he had to cold turkey at that much high doses,even after you know this site.

I am worried about him.

[Banana121]

21 minutes ago, rupa said:

I didn’t know I have to reinstate within 8 days (of 1 mg risperidone ,which I colturkeyed. Out of ignorance)back in 2016,by the time  I reinstated after a month it’s already late and brain settled with hypnagogia without sleep tablet and hypnopompic hallucinations with sleep tablet(olanzapine).After 2 years my damage increased with time but not subsided.

I did not understand why he had to cold turkey at that much high doses,even after you know this site.

I am worried about him.

Thanks for the advice, how much did u reinstate by?

[rupa]

1 minute ago, Banana121 said:

Thanks for the advice, how much did u reinstate by?

Total 1 mg. When I noticed it’s a total waste to reinstate ,after 3 months I tapered slowly and stopped risperidone.

With experience I would suggest ,please advise your brother ,not to reinstate risperidone at all,Instead reinstate 2.5 m.g of olanzapine ,or lowest available mg of olanzapine,which will help with sleep and day time withdrawal symptoms of risperidone.

Once he stabilise on olanzapine he can taper olanzapine slowly.

Even after reinstating olanzapine,he still feels risperidone withdrawal is horrible,he can reinstate risperidone 0.5 mg for a month and start tapering .

Risperidone won’t help for sleep.

It only controls thought process.

olanzapine helps sleep and thought process both.

[Banana121]

2 minutes ago, rupa said:

Total 1 mg. When I noticed it’s a total waste to reinstate ,after 3 months I tapered slowly and stopped risperidone.

With experience I would suggest ,please advise your brother ,not to reinstate risperidone at all,Instead reinstate 2.5 m.g of olanzapine ,or lowest available mg of olanzapine,which will help with sleep and day time withdrawal symptoms of risperidone.

Once he stabilise on olanzapine he can taper olanzapine slowly.

Even after reinstating olanzapine,he still feels risperidone withdrawal is horrible,he can reinstate risperidone 0.5 mg for a month and start tapering .

Risperidone won’t help for sleep.

It only controls thought process.

olanzapine helps sleep and thought process both.

Alright, thanks for the tips, did you feel any adverse reactions or side affects when you started the risperidone second time?

[rupa]

8 hours ago, Banana121 said:

Alright, thanks for the tips, did you feel any adverse reactions or side affects when you started the risperidone second time?

Yes,uneayness full day ,sleeplessness even using olanzapine for sleep.

Very beginning when I used risperidone for thought control for one month,Lorazapam had been given for sleep.

Later I came to understand risperidone disturbed sleep.

[Banana121]

Hello, can I please have some advice, my brother stopped his medication on 20th April. I would like to know what step to take next. His mouth twitches sometimes during the day while eyes a rolling a bit and he whispers something sometimes but doesnt realize that he is doing it. I wanted to know whether reinstating is a good idea for someone who has TD like symptoms.

[Banana121]

Hello everyone, he continous to twitch his face for a few seconds, a few times a day. Does anybody have any experience about twitching and reinstating an antipsychotic that caused it? Thank you.

[rupa]

Reinstating will work only within two weeks of coldturkey.

Now wait patiently to subside symptoms with time.

Ask him to be away from any kind of brain medication.

Because his nervous system sensidized with high doses of coldturkeys.

Now if he take any meds, those may give more adverse life threatening reactions.

Read Bhasski in this site.

[mammaP]

Hi Banana, can you tell us how old is your brother, and was he ok before his first episode at the beginning of this year? 

How is he now, is it only the twitching?  

Edited June 22, 2018 by mammaP

[Banana121]

22 hours ago, mammaP said:

Hi Bananas, can you tell us how old is your brother, and was he ok before his first episode at the beginning of this year? 

How is he now, is it only the twitching?  

Thank you for getting back to me mammaP. My brother is 17. He, thank god, has been completely fine his whole life before this episode.

 

I have also noticed that he is fidgeting throughout the day, sometimes readjusting his legs and needs to stay preoccupied by listening/watching something. with an hour's relief in the morning and evening. His nose is blocked as well.

[mammaP]

Thank you for the info B,  your brother will get better, his nervous system and brain are resetting themselves after the drugs and this takes time.  Try not to worry too much. He needs good fresh food if possible, plenty of water to drink and exercise, walking is good in the fresh air. Good sleep patterns are important too. Going to bed and getting up at the same time every day and reducing computer, phone and ipad use an hour before sleep helps a lot. It also helps to avoid over stimulation with violent or very loud games and movies when the nervous system is struggling.  

 

 

[Banana121]

On 22 June 2018 at 4:26 PM, mammaP said:

Thank you for the info B,  your brother will get better, his nervous system and brain are resetting themselves after the drugs and this takes time.  Try not to worry too much. He needs good fresh food if possible, plenty of water to drink and exercise, walking is good in the fresh air. Good sleep patterns are important too. Going to bed and getting up at the same time every day and reducing computer, phone and ipad use an hour before sleep helps a lot. It also helps to avoid over stimulation with violent or very loud games and movies when the nervous system is struggling.  

 

 

Thank you mammaP for the support and tips. I have been preparing him fresh veggies everyday to eat! I was just wondering whether reinstating a small amount of his medication (0.02mg and working my way up) would benefit his symptoms (mainly restlessness/akathisia) at this point as I have got my hands on the liquid solution, or if riding the withdrawal is better. Im just afraid of his akathisia getting worse as I have seen it before and he would just go outdoors and keep walking for hours and he was obviously distressed. I also remember his akathisia getting worse when the doctor put his dosage up and when we would reduce it.

[Banana121]

Heya. I was wondering whether I could get some advice on my question above? Preferably someone with experience on akathisia and antipsychotics. Thanks.

[mammaP]

How is he now, has he worsened at all, or improved in any way? It is a tough one, His akathisia worsened when the dose was increased and also when it was decreased so reinstating could aggravate it. Does he realise how the drugs affect him when they are changed? He has had so many drugs over a 6 months period that his brain and nervous system has to recover from.  Does he still see the psychiatrist? 

[Banana121]

He is about the same, better off the meds. I agree that reinstating could aggravate his akathisia, its best to leave it be to be honest. He doesn't realize how the drugs affect him, especially when changed. All he knows was that he wasn't well and was given them and know that he is better he doesn't need them anymore. He still sees his psychiatrist every month or so and I have told him that he is still taking meds. Even though he is off now, my mother has asked him if we could take him off and the doctor said he will discuss it at the next meeting.

[rupa]

On 28 June 2018 at 7:04 PM, Banana121 said:

He is about the same, better off the meds. I agree that reinstating could aggravate his akathisia, its best to leave it be to be honest. He doesn't realize how the drugs affect him, especially when changed. All he knows was that he wasn't well and was given them and know that he is better he doesn't need them anymore. He still sees his psychiatrist every month or so and I have told him that he is still taking meds. Even though he is off now, my mother has asked him if we could take him off and the doctor said he will discuss it at the next meeting.

You and your mother are doing the brilliant thing.In this way you will get the doctor's prescription if your brother ever needs to taper.

[Altostrata]

Many people do better with fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

A lot of people find them helpful. Your brother might try a little bit of one at a time to see how it affects him.

 

[Banana121]

On 5 July 2018 at 8:22 AM, Altostrata said:

Many people do better with fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

A lot of people find them helpful. Your brother might try a little bit of one at a time to see how it affects him.

 

Thanks Alto, I have been checking out the magnesium topic recently. Im just thinking of which type to get for him.

 

[mammaP]

I have been fine with the ones from Boots, but only the ones that only have magnesium. Lots have other additions like vit B6 or calcium etc. Make sure it is only magnesium. They are small and easy to swallow. 

Edited July 6, 2018 by mammaP

[Banana121]

9 hours ago, mammaP said:

I have been fine with the ones from Boots, but only the ones that only have magnesium. Lots have other additions like vit B6 or calcium etc. Make sure it is only magnesium. They are small and easy to swallow. 

Thanks for the recommendation, mammaP. I'll definitely check out the ones at Boots. 

[bheb]

Hey Banana, how's your brother doing? It's really great that you've been doing this research for him.

[Banana121]

On 3/9/2019 at 1:06 AM, bheb said:

Hey Banana, how's your brother doing? It's really great that you've been doing this research for him.

Hello, thanks for asking, was doing good but not well now.