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LostWaves

LostWaves: Few questions about Risperidone

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LostWaves

I've updated my signature to show the general understanding of what's going on with me. I was on antipsychotics for a week prior to August 14, but I believe I was given varying dosages during that time. Additional information is in my previous post, if needed.

 

Summary: I went to the hospital because I was hearing voices. The voices came immediately after smoking weed. Me and Doc both think weed played a major factor with causing the visit. I've felt recovered for weeks. I plan on taking 1 mg of Risperidone, then taking .5 mg of Risperidone to taper off. I'm being prescribed the 1mg, and I have .5 mg pills leftover, from when I was prescribed them months ago. I'm currently being monitored while taking the pills, but I can still hide them and spit them out after.

Mainly what I'm wondering is: Should I take 1 mg risperidone for two weeks, then .5 mg for two weeks; or should I take 1 mg for a month, and then .5 mg for two weeks? I only have enough .5 mg pills to last me a little more than two weeks.

 

I remember having 'small movements,' two to three months after my rapid taper last time, and I'd rather prevent that if possible this time. However, last time I was on antipsychotics for two and a half months when I decided to taper (for two weeks on 1mg risperidone). Also, for almost two of those months, I had been on 4 mg risperidone with no change in dosage (which might have built a stronger dependency). This time, I've been on antipsychotics for one month and one week in total. Also, I was never on any single dosage for an entire month. The longest dosage I stayed with was the 3.3 mg of Haldol, for two weeks and two days. In truth, it should probably be even shorter than that, because half the injection was given four to five days earlier, I believe. So again, I'm asking you: Should I take 1 mg for two weeks, then .5 mg for two weeks; or should I take 1 mg for a month, and then .5 mg for two weeks?

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Glosmom

Hi Lost Waves,

"Past performance is not an indicator of future success"  I want nothing but success for you in getting off risperidone but your plan is concerning since it is a rapid taper.  Even though you have been on it for a short time, it is not an indicator that it will be 'easy to come off.'  Nor is it guaranteed that your withdrawal pattern will be the same as last time.  Systems can get sensitized from going on and off of medication.  Do you have a  plan if you have unbearable withdrawal symptoms (inclucing rebound psychosis)?  Can you ask to switch to liquid and then if something goes awry you can taper more slowly?  You pdoc doens't need to know you are lowering from 1mg if you move to a liquid.  Of course i am not a doctor nor am I a mod. So maybe they have better/different advice. I am just a concerned supporter who wants you to succeed....please be careful and take the time you need to come off this drug safely.  Glosmom 

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LostWaves

Glosmom,

 

I don't think I'll be able to go on liquid. Also, I stated that the Doc and I both strongly believe the Cannabis played a major factor in my problem. As long as I avoid that, I shouldn't have to worry about psychosis.

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SkyBlue
14 hours ago, LostWaves said:


Mainly what I'm wondering is: Should I take 1 mg risperidone for two weeks, then .5 mg for two weeks; or should I take 1 mg for a month, and then .5 mg for two weeks? I only have enough .5 mg pills to last me a little more than two weeks.

 

 

Short answer: probably not. 

 

Please read Shep's post (second post on page 1 of this thread) on why 10% (of current dosage) is best. 

 

You've been on R for several months now. 

The main question here is, why hurry? If you're wanting to be off it ASAP, that's definitely understandable. We all do!! But that's not the way safe tapering works. 

 

If you're having trouble w/access to refills, that is another problem. Is that the case?

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LostWaves

SkyBlue, I was on risperidone for three months in total, and that was as of March. I'm on risperidone again right now, and that's only been for a few days. I stated already that I have a limited amount of .5 mg pills, from when I was prescribed them months ago. That doctor is not going to give me .5mg pills now, after I've already been put on 1 mg.

I have read the thread on tapering by 10%. I understand that the 10% is a guideline to minimize harm, because doctors allegedly advise tapers that are too fast. However, I also read that if you have minor, or no withdrawal symptoms, from tapering, then you may taper at a faster rate.

My psychiatrist at the time, reduced the dosage by 50%, twice. In the second instance, she reduced my dosage after only two weeks of being on the previous dosage. I never had any adverse reactions to either of the dosage changes. I also went off the drug completely, after taking my lowest dose (1mg) for two weeks. After two and a half months, I started having a minor symptom.

 

When I tapered last time, Shep himself had told me that I could 'get away with a much more rapid taper.' He also spoke to another moderator, and they both agreed that I shouldn't reinstate, even though my taper was considered rapid to an extent. Even when I started reporting my minor symptom, months later, Shep still said that it would be better for me to wait it out, rather than reinstate.

Considering the fact that Shep said that I could get away with an even more rapid taper, and also considering the fact that I'm doing a more gradual taper this time, I don't understand why either of you are reacting the way you are.

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SkyBlue
8 hours ago, LostWaves said:

Considering the fact that Shep said that I could get away with an even more rapid taper, and also considering the fact that I'm doing a more gradual taper this time, I don't understand why either of you are reacting the way you are.

 

You asked for help and this was my suggestion. I encourage you to proceed as you see fit.

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Glosmom

Everyone has to find their own way. No judgement here..... only support for you to be able to get off successfully. Wishing you the best!

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LostWaves

Hi everyone. I was on 1mg risperidone for two weeks, and in a few days, I will have been on .5 mg for two weeks. I then plan on taking .25mg for two weeks. However, I only have enough .25 mg pills to last me eight days, so I tried cutting my leftover .5mg pills, to cover the last six days.

 

fohk4m.jpg

 

Unfortunately, I wasn't precise.

I'm wondering if I should:

 

A. Take six of these pills, for the last six days of my .25 mg taper. These were originally .5 mg pills, and a whole .5mg pill is shown at the left for reference. Please specify which pills, if so.

 

B. Take .25mg for one week, and do not taper the following week (this is if the difference in pill sizes is enough to have a negative effect on the taper).

 

C. Do not take the .25mg at all, and simply stop tapering after .5mg (this is if the pill size differences would have a negative effect, and if you believe one week for a taper is not a good idea for my particular situation [Reminder: Surviving Antidepressants actually says some people can taper, by staying on a dose for only a week.])

 

Any help is appreciated (but please explain your rationale).

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LostWaves

Bump

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ChessieCat

I've let the mods know that you need assistance.

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Shep
On 9/10/2018 at 11:31 PM, LostWaves said:

My current psychiatrist thinks both of my episodes may have been caused by Cannabis use.

 

On 9/14/2018 at 9:52 PM, LostWaves said:

Summary: I went to the hospital because I was hearing voices. The voices came immediately after smoking weed. Me and Doc both think weed played a major factor with causing the visit. I've felt recovered for weeks.

 

LostWaves, have you stopped using weed? When you first came to the site back in March, you were completely off the antipsychotic and were not having any withdrawal symptoms. 

 

Whether or not you will need to continue with psychiatric drugs is contingent on whether or not you are able to stay away from marijuana and considering how this affects you, I would avoid all recreational drugs and even alcohol until you are completely healed. 

 

You have now been on antispychotics in either an injection and / or pill form for nearly 3 months. You may be dependent on them at this point, so a rapid taper may not be in your best interest. 

 

Before giving tapering advice, we need a drug and symptoms journal. Please use this format:

 

Drug and Symptoms Journal

 

Please also include:

  • any supplements you are taking
  • when you eat
  • how much sleep you are getting each night

 

Once you have a few days of your symptoms journal, we will be better able to guide you off.

 

On 10/8/2018 at 6:54 PM, LostWaves said:

[Reminder: Surviving Antidepressants actually says some people can taper, by staying on a dose for only a week.])

 

Any help is appreciated (but please explain your rationale).

 

You may need to get another prescription and prepare for a longer taper,  depending on the severity of your symptoms.  Please note, my previous advice to you regarding a rapid taper was back in March after your first short time on an AP and having zero withdrawal symptoms.  That may not be the case now, so you may be looking at holding until you are more stable to taper. 

 

Also, from the picture you posted, the way you are cutting your pills is giving you very uneven dosing. Please see:

 

How to cut up tablets or pills

 

 

 

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LostWaves

Thank you, ChessieCat.

 

And Shep, my supplements are listed in my signature. 

Finasteride 1.25 mg (hair growth, no interaction), Fexofenadine HCI 180 mg (allergy pill), Amoxicillin 875 mg (skin care).
I believe that I eat at around 11 AM to 12 PM, then again around 4 PM, then again around 7-8 PM, and also around 11PM-12 AM.
I believe I sleep from 8-10 hours every night.

 

My sleeping, eating, and supplements have been this way for at least two weeks now.
I have no symptoms, aside from what I believe to be minor movements, which I believe might have been caused by Haldol (I feel like it started in the hospital), and which I am going to see my Psychiatrist about soon.

I have stopped using Cannabis.

 

Shep, the last time you advised a rapid taper, which you said I could get away with a much more rapid taper, I had been on antipsychotics for three months in total. I have now been on antipsychotics for 2 months and 2 weeks, and for the past three weeks, I've been on lower doses than I ever have been before. Also, I previously had issues with small movements, and you had told me to just wait it out, instead of reinstating. Seeing how I've been on antipsychotics for a shorter amount of time than last time, and since I've been gradually tapering during this time, I would imagine that I should be fine. Obviously you're allowed to disagree, but I want to make sure all the details are out there.

Also, Shep, would recommend me not using those uneven pills for my last six days of tapering? I've taken .25 mg pills of Risperidone for the last 8 days. I cannot get the prescription refilled. I would imagine that I would be fine if I stopped now, considering I've been on antipsychotics for a shorter amount of time than last time, and I've spent the last five weeks tapering (compared to two weeks last time).

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Shep
18 hours ago, LostWaves said:

And Shep, my supplements are listed in my signature. 

Finasteride 1.25 mg (hair growth, no interaction), Fexofenadine HCI 180 mg (allergy pill), Amoxicillin 875 mg (skin care).

 

LostWaves, these aren't supplements. Finasteride (Propecia) and amoxicillin are prescription drugs. And fexofenadine (Allegra) is an OTC drug.

 

Supplements are vitamins such as vitamin B12.

 

18 hours ago, LostWaves said:

Shep, the last time you advised a rapid taper, which you said I could get away with a much more rapid taper, I had been on antipsychotics for three months in total. I have now been on antipsychotics for 2 months and 2 weeks, and for the past three weeks, I've been on lower doses than I ever have been before. Also, I previously had issues with small movements, and you had told me to just wait it out, instead of reinstating. Seeing how I've been on antipsychotics for a shorter amount of time than last time, and since I've been gradually tapering during this time, I would imagine that I should be fine. Obviously you're allowed to disagree, but I want to make sure all the details are out there.

 

You may be fine with a rapid taper. And you may not be. There's no way for anyone to know for sure.

 

From About reinstating and stabilizing to reduce withdrawal symptoms

 

This applies to tapering too quickly: 

 

  On 10/8/2012 at 7:17 PM, Altostrata said:

Don't suddenly go off medication assuming that reinstatement is a safety net. This is one of the reasons we advocate gradual tapering to minimize withdrawal symptoms. Once the nervous system is destabilized by withdrawal, all bets are off Humpty Dumpty has fallen off the wall.

 

In the past 11 months, you have been on antipsychotics for 5.5 months. Your nervous system may be kindled now. For more on kindling, see:

 

Limbic Kindling -- Hardwiring the brain for hypersensitivity

 

18 hours ago, LostWaves said:

Also, Shep, would recommend me not using those uneven pills for my last six days of tapering? I've taken .25 mg pills of Risperidone for the last 8 days. I cannot get the prescription refilled. I would imagine that I would be fine if I stopped now, considering I've been on antipsychotics for a shorter amount of time than last time, and I've spent the last five weeks tapering (compared to two weeks last time).

 

If you are going to continue to rapid taper off, it probably doesn't matter that your pills are uneven. If you decide to stay on a low dose of Risperidone and do a slow taper, than you'll want to get a scale or learn how to do a liquid titration. 

 

Hopefully, you will continue doing well with only minor symptoms. 

 

At this point, LW, you'll have to decide which way to go. You have the information you need should you decide to taper longer. If not, these are great skills to develop should you need them:

 

Non-drug techniques to cope with emotional symptoms

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