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sunnylou: 1mg Risperidone 900mg gabapentin taper

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sunnylou

Hi. I'm about to start a Risperidone taper using milligram scales. I was on 1.5mg but 3 wks ago I lowered to 1mg and felt fine. I'm going to wait another couple of weeks before commencing slowly steady 10℅ drops as I successfully tapered Diazepam this way in the past.

 

However 2 weeks ago I also dropped one of my 3 x a day 300mg gabapentin so now I'm on 600. The capsules being 300 mean I'm just taking 2 doses at 8am and 8pm rather than the usual 3. I've felt pretty much Ok although I can feel short lived definate withdrawal symptoms at 8am and around 7pm. Will I be ok to stay like this whilst I begin the Risperidone taper? I suppose ideally I should at least try split the 600mg into 3. How easy is it to split the powder? I would need 2/3rds of a capsule each dose. Part of me is thinking just go back to 900mg and get the Risperidone dealt with first instead of starting compromised. 

 

From what I can gather both are terrible drugs to get off. After my Diazepam nightmare a few years ago I'm really sickened to end up with these problems again. I'm also on 30mg of Amyltryptline due to chronic inner thigh pain. This did nail the constant agony whereas the Gabapentin didn't.  Im not sure it was ever very helpful.  Would be great to hear from anyone e who got off these succesfully., and any advice would be appreciated.

 

 

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Altostrata

Welcome, sunnylou.


We advise tapering one drug at a time. When you change the dosage of more than one drug at a time, you won't know where adverse symptoms come from. This creates a terrible mess.

 

It sounds like your body is still getting used to the gabapentin reduction. If I would you, I'd let that settle down until early May, then decide what you want to do.

Please read:

 

Tips for tapering off Risperdal (risperidone)

 

Tips for tapering off Neurontin (gabapentin)

 

What symptoms are each of these drugs supposed to address? Do you have adverse effects from any of the drugs you take? Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php and copy and paste the results in this topic.

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sunnylou

Drug Interaction Report

Drug interactions for the following 3 drug(s):

My Interactions List: (Unsaved)Email Print Save Start Over
amitriptyline
risperidone
Neurontin (gabapentin)
 
 Major (0)
 
 Moderate (3)
 
 Minor (0)
 
 Food (2)
 Therapeutic Duplication (0)

Interactions between your drugs

Moderate

amitriptyline  risperidone

Applies to: amitriptyline, risperidone

Using amitriptyline together with risperiDONE may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipationirregular heartbeat, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

Moderate

amitriptyline  gabapentin

Applies to: amitriptyline, Neurontin (gabapentin)

Using amitriptyline together with gabapentin may increase side effects such asdizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

Moderate

risperidone  gabapentin

Applies to: risperidone, Neurontin (gabapentin)

 
Using risperiDONE together with gabapentin may increase side effects such asdizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
 
Altostrata, Thankyou so very much. I am so relieved to hear from you. Hopefully I've done the above correctly.  I believe you're right. I am taking that on board.
I'm So worried about the future. It took me 3 years 7 months to taper off Diazepam 10mg after 9 years use which ended in 2015. However as I tapered off I developed chronic inner thigh pain to the point I could not sit or walk without pain. In the end I ended up on firstly Gabapentin (didnt nail pain), and Amiltriptyline (nailed pain) just before the end of the taper. No specialist can understand this leg pain so I'm still not sure if Diazepam withdrawal caused it. Hope this explains the situation. After Risperidone, and Gabapentin I will have to eventually see if I can ever withdraw from Amiltriptyline because of this as it was delibitating. I did feel slight discomfort in my leg when I cut this Gabapentin from 900mg to 600mg but it has dissipated and everything feels ok so far right now.
 
The Risperidone is for anxiety but it wasn't worth it. The anxiety of looking at tapering it is causing more anxiety than I ever had before it. So glad to be here but sad to see so many people suffering
 
 
 

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Altostrata

Thanks for the interaction report, sunnylou. Have you had any of those symptoms?

 

On 4/21/2018 at 6:08 AM, sunnylou said:

It took me 3 years 7 months to taper off Diazepam 10mg after 9 years use which ended in 2015. However as I tapered off I developed chronic inner thigh pain to the point I could not sit or walk without pain. In the end I ended up on firstly Gabapentin (didnt nail pain), and Amiltriptyline (nailed pain) just before the end of the taper. No specialist can understand this leg pain so I'm still not sure if Diazepam withdrawal caused it.

 

You are right to leave the amitriptyline for last, since that seems to help your pain. Since gabapentin doesn't seem to be helping, perhaps tapering off that won't cause any problems.

 

Going off drugs can cause muscles to be abnormally tense. Sometimes chiropractic, acupuncture, or osteopathic manual therapy can help.

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sunnylou
12 hours ago, Altostrata said:

Thanks for the interaction report, sunnylou. Have you had any of those symptoms?

 

 

You are right to leave the amitriptyline for last, since that seems to help your pain. Since gabapentin doesn't seem to be helping, perhaps tapering off that won't cause any problems.

 

Going off drugs can cause muscles to be abnormally tense. Sometimes chiropractic, acupuncture, or osteopathic manual therapy can help.

I have trouble concentrating and a bit of confusion now and again but thankfully not so affected by the rest of the side effects mentioned. I have been feeling the inner thigh/groin burning a bit last night. I hope I'm right about the Gabapentin not helping. I would love to taper this first but seeing as Risperidone is so scary and I've only been on it 9 months I think it might be best to deal with that first. 

 

Still got another week to judge whether I'm stable since the Gabapentin drop. My scales should be here today/tomorrow. I'm struggling with the maths though. I've been reading tips for tapering but because Risperidone is 1mg It seems harder. I will post the pill weight as soon as the scales arrive. Thanks Altostrata

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sunnylou

I hope I haven't messed this thread up. The drug interaction report seems huge. I'm not brilliant on a computer!

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sunnylou

My milligram scales have arrived. I have weighed the Risperidone. I weighed 7 tablets (1mg ingredients each)mgai?

0.201

0.209.         I added these together and devided by 7, which gave an average of 0.205

0.207

0.205

0.203

0.204

0.207

 

Is the sum to drop 10℅ this?    0.205 ÷ 1.0 x 0.9 =0.1845

 

Mostly the tablets are long and slender without a deciding line (made by accord). However I have been given 2 different makes (actavis, and Almas), which weigh about 0.93 so are half the size, small oval shape and have a deviding line. I'm hoping I won't have to use these to keep things simple but that depends on what they send me. I suppose as long as I can do the maths it won't be a problem.

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Altostrata
4 hours ago, sunnylou said:

Is the sum to drop 10℅ this?    0.205 ÷ 1.0 x 0.9 =0.1845

 

Hi, sunnylou. You're doing everything right.

 

The formula is 0.205 x 0.9 = 0.1845

 

0.185mg pill weight is 90% of the weight of your tablet. That would be the amount you would take. As your tablet is 1mg active ingredient, you would be taking 0.90mg Risperdal, a decrease of 110% or 0.10mgai.

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brassmonkey

Hi SunnyLou-- It looks like you're off to a good start.  Your calculations are correct, well done.  With having two different sized pills to work with you will have to do separate calculations for each different size.  Also it isn't a good idea to mix the two.  Many people seem to be sensitive to different manufacturers so there is a good chance that the different pills will affect you in different  ways at the same dose.  If they keep sending you a mix of brands let us know so we can try and figure out a good way to handle it.

 

Yes, that is the correct usage of mgai (milligrams active ingredient).  One of your whole tablets will contain 1mgai, while your new dose with the cut up tablets will have .9mgai.

The weight of the whole tablet is referred to as mgpw (milligrams pill weight) in this case the average pill weight is 205mgpw.  This is also used to refer to the weight that you measure on the scales for each dose. So your first reduced dose will be 185mgpw.  We always round up so 1845 becomes 185.

 

Brassmonkey

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sunnylou

Thankyou very much. Nice to meet you.  Now feeling somewhat near being able to start the taper very soon. So glad I found this site.

 I'm still stupidly however struggling to see what the formula for the second and third reductions would be though. I better not  put what I think it is to avoid confusing anyone. Once I can see a pattern I will be fine. Just want to be sureI know what I'm doing. Really pleased with the milligram scales. They cost only £13 free postage

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brassmonkey

Hi Sunny-- it's a really easy formula for the weight that you'd measure on the scale. This would be in mgpw (milligrams pill weight)

 

Current dose weight X .9 = 10% reduction

Current dose weight X .95 = 5% reduction

Current dose weight  .975 = 2.5% reduction

 

You would use a similar formula to determine the strength of the dose in mgai (milligrams active ingredient)

 

Strength of current dose X .9 for a 10% reduction

Strength of current dose  .95 for a 5 reduction.

 

For reference 100% minus 10% = 90% or .9

 

Hope that helps.

 

Brass

 

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sunnylou

Thanks! I am amazed at youre responses. How kind. I think I've got it. I might taper using mgpw. Thinking this seems straight forward. I'm really worrying about my different pill sizes. If my pills weigh:

0.205 and

0.093.    (2 different brands) are the smaller pills vertualy half the weight of the larger?  Would it work to say right the smaller pill is 50℅ smaller and taper the mgpw by exactly half. For instance if I was at 0.16mgpw with the larger, would it be ok to say 0.08mgpw.  as an easy rule of thumb? 

 

Or would I have to be more precise and use the formula, remembering how many 10% cuts from each? Has anyone else had this problem and managed fine around it?

 

I've been reading More about Risperidone withdrawal and it is very frightening. I hope I can get off this slowly but surely, and safely. 

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brassmonkey

Hi SunnyLou-- This is where it s going to get a bit tricky. The conversion factor between the two different tablets is 2.2:1 which is markedly higher that your estimated 2:1.  Enough so that there could be a real difference in the effects of taking doses of the same weight.  I need to work out some calculations using the Active Ingredient Concentration of each one to see what the difference really is, that's going to take a few hours. This is the first time I've run into trying to match doses from pills of different weights, but it can be done. The big question is how you react to pills from different manufacturers.  How do you get the pills, you mentioned that they were "sent to you"?

 

We end up making changes for just a few milligrams in pill weight to change the dose that we are taking so accuracy is very important.

 

Brassmonkey

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sunnylou

Hi Brass Monkey,  My Dr thinks I'm on 2mg but I never went up that far so I'm getting refills twice as quick but have built up a few boxes of these smaller pills I've never tried. I will take them for the next few days before starting to taper on the 1st May ( to check if they have the same effect). First I will actually ring the Chemist tomorrow just to check if its possible to stick with one brand. Wish I'd done that today. I've actually got 3 different brands here and sure I've had others. Its worth a go but I expect they'll have their excuses. If not I'm going to ask them how many different brands I could expect.

 

Thankyou for your help.. I will get back with the answers asap.

 

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sunnylou

Well I've just come off the phone to both Chemists in my vicinity and neither can guarantee which brand I will be sent.  Both say they get different brands themselves and are not guaranteed which make. Its so annoying. Preparing to taper is difficult enough without the tablet sizes changing, and maybe I might get numerous different sizes. I have 3 different ones at the moment. 

 

I have 82 accord 1mg   0.205

 

            40 actavis 1mg  0.0924

            20 Almus. 1mg. 0.0918

 

My next prescription is in 2 weeks time and could be any of these makes, and I should have asked them just how many different brands I could expect. Hopefully no more than these, and at least I'm getting double tablets (Dr thinks I'm on 2mg but am on 1mg), which means I can gather them each into their own collection to use in blocks rather than constantly switching. 

 

I really hope I get the Actavis ones sent in 2 weeks as they are bigger, easier to handle, and I already have 82 of them. 

 

Brass Monkey I appreciate you're help. I just averaged the weights of the smaller 2 makes using 5 tablets of each which I should have done in the first place. To be fair these 2 (actavis & almus) look exactly the same shape and size. I think they are identical. Even though I got two different averages. I hope I haven't ruined hours of you're time. 

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brassmonkey

Hi SunnyLou--  I multi task quite nicely so the time is no big deal.  I suspect that if you used a bigger sample to calculate your average weight for the Actavis and Almus that you'd get exactly the same number. So I wouldn't worry too much about them.  There is a good chance that they are made by the same people and just a different label put on the bottle. Sticking to one brand is going to be the best thing and using them in blocks, if possible would be a good way.  I am a bit worried about having to switch back and forth between blocks though, it could cause some sensitivity issues down the road.

 

ATM I'm thinking about maybe crushing some of each type and mixing the powder.  Then measuring your dose out of that.  It's sort of a last resort type of thing, but should work if it comes down to that.  Hopefully they will be consistent enough with what you get that you can build a nice stock pile and not have to worry about it.

 

Brassmonkey

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sunnylou

I'm wondering if writing down a whole tapering schedule for the 2 different tablet sizes alongside each other from the start would work? (to avoid panick later on)

 

Also struggling with rounding numbers. Do we sometimes round down as well as up? 

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brassmonkey

Rounding depends on how well a person tolerates their taper.  The general rule is to round up because it is conservative.  In some cases with rounding down it can cause to decrease to be more than the recommended 10% and the more sensitive members can have trouble with that.  When a taper gets to the very small doses toward the end the direction of the rounding can make quite a difference.  Personally I followed the rules of mathematics , above half round up below half round down, and didn't have any problems.

 

Seeing as you are starting at the 1mgai level, which would be considered small, it would be a good idea to always round up.

 

Writing down both tapers would make it easier to change between different tablets when it became necessary.  You'd have to pay attention not to weigh out your dose from the wrong records though.

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sunnylou

Hi. I've been stupid. I couldn't help trying to take my morning dose of Ggabapentin out. I was on 300mg am 300mg afternoon 300mg evening. I took the afternoon does out about 6 weeks ago, felt nothing. Then 12 days ago I stopped taking the morning dose leaving just 300mg at night.

 

I'm not feeling too great and am thinking of updosing but not sure how much to try. Has anyone got any advice? I should have been happy to be down to 2 doses a day and left it for now as I have started a Risperidone taper (only on first 10% cut from 1mg), 

 

I'm wondering if staying stable on Gabapentin would help whilst withdrawing the Risperidone?

Has anyone successfully got off Gabapentin?

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Gridley

 

10 hours ago, sunnylou said:

Hi. I've been stupid. I couldn't help trying to take my morning dose of Ggabapentin out. I was on 300mg am 300mg afternoon 300mg evening. I took the afternoon does out about 6 weeks ago, felt nothing. Then 12 days ago I stopped taking the morning dose leaving just 300mg at night.

 

I'm not feeling too great and am thinking of updosing but not sure how much to try. Has anyone got any advice? I should have been happy to be down to 2 doses a day and left it for now as I have started a Risperidone taper (only on first 10% cut from 1mg), 

 

I'm wondering if staying stable on Gabapentin would help whilst withdrawing the Risperidone?

Has anyone successfully got off Gabapentin?

 

SA recommends that you taper only one drug at a time.  So, yes, hold on the Gabamentin while you are tapering the Respiridone.

 

I will ask the other mods for a recommendation for the dosage to updose the Gabamentin.  Don't taper either any further until we get back to you.

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Altostrata

How exactly are you "not feeling too great"?

 

Please do not make any more drug changes for the time being.

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sunnylou

Thanks for your help. I'm having burning flashes all over body and arms on and off especially when stressed. Not all day but on and off. I'm finding it a bit hard to eat (nausea), and the most worrying is my heart keeps palpitating singular forceful perceivable thuds. This is on and off but noticeably when still and peacfull. Like when I'm trying to read. Also anxiety on and off especially upon waking. 

 

I will follow your advice and not make any changes

 

It feels the same as the benzo withdrawal. There are times during the day I feel quite normal aswell. So glad you do this to help people. 

 

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Altostrata

You might reinstate 100mg-150mg gabapentin in the morning. This topic explains how to take a smaller dose of gabapentin Tips for tapering off Neurontin (gabapentin)

 

Please do not make sudden, dramatic drug changes again.

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sunnylou

I won't. I feel a right idiot. I tried to put up with it but I couldn't and today have updosed 100mg Gabapentin in the morning. So that's 100mg am and 300mg pm I'm really scared, and so low right now. Its day one so am not expecting to feel immediatly better, and 100mg might not be enough.

 

I have to get stable so I can carry on tapering the Risperidone. Sorry Altostrata

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Gridley
5 minutes ago, sunnylou said:

 Its day one so am not expecting to feel immediatly better

 

 


It takes about 4 days for a dose change to get to full state in the blood and a bit longer for it to register in the brain. 

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sunnylou
17 minutes ago, Gridley said:


It takes about 4 days for a dose change to get to full state in the blood and a bit longer for it to register in the brain. 

 

Thanks Gridley. I thought I read that somewhere. So glad you confirmed this. It has helped my mental state a lot.

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sunnylou

I am panicking. Woke up burning all over upper chest, back, arms. Im wondering if I should have 150mg Gabapentin in the morning. Maybe 100mg won't be enough and I don't want to mess this getting stable up. 

 

I hope in 4 days I can be stable. I am catatonic right now. I've never faltered with this medication so I have only just realised how powerful it is, and it is a very terrible thought.

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sunnylou

Is there anyone around who could say what they would do in my situation? It would be greatly appreciated. Thanks.

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sunnylou

I stuck with 100mg Gabapentin this morning but Altostrata said 100-150mg so because I've started getting my bad leg pain, I better try 150mg.

 

I might have to stay on Gabapentin because of this leg pain, and it breaks my heart. The leg pain started half way through my Diazepam taper which ended 33months ago. Have seen lots of specialists but nobody can explain it. I believe its a varicose vein that runs down the back of my right thigh (the pain radiates down the inside and back of thigh, groin as well on a bad day). The vein specialist says veins don't cause pain. He had me checked out by a spinal surgeon. Had an MRI x rays alsorts. I could not sit down for 3 years. This was about age 42. I am 46 now.

 

I thought the Gabapentin wasn't helping this as I ended up taking Amiltryptline after this towards the end of Diazepam taper which worked so well I was astounded. Maybe the vein specialist was right. I wonder if it was the Diazepam withdrawal which damaged a nerve. I just hope I haven't compromised a very delicate balance and compromised my leg. For this reason I am worried sick right now. Been limping today, and haven't been like that in a while

 

 

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SkyBlue

Sunnylou, with gradual enough changes, a lot is possible. Try not to catastrophize about staying on the meds, especially when you are trying to stabilize. I know it seems like a long time, but your first post was just about a month ago. 

Slow and steady is the key. 

 

Do you have non-drug techniques for panic, like you wrote that you were experiencing? Please take a look at the Self-Care and Symptoms section of the forum--there is a lot of useful information there, including Non-Drug Techniques for Coping with Emotional Symptoms (pinned near the top).

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sunnylou

I'm sorry, I'm in a bit of a state, My body was burning up (chest, shoulders arms torso) upon waking each morning, and intermittently throughout the day, and my inner thigh pain was starting like when it first started, and was given Gabapentin, which worked well for it and also for my inability to sit at all due to pain and also inability to stand in the same position which is terrible as I have to keep moving. I was starting to limp, couldn't sit, and have spent lots of time on my bed to be pain free.

 

So basically I reinstated to my original dose I took for 4 years. 3 x 300mg a day. It has been 4 days now and still I have all the above. Because I haven't had to deal with all this leg pain for years, and its so apparent, I'm truly starting to believe I am now doomed, and will be unable to stabilize. Please don't be harsh as It will sting me physically. I'm fearing the worst. 

 

I'm worried about speaking to a Dr as they might not believe Gabapentin causes withdrawal. That's what I've read many times, and make me taper too quick which would probably do me in. So I'm not sure what to do. I couldn't eat at 300mg. I think it would make me close to bed bound as well. I cannot cope with this burning I really cant. I would welcome any responses. I really would. Feeling desolate right now.

I dropped from 3x 300mg Gabapentin approx 2 months ago to 2x300.

Then dropped to 1x300 about 3 weeks ago.

Then I tried 150mg + 300mg for a few days but was burning up.

Then panicked and went back to 3x300mg a day. This was 4 days ago

 

 

 

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Melissa5000

Helly sunnylou, thanks for stopping by on my thread. 

 

It seems that you and I are in the same boat now. I did not fully recover yet from my last updose of 25 mg lyrica but I did improve. 

It may take some more time. You were not too long out, so I would expect you to recover some in near future from your updose. 

 

Like you I am very unsure about my future. Right now I am very handicapped. Because of the pain I can barely use my hands/arms or walk. The tapering caused a lot of musclepain/nervepain and burning for me. My fingers are so painful! Like an inflammation. But they look normal.  My general practioner gave me a form and tomorrow I will do some bloodwork. 

 

 

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sunnylou
On 5/23/2018 at 10:20 PM, SkyBlue said:

Sunnylou, with gradual enough changes, a lot is possible. Try not to catastrophize about staying on the meds, especially when you are trying to stabilize. I know it seems like a long time, but your first post was just about a month ago. 

Slow and steady is the key. 

 

Do you have non-drug techniques for panic, like you wrote that you were experiencing? Please take a look at the Self-Care and Symptoms section of the forum--there is a lot of useful information there, including Non-Drug Techniques for Coping with Emotional Symptoms (pinned near the top).

 

Thankyou SkyBlue. I will check this out. Going to need something like this. Its my 5th day of updosing today so I'm hoping It could still improve. 😕

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sunnylou
2 hours ago, Melissa5000 said:

Helly sunnylou, thanks for stopping by on my thread. 

 

It seems that you and I are in the same boat now. I did not fully recover yet from my last updose of 25 mg lyrica but I did improve. 

It may take some more time. You were not too long out, so I would expect you to recover some in near future from your updose. 

 

Like you I am very unsure about my future. Right now I am very handicapped. Because of the pain I can barely use my hands/arms or walk. The tapering caused a lot of musclepain/nervepain and burning for me. My fingers are so painful! Like an inflammation. But they look normal.  My general practioner gave me a form and tomorrow I will do some bloodwork. 

 

 

 

Hi Melissa,

                  Thanks for replying. Its awful its affecting your hands and legs so much. I'm proper routing for you to improve.

 

I Can't believe how dangerous these meds are and yet they're been dished out every day. What's worse is when the Drs don't believe in all the withdrawals like you said your Dr said in your post. He dosent believe Amiltriptyline wd can last 8 months. I can! I've read most Drs don't believe Gabapentin withdrawals. Not sure what mine thinks yet. Im not in a hurry to find out. I really hope this can get better for you. I really feel for you. 

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sunnylou
On 5/22/2018 at 9:09 PM, Gridley said:


It takes about 4 days for a dose change to get to full state in the blood and a bit longer for it to register in the brain. 

 

Dear Gridley,

                     I am on day 6 of updosing. I updosed back to 3 x 300mg my long time dose.  I have realised that I need this Gabapentin because it stops me being disabled by terrible leg/buttock pain. I have been unable to sit for the last week which is why I was prescribed it. I thought the Amiltriptyline was doing all the pain killing see. I wish I never tried to get off it. I'm worried as it doesn't seem to be working as well. Do you think there's still time yet? I'm still getting flashes of burning sensations on chest, shoulders, and arms. 

 

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Gridley

Are your symptoms worse, better or about the same as before you updosed?

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