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gladtobehere1984

gladtobehere: Switching antipsychotics

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gladtobehere1984

Hi everyone,

 

Thank you first of all for this helpful forum. My question is about switching antipsychotics.

 

About 4 weeks ago, I was hospitalized due to a psychotic episode, and in the hospital I was given 20mg of haloperidol and akineton to go along with that for 3 weeks. That stabilized things, but also gave me extreme akathisia and dystonia, along with an "always on" confusion state.

 

So when I got out, I visited a psychiatrist. He said he would switch me to Abilify monthly injection, and that I should reduce the dosage of Haloperidol to 5mg (which I did), keep using haloperidol for 2 more weeks and while also getting the Abilify injection and then drop the haloperidol.

 

I however do not want to go on an injection type of drug. The reason is it is planned for 2 years at least, but most probably for life.  I have high hopes for my recovery and am doing something called Focused Listening which seems to have helped some people. I don't want to resign to the idea that I'm a schizophrenic for life, by accepting a life long injection.

 

So I told him I want to switch to Abilify pills (which he refused to do), and thus now I plan to switch to Risperidal (available over the counter, and I have some experience using it in the past)

 

Right now I'm stable on 5mg of haloperidol, and I checked the dosage equalivancies from here https://academic.oup.com/schizophreniabulletin/article/40/2/314/1944491 and found that 2.5 mg of Risperidone would equal to 5mg of haloperidol.

 

My question is, would it be ok if I used 5mg of haloperidol for 2 more weeks like the doctor suggested, and at the same time start the risperidone 2.5mg(I already started), and when the 2 weeks are over simply continue with the 2.5 mg risperidone?

 

My reasoning behind this is when the therapy I'm working with starts showing results, I'll gradually taper the 2.5mg risperidone. I think it'd be much easier to taper that than an injection type of drug.

 

I would really appreciate your thoughts on this. Thank you.

 

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Petunia

Welcome Gladtobehere,

So sorry you are finding yourself in this difficult situation. I know how awful akathisia is as I've had it myself. Has reducing your dosage of Haloperidol helped at all?

 

Unfortunately, we can't give advice about switching medications, we only offer support and information related to safely coming off them. I'm surprised to hear that Risperidal is available over the counter in your country, it's prescription only in most parts of the world.

 

Personally, I also would not like to accept any medication by long acting injection, if there is a bad reaction, you have no alternative but to wait until it wears off. Perhaps you will be able to manage your symptoms with a lower dose of what you are currently taking and the program you have started.

 

Could you look for a different psychiatrist, one who will work with you and respect your wishes.

 

You might find some useful tips here:  How do you talk to a doctor about tapering and withdrawal?

 

I'd highly recommend reading Anatomy of an Epidemic by Robert Whitaker. Psychiatric drugs can cause harmful side effects and long term, they can worsen health, increasing the risk of other illnesses. They don't cure anything, but work by creating a chemical imbalance in the brain, which alters natural brain function. For some people, these changes may seem helpful. But evidence is starting to show that long term, they cause more harm than good. From personal experience, my own research, and reading thousands of anecdotal stories, I've come to the conclusion that psychiatric drugs should only be used in the most serious of cases and then for the shortest possible amount of time. But you do need to find other ways to manage any difficult emotions and behaviors if you are going to come off your medications.

 

Other resources you may find helpful are Your Drug may be you Problem by Dr. Peter Breggin and Council for Evidence Based Psychiatry

 

The Icarus Project   Hearing Voices Network   Beyond Meds   Bipolar or Waking Up

 

I wish I had more to offer in support of your plans, it does sound like a good long term goal and I wish you well.

 

Please stay in touch and let us know how you are.

 

Petunia.

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gladtobehere1984

Petunia thank you very much for your warm welcome and helpful reply.

 

To my surprise I found that Abilify pill form is also sold without a prescription here, so I might go with that. That way I might not have completely refused the doctors prescription but also not be forced to an injection.

 

One question, in your experience here, have you seen that it is easier to withdraw from Risperdal vs Abilify? Or vice versa?

 

Cheers

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arwilliams

Risperdal/Risperdone has affinity for h1 receptors so I wouldn't take that which means you might stop sleeping with out it eventually.  Abilify is likely better of the 2.  That is interesting you don't need a prescription for abilify.  You definitely do in the USA.

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Altostrata

Welcome, glad.

 

Please Google for a method called cross-tapering, which is the best way to change psychiatric drugs.

 

As Petunia said, we don't do drug switches here unless it's for the purpose of going off the drugs. Drug switches can be hard on your nervous system.

 

There is no antipsychotic that is easier to taper than another. They are all high-risk drugs. You have already had a sample of adverse effects, they could get a lot worse. No one should be taking them for insomnia.

 

The injectables gradually wear off, so you might say they taper themselves. However, once they wear off, we have seen some people still get withdrawal syndrome from the absence of the drug.

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Songbird
19 hours ago, gladtobehere1984 said:

I have high hopes for my recovery and am doing something called Focused Listening which seems to have helped some people. I don't want to resign to the idea that I'm a schizophrenic for life, by accepting a life long injection.

...

My reasoning behind this is when the therapy I'm working with starts showing results, I'll gradually taper the 2.5mg risperidone.

 

I really like your attitude about not letting one psychotic episode be a life sentence on meds, and finding non-drug ways to help yourself instead.

 

Please keep us updated with your progress.

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gladtobehere1984
Quote

The injectables gradually wear off, so you might say they taper themselves. However, once they wear off, we have seen some people still get withdrawal syndrome from the absence of the drug.

 

Thank you for all of your replies, they are very helpful.

 

Altostrata, you said that the injectibles taper themselves off. I'm wondering if that applies when I would be getting a monthly injection for some months as well? So say I got the injection for 12 months, would withdrawing then be just as easy as not getting a further injection on the 13th month?

 

If that's the case then maybe I should go with the injection for 12 months and then I can simply stop it when the right time comes and not have to deal with tapering as in pills?

 

Did I get you right or am I missing something? Do injections basically (usually) not need tapering?

 

Thank you

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ChessieCat
12 hours ago, Altostrata said:

The injectables gradually wear off, so you might say they taper themselves. However, once they wear off, we have seen some people still get withdrawal syndrome from the absence of the drug.

 

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gladtobehere1984

 

2 hours ago, ChessieCat said:

 

So would it mean one has to do a seperate taper for injectables as well(possibly by using pills) or am I right to understand that if you are using injectables you simply stop and hope that withdrawal symptoms don't happen? If so, that sounds too good to be true to me. Btw, the reason I'm asking these questions is because I'm trying to decide between Abilify pills vs injection. Whichever one would be less hassle to taper off would be my choice. Injectable sounds easier but I need to be sure before I commit to it.

 

Thank you

 

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Songbird

I think the advantage with pills is that you would be able to control the rate of your taper.  If you started having withdrawal symptoms you could slow it down accordingly.

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Altostrata

I updated Tips for tapering off aripiprazole (Abilify) to include the injectable forms.

 

The injectable forms deliver a huge amount of drug at once. I would not do this except as a very last resort, and only if I already know I can tolerate Abilify.

 

gladtobehere, I would not request an injection for the convenience of tapering. You might end up with tardive dyskinesia.

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gladtobehere1984

Thank you everyone and Altostrata. I'm planning to go with the pills as of now. Cheers

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arwilliams

You are very smart to do this research before starting the medications.

 

Everything has withdrawals and it is rather hard to compare issues because everyone experiences them differently, but they sedating ones are definitely on my do not take recommend list.

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