whatisbrain: Acceptable rate of risperidone reductions based on Horowitz paper

[whatisbrain]

Hello all. First, I apologize for not having a more extensive withdrawal schedule in my signature, but unfortunately I haven't kept records and have forgotten when or how I got off some previous medications I was on. At this point I have one left, Risperidone .875 mg (.5 mg pill, .25 mg pill, and half a .25 mg pill, altogether .875 mg per day). This is the dose I have been taking for the last three months, and I have not had any symptoms during that time. I have read Mark Horowitz's amazing paper on hyperbolic tapering, and its "Supplemental" link on the left has a clear chart for Risperidone reductions that step down receptor occupancy slowly. What I didn't see in the paper, perhaps because I missed something while reading, is how long to stay at each level. Of course everyone's brain adjusts differently, but just a general idea - is a few weeks enough if one is feeling stable, or is a few months between each level change necessary. Here is a link to the paper:

 

https://academic.oup.com/schizophreniabulletin/article/47/4/1116/6178746

 

The charts for dose level vs. receptor occupancy for many drugs are listed in tables in the link on the left where it says "Supplemental"

 

Thank you all in advance.

Edited August 21, 2021 by manymoretodays
added name to title

[Onmyway]

Dear Whatisbrain, 

welcome to SA. I think in that paper they mention 25-50% every 3 months or 10% every month (abstract). Nobody has done research on what is optimal and even if they did, optimal may vary for various people - I am currently only able to go about 3-4% a month at the lower doses of citalopram. 

 

My suggestion would be to go as slow as possible if you are not experiencing serious medication side effects and minimize the chance of withdrawal. If you had been prescribed antipsychotics for psychotic episodes, if you go too fast and that causes psychosis you may risk being put into hospital or forced the drugs or may believe that you need them forever. You may be told that you have relapsed and need life-long treatment. If that was not a danger then I'd suggest trial and error - try 10% a month and see if that is ok and if it becomes too hard, go slower. 10% a month seems tolerable to most people here. 

 

There is also a smoother method - Brassmonkey's slide taper in this forum. You decrease by 2.5% every week and then hold for 2 weeks. I currently do 0.5% every 4-5 days. It's snail's pace and it's frustrating but I have emotional symptoms still and some insomnia so need to do it this way. 

 

That's the best guess that I can provide until more studies are done. 

OMW

[whatisbrain]

Thank you, that is very clear and helpful.

[Ariel]

Hi @whatisbrain

Stopping by your thread to see how you're feeling. 

You haven't posted in a while, though it looks like you're keeping your drug signature up to date.

No pressure for an update if you don't feel like writing. 

Just to say I'm thinking of you and appreciate your contributions to the site. 

Wishes of peace and healing, 

A. 

[whatisbrain]

Hi Ariel, thanks for asking. I am doing fine. My digestive issues have ceased, so my sleep is no longer interrupted by them, and my memory function is improving as well, even though it's nowhere near what it used to be. I have a new situation not only in health, but also in housing, in both family and romantic relationship developments, and in spiritual matters, all going great, just couldn't be better. Thank you so much for your support.