mkat71: Liquid risperidone

[mkat71]

bump

[mammaP]

Hi Mkat, glad that your risperdone taper is going well. Have you thought about holding your 

risperdone taper and starting to taker the fluvoxamine rather than tapering concurrently? 

It would be less stressful for your nervous system and as you get lower you should see 

the side effects get easier as they are usually dose related. 

[mkat71]

Hi mammaP...thanks for your reply. Yes, I have thought of holding the risperidone. The problem with that is if I hold too long at a particular dose of risperidone, I start to feel pain and discomfort from the medicine. As it builds up in my system I start to feel a tight "compressed" feeling in my brain, like the risperidone is squeezing my brain. That's always a sign that I'm ready for a dose reduction. If I could tolerate the physical pain of the medicine I would be willing to hold it while tapering another drug. But it's intolerable.

 

Perhaps I could alternate between drugs, like taper the fluvoxamine for awhile, then stop and taper something else. But again, it's that holding of the risperidone that is the problem. I would have already switched temporarily to tapering another drug if it hadn't been for that physical pain. That pain made me decide I had to keep going with the risperidone taper. But it's taking such a long time. I can only reduce a little at a time. Nowhere near 10%. More like 3%.

[Altostrata]

From the drug interactions checker mentioned long ago in this post http://survivingantidepressants.org/index.php?/topic/4145-mkat71-liquid-risperidone/?p=85604

 

http://www.drugs.com/interactions-check.php?drug_list=1128-0,1832-0,2019-0&types[]=major&types[]=minor&types[]=moderate&types[]=food&professional=1
 

 

Interactions between your selected drugs

perphenazine ↔ risperidone

Applies to: perphenazine, risperidone

MONITOR: Agents with anticholinergic properties (e.g., sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal muscle relaxants; tricyclic antidepressants; disopyramide) may have additive effects when used in combination. Excessive parasympatholytic effects may result in paralytic ileus, hyperthermia, heat stroke, and the anticholinergic intoxication syndrome. Peripheral symptoms of intoxication commonly include mydriasis, blurred vision, flushed face, fever, dry skin and mucous membranes, tachycardia, urinary retention, and constipation. Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures. Central nervous system-depressant effects may also be additively or synergistically increased when these agents are combined, especially in elderly or debilitated patients. Use of neuroleptics in combination with other neuroleptics or anticholinergic agents may increase the risk of tardive dyskinesia.

MANAGEMENT: Caution is advised when agents with anticholinergic properties are combined, particularly in the elderly and those with underlying organic brain disease, who tend to be more sensitive to the central anticholinergic effects of these drugs and in whom toxicity symptoms may be easily overlooked. Patients should be advised to notify their physician promptly if they experience potential symptoms of anticholinergic intoxication such as abdominal pain, fever, heat intolerance, blurred vision, confusion, and/or hallucinations. Ambulatory patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them. A reduction in anticholinergic dosages may be necessary if excessive adverse effects develop.

References

1. Kulik AV, Wilbur R "Delirium and stereotypy from anticholinergic antiparkinson drugs." Prog Neuropsychopharmacol Biol Psychiatry 6 (1982): 75-82
2. Hvizdos AJ, Bennett JA, Wells BG, Rappaport KB, Mendel SA "Anticholinergic psychosis in a patient receiving usual doses of haloperidol." Clin Pharm 2 (1983): 174-8
3. Mann SC, Boger WP "Psychotropic drugs, summer heat and humidity, and hyperplexia: a danger restated." Am J Psychiatry 135 (1978): 1097-100

View all 15 references

Switch to consumer interaction data

perphenazine ↔ fluvoxamine

Applies to: perphenazine, fluvoxamine

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

 

 

My guess is you are experiencing a drug-drug interaction. When you reduce the risperidone, it gets better for a little while, then it sets in again.

 

My guess is if you reduce the perphenazine, you will have fewer reactions from the other drugs.

 

Are you taking anything else? Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html (or edit the list I used at the link above) and post the results in this topic.
 

[mkat71]

Hi Alto...

 

I'm only taking these three: risperidone, perphenazine, and fluvoxamine. Once in a blue moon when I am weathering a tough withdrawal (after dropping a dose), I might take a small dose of Ativan.

 

I don't see anything in those drug interactions that correlates to the physical "compression" I feel from too much risperidone. I've tried risperidone in the past when I was not taking any other drugs, and it seemed to have the same physical effect on me. Like a vice clamp on my brain. I am inclined to think that is the physical mechanism of that drug, and the way I personally experience it. 

 

Immediately after making a drop in risperidone, I naturally don't feel it as strongly. Then as I stay at the new dose for several days, it builds up in my system and I begin to feel the effects of the drug. That pain I feel has always been the best indicator that I am ready for a dose reduction. I actually look forward to it for that reason.

 

I think I'm just one of those people that is very physically sensitive to drugs, especially brain-altering (and disabling) drugs.

[Altostrata]

Perhaps that's so.

[mkat71]

Hi everyone. I've been doing very well with my taper, but 10 days ago I got off track for the first time in months, and I'm now scrambling to contain the damage and not lose too much of my progress.

 

It was Sunday, October 5th that I got off track. I ran out of my (very) expensive compounded medication. I lacked ONE capsule in order to make it to Monday to get my check to pay for a new refill. It was the weekend, and I had no choice but suffer through Sunday night at a lower dose than I was ready for. Monday came along, and instead of immediately making up for the missed dose, I decided to try and make the new lower dose work. That was a mistake. Now I'm chasing my tail trying to get caught up.

 

Over the last 10 days I have gone from 1.09375 mg back up to 1.25 mg, and I may need to go higher. I am trying to hold steady at 1.25 mg starting today (instead of taking haphazard doses at irregular times in an attempt to make it to dose time, and raise the level of medicine in my system).

 

I take two doses a day (8 am & 8 pm), split equally. I barely made it to dose time this morning after a rough night, and I figure if I can make it to 8 pm tonight without taking an extra dose (or a benzo) I've got it made. Hopefully from there the medicine will slowly build up in my system if I take the same amount every day at the same time, and I will get stable again and back on track.

 

It's 3:30 pm, and the suspense is enormous, wondering whether I'll make it to dose time, and wondering whether I should have taken more this morning, and whether I'm getting even further off track by trying to force this dose to work.

 

I know nobody but me can really answer this, but should I hang tough at this dose? At what point do I decide I don't have enough of the drug in my system to make this dose work, and increase the dose? How much do I increase to get back on track?

 

I've been doing well on my own for a long time now, but today I could use some wisdom from you kind souls who have been through this sort of thing more than I have. Thanks.

[mammaP]

It's a shame that one days altered dose has caused all this after you have been doing so well! 

I suspect that if you hold at the current dose you will stabilise, but switching doses will be destabilising your

nervous system even more.  If you can hang in there things will settle down again. You need to leave about 

4 weeks between cuts, you can leave longer between cuts but cutting too soon means your brain hasn't time to

adjust to the new dose before another cut. This can cause problems further down the line. 

 

I hope you feel better very soon, let us know how it is going. 

[mkat71]

Hi mammaP, thanks so much for your reply. It seems that maybe today I have "stopped the bleeding" and contained the damage. It's almost evening dose time, and I am so happy to be feeling that physical pain I feel when I am taking too much risperidone. That is a sign that I have "hit the ceiling" and will be ready soon for a med drop. It's 7:45 pm (15 minutes before dose time), and I'm not feeling wear off from the medication, only physical pain.

 

All this year I've been making drops of .03125 mg, which is about 1.5% of my original dose. These small drops have enabled me to make more frequent cuts. When I begin feeling a tight, "compressed" pain in my head from the risperidone, it's always a sign I'm ready for a drop. That pain has typically been occurring between 5-7 days after I make a cut, so in my case, I can't wait 4 weeks between cuts, because it would be agonizing to be in that much pain.

 

The only question I am pondering now is whether to take the same dose tomorrow as I took today. Today I maxed out at 1.25 mg, which apparently is the current "ceiling." If I take the same dose tomorrow, the pain will only be worse, and I have a quiz in one of my classes. So I have to choose wisely. I may take just a fraction (.03125 mg) off of the morning dose and hold steady at that new dose (1.21875 mg) until I feel pain again. The only concern is if I'm ready to make that drop. That's always the question. All I know is I don't want the physical pain to get worse.

[Petunia]

Hi mkat,

I'm sorry we didn't get back to you in time for your dose.  What did you decide to do and how did it work out?  I hope you did well in your quiz.

[mkat71]

Hi Petu,

 

Sorry, didn't see this post from last month. Things seem to be back to normal. I stayed at 1.25 mg for a week, and then began descending again. I'm now at 1.15625 mg, and am trying to be more careful now. I hope to be down to 1 mg by the holidays.

 

When I get to 1 mg, I'm planning on holding for a while and turning my attention to the antidepressant in my three-drug cocktail. My prescriber has agreed to help me taper the Luvox, and I wanted to get some advice about my plan from the wise folks here.

 

My prescriber suggested to first switch from Luvox to Prozac, because Prozac has a longer half life. He has already provided a supply of 10 mg capsules, which I haven't started yet. Then after I am used to the Prozac capsules we're planning on switching to liquid Prozac to make tapering easier.

 

Does this sound like a wise plan of action? Thanks.

[mkat71]

Hi Petu,

 

Sorry, didn't see this post from last month. Things seem to be back to normal. I stayed at 1.25 mg for a week, and then began descending again. I'm now at 1.15625 mg, and am trying to be more careful now. I hope to be down to 1 mg by the holidays.

 

When I get to 1 mg, I'm planning on holding for a while and turning my attention to the antidepressant in my three-drug cocktail. My prescriber has agreed to help me taper the Luvox, and I wanted to get some advice about my plan from the wise folks here.

 

My prescriber suggested to first switch from Luvox to Prozac, because Prozac has a longer half life. He has already provided a supply of 10 mg capsules, which I haven't started yet. Then after I am used to the Prozac capsules we're planning on switching to liquid Prozac to make tapering easier.

 

Does this sound like a wise plan of action? Thanks.

 

bump

[mkat71]

 

Hi Petu,

 

Sorry, didn't see this post from last month. Things seem to be back to normal. I stayed at 1.25 mg for a week, and then began descending again. I'm now at 1.15625 mg, and am trying to be more careful now. I hope to be down to 1 mg by the holidays.

 

When I get to 1 mg, I'm planning on holding for a while and turning my attention to the antidepressant in my three-drug cocktail. My prescriber has agreed to help me taper the Luvox, and I wanted to get some advice about my plan from the wise folks here.

 

My prescriber suggested to first switch from Luvox to Prozac, because Prozac has a longer half life. He has already provided a supply of 10 mg capsules, which I haven't started yet. Then after I am used to the Prozac capsules we're planning on switching to liquid Prozac to make tapering easier.

 

Does this sound like a wise plan of action? Thanks.

 

bump

 

 

Could anyone (not just Petu) give me feedback about my plan to switch from Luvox to Prozac, and taper from the liquid form? Does that sound like a wise course of action?

[Petunia]

Hi mkat,

Glad to hear that things are back to normal and you are well.  I'm sorry, it looks like its just me with a comment for now.... and all I can do really is post you some links to help you make your decision because I have no personal experience with luvox, or using the prozac bridge.

 

We usually recommend trying to taper off the AD you are currently on, rather than changing to another kind for tapering because:

 

A direct taper from the drug to which your nervous system is accustomed carries less risk than a switch to a new drug This is the "the devil you know is better than the devil you don't know" rule.

 

Please see:  The Prozac switch or "bridging" with Prozac    (Substituting one medication for another for easier tapering)

 

But on the other hand:

 

Luvox's half-life is the shortest of all SSRIs and it is well known to incur withdrawal symptoms.

 

Please see:  Tips for tapering off Luvox (fluvoxamine)  for information about how to safely taper directly from Luvox.

 

If I were in your situation, I would try tapering directly off Luvox first, you may have no problems.  The issue with its short half life can be overcome by halving your dose and taking it twice a day.

 

But this is your decision.

 

If you switch to Prozac, what is the plan for the actual switch?  Is there going to be some overlap with taking Prozac and Luvox at the same time?  What dose are the Prozac capsules you have been given?  What dose of fluoxamine are you on now, please would you add your dose to your signature?

 

I hope others have some more feedback for you

 

Petu.

[degen12]

It is fairly common (although stupid, IMO) for two neuroleptics to be prescribed in tandem. Having taken both risperidone and perphenazine, I can relate, somewhat.

 

Risperidone, at even small doses (0.5 mg), made my muscles stiff and painful (EPS).

 

I tolerated perphenazine much better, and took it as needed.

 

The *insert SSRI, in your case Luvox* --> Prozac can be done, but why don't you try and taper Luvox first? Prozac can take up to a month to reach steady-state in your brain, requiring taking extra Prozac during the beginning of your taper to avoid acute withdrawal. All SSRIs are not made equal, Luvox is a sigma-1 agonist and has inhibiting properties (behaviorally). Prozac is a mild sigma-1 antagonist, a 5-HT2C antagonist, a mild NRI, and is, in my personal experience, more agitating than Luvox.

 

A more interesting aspect for me personally is how some SSRIs reach different levels in different areas of the brain. I will dig up a citation if anyone is interested.

 

Sheesh. I just noted how many drugs I can add to my "have tried" repertoire after even a short stay at a psych ward.

[mkat71]

Petu and degen12,

 

Thanks so much to the both of you. I'm really glad I asked for advice from you all before taking my doctor's. 

 

Splitting up the Luvox sounds like a good plan, Petu. I think there is a liquid form of it. I'm at 25 mg right now, which is the lowest pill increment. I guess compounding is an option, but that sure is expensive, as I've learned from tapering risperidone. My doctor was thinking 25 mg Luvox was roughly equivalent to 10 mg Prozac, so his idea was switching over directly, but as you both are indicating, that may not be the best idea.

 

I want to be slow and careful, because I don't want to get PGAD, which I think I experienced years ago. At the same time, I'm getting older all the time and losing out on my life by taking these drugs, so I hope it doesn't take years and years, like the neuroleptics in my cocktail.

 

Degen, I can totally relate to your reaction to risperidone. My muscles are so stiff I dread walking five blocks to the bus stop. I used to love going for walks, but not anymore.

 

I'll keep you all posted on my progress. Thanks again. (If anyone else wants to chime in on this topic that would be great.)

[mkat71]

I just learned that there is no liquid form of Luvox, so I may have to go through with the Prozac switch after all. I'm on 25 mg Luvox, and have been for a long time now. I think my doctor wants me to do a sudden shift to 10 mg Prozac capsules. Some sources say 25 mg Luvox is the same as 10 mg Prozac, other sources seem to disagree. What is the best source to determine equivalencies?

[mkat71]

Hi everyone...I'm still trying to get some feedback regarding my plan to begin tapering Luvox (or Prozac, if I decide to switch over).

 

I am on 25 mg Luvox. I have been at this dose for a long time now. I would prefer to not make a dangerous switch to Prozac, which my doctor is recommending. The problem then is, how on earth do I taper from Luvox? The page on this site regarding Luvox tapering is not particularly helpful, because it doesn't explain how to taper 10% from 25 mg, which is the smallest pill increment. Other than going the expensive and frustrating "compounding" route, there is no other way that I know of. Cutting a 25 mg pill in fourths would be too much of a drop. And I just found out there is no liquid Luvox, which is very disappointing to me. So is making an expensive, compounded liquid version of Luvox the only way?

 

If that is too expensive, that then leaves switching to Prozac, which obviously has its share of potential problems. I think my doctor wants me to switch directly from 25 mg Luvox to 10 mg Prozac capsules, then move on to liquid Prozac for the taper. I have seen different sources give different equivalencies for Luvox and Prozac. Some say that 25 mg Luvox is equivalent to 10 mg Prozac. Some say 25 mg Luvox is equivalent to 5 mg Prozac. Which source do I trust?

 

So to sum up, tapering directly from Luvox is best, but how do I do it affordably? And if I make the Prozac switch, how do I know what the equivalent dose is? Furthermore, what if I begin tapering Luvox only to find the short half-life makes tapering impossible? Switching to Prozac in the middle of a botched Luvox withdrawal is worse than switching over when I am stable, as I am now. 

 

Thank you all. I need help with this. 

[Altostrata]

From Tips for tapering off Luvox (fluvoxamine)

 

Do-it-yourself liquid
You may be able to make a liquid with immediate-release tablets and water. A liquid makes it easier to titrate by small, controlled amounts.

It is "sparingly soluble" in water, see http://www.drugbank.ca/drugs/DB00176 -- stability (shelf-life of dilution) is unknown. As traces are found in municipal water supplies http://cfpub.epa.gov/ncer_abstracts/index.cfm/fuseaction/display.abstractDetail/abstract/1755/report/F
it is somewhat stable, but degraded by light.

See How to make a liquid from tablets or capsules

[mkat71]

Thank you.

 

Does anyone have any information about my other question, about contradictory equivalencies between Luvox and Prozac? Some sources say 25 mg Luvox/10 mg Prozac, others say 25 mg Luvox/5 mg Prozac. Which source is correct? (In case I decide or need to make the Prozac switch)

[Petunia]

I found several sources which stated 25mg of Luvox is equivalent to 10mg of Prozac.  According to drugs.com, the starting pediatric dose of Luxox is 25mg and the starting pediatric dose of Prozac is 10mg.

 

I only found one site which suggested 25mg of Luvox is equivalent to 5mg of Prozac, but that same site said 50mg of Luvox is equivalent to 20mg of Prozac, so that doesn't really add up. (http://www.crazymeds.us/pmwiki/pmwiki.php/MedClass/SSRIPoopOut#_note-14)

 

Unless someone else has other advice, I would go with 10mg being the closest equivalent dose.

 

Of course if you did switch to prozac its possible 5mg would be enough, then you would have less to taper off. 

[degen12]

The affinity of Luvox, (in Ki, nmol/L) for the serotonin transporter is 11. The affinity of Prozac for the serotonin transporter is roughly 6 (once again, in Ki, nmol/L). A lower number means a higher affinity for the transporter and greater potency. Complicating the issue is the incredibly twisted pharmacokinetics of Prozac and it's active metabolite, which inhibit each other's metabolism, have extremely long half-life's and potentially continue to increase in tissue concentration for a full month. Compared this to 4 to 9 days for Luvox.

 

I found Prozac to get progressively stronger the longer I took it. Much like Luvox, higher doses are disproportionately more potent on a mg per mg basis. I don't think it will be as easy as switching over to an "equivalent dose" and moving forward from there. You might try 10 mg of Prozac first, and then play it by ear and decrease the dose to 5 mg when you feel SSRI start-up effects. That is just a suggestion, and the staff should of course reign supreme here...

[mkat71]

Thank you all for your help.

 

I'll have to decide on my own whether to taper directly off Luvox or do a Prozac switch. I guess there's no way to know which is "better." I'm looking into the financial feasibility of having a Luvox liquid compounded for me, in case I decide to do a direct taper. I don't trust my own ability to accurately make my own liquid.

 

It seems reasonable that it would be better to taper off the same drug I'm on, although I may find out when it's too late that that's not the case. 

 

I should never have started Luvox three years ago. I may be in for much more than I'm aware of.

[mkat71]

Hello everyone...

 

Been a long while since I've posted. My risperidone taper is going well, albeit slow-going. I am now down to .875 mg. When I hit 1 mg, I found that the .03125 mg I was reducing by had become too large of a cut, and so I cut that amount in half, and am now reducing by .015625 mg. That's a percentage cut of about 1.5%. I find when I get past 3%, I start having a harder time making cuts. For me, 3% or less seems to be the magic number.

 

Anyway, I have decided to hold the risperidone for a bit and work on tapering the fluvoxamine in my cocktail. (I am going to go back and forth between the two, between cuts.) I really didn't know whether that 3% or less cut would apply as equally to antidepressants as it would for neuroleptics, since they are different animals, and working on different receptors.

 

So I decided to take a chance and go with a 10% cut. I was on 25 mg fluvoxamine, so I went down to 22.5 mg, and split the dosage into twice a day because of the short half-life. This is my fourth day at 22.5 mg (11.25 mg x 2), and it seems to be going ok, after a mildly rough first day.

 

My only real complaint is I am dragging a bit, and maybe feeling a bit of "withdrawal depression." Not crippling, but noticeable to others at times. I also have a bit of "pressure" in my head, and don't feel quite myself, but that could equally be because I have been holding the risperidone too long.

 

I am not used to withdrawing from antidepressants, and don't really know what to expect. A few questions:

 

--Do any of you have any advice about what signs I should look for that say I am stable and ready for another drop?

 

--How long do I give it before knowing I have perhaps taken too big of a cut?

 

--If a 3% or less cut applies to neuroleptics for me, does the same apply to antidepressants?

 

I appreciate any feedback. Thanks!

[mkat71]

bump

 

 

 

[Adagiooo]

Hi Mkat71,

 

I've been following your thread and it seems as if your taper is going well, congratulations. I hope this continues for you.

 

I,too, am trying to taper from risperdal, but I'm using the liquid. I'm making very small cuts but I'm finding that with each cut I lose about an hour of sleep. Are you experiencing anything similar?

[mkat71]

Hi Adagiooo,

 

I tried to use the liquid when I was at 2 mg Risperdal, but I got way off track somehow, because the equivalencies between liquid and tablets didn't seem to be the same. I also couldn't get a steady amount of liquid measured out each day because of air bubbles. I just found it very difficult, so I went back to tapering from tablets, but I started using a compounding pharmacy, and that has been the key to my success so far.

 

Anyway, to answer your question, I don't really have a problem with sleep. I guess it's because the amount I'm tapering by is so small. I actually find that when I hold at a particular dose long enough, I start feeling so much discomfort from the built-up dose of medication that I have trouble sleeping, and a dosage cut will be the answer.

 

How much are you tapering by? i.e. How big/what percentage are your cuts? And, very importantly, how many days are you waiting before making a drop? If you're not waiting long enough, you won't be ready for a drop, and you will lose sleep.

[mkat71]

Hi Mkat71,

 

I've been following your thread and it seems as if your taper is going well, congratulations. I hope this continues for you.

 

I,too, am trying to taper from risperdal, but I'm using the liquid. I'm making very small cuts but I'm finding that with each cut I lose about an hour of sleep. Are you experiencing anything similar?

 

 

Hi Adagiooo,

 

I tried to use the liquid when I was at 2 mg Risperdal, but I got way off track somehow, because the equivalencies between liquid and tablets didn't seem to be the same. I also couldn't get a steady amount of liquid measured out each day because of air bubbles. I just found it very difficult, so I went back to tapering from tablets, but I started using a compounding pharmacy, and that has been the key to my success so far.

 

Anyway, to answer your question, I don't really have a problem with sleep. I guess it's because the amount I'm tapering by is so small. I actually find that when I hold at a particular dose long enough, I start feeling so much discomfort from the built-up dose of medication that I have trouble sleeping, and a dosage cut will be the answer.

 

How much are you tapering by? i.e. How big/what percentage are your cuts? And, very importantly, how many days are you waiting before making a drop? If you're not waiting long enough, you won't be ready for a drop, and you will lose sleep.

[mkat71]

Hello everyone...

 

Been a long while since I've posted. My risperidone taper is going well, albeit slow-going. I am now down to .875 mg. When I hit 1 mg, I found that the .03125 mg I was reducing by had become too large of a cut, and so I cut that amount in half, and am now reducing by .015625 mg. That's a percentage cut of about 1.5%. I find when I get past 3%, I start having a harder time making cuts. For me, 3% or less seems to be the magic number.

 

Anyway, I have decided to hold the risperidone for a bit and work on tapering the fluvoxamine in my cocktail. (I am going to go back and forth between the two, between cuts.) I really didn't know whether that 3% or less cut would apply as equally to antidepressants as it would for neuroleptics, since they are different animals, and working on different receptors.

 

So I decided to take a chance and go with a 10% cut. I was on 25 mg fluvoxamine, so I went down to 22.5 mg, and split the dosage into twice a day because of the short half-life. This is my fourth day at 22.5 mg (11.25 mg x 2), and it seems to be going ok, after a mildly rough first day.

 

My only real complaint is I am dragging a bit, and maybe feeling a bit of "withdrawal depression." Not crippling, but noticeable to others at times. I also have a bit of "pressure" in my head, and don't feel quite myself, but that could equally be because I have been holding the risperidone too long.

 

I am not used to withdrawing from antidepressants, and don't really know what to expect. A few questions:

 

--Do any of you have any advice about what signs I should look for that say I am stable and ready for another drop?

 

--How long do I give it before knowing I have perhaps taken too big of a cut?

 

--If a 3% or less cut applies to neuroleptics for me, does the same apply to antidepressants?

 

I appreciate any feedback. Thanks!

 

Does anyone have any response to these questions?

 

I am also concerned about what my luvox taper is doing to my sexual functioning. I was pretty numb sexually at 25 mg luvox, but after 5 days at 22.5 mg, I have absolutely NO sensation at all. I would have thought it would be the opposite.

 

Does this suggest I took too big of a cut, or could this possibly work itself out over time?

[Adagiooo]

 

Hi Mkat71,

I've been following your thread and it seems as if your taper is going well, congratulations. I hope this continues for you.

I,too, am trying to taper from risperdal, but I'm using the liquid. I'm making very small cuts but I'm finding that with each cut I lose about an hour of sleep. Are you experiencing anything similar?

 

 

 

 

Hi Adagiooo,

 

I tried to use the liquid when I was at 2 mg Risperdal, but I got way off track somehow, because the equivalencies between liquid and tablets didn't seem to be the same. I also couldn't get a steady amount of liquid measured out each day because of air bubbles. I just found it very difficult, so I went back to tapering from tablets, but I started using a compounding pharmacy, and that has been the key to my success so far.

 

Anyway, to answer your question, I don't really have a problem with sleep. I guess it's because the amount I'm tapering by is so small. I actually find that when I hold at a particular dose long enough, I start feeling so much discomfort from the built-up dose of medication that I have trouble sleeping, and a dosage cut will be the answer.

 

How much are you tapering by? i.e. How big/what percentage are your cuts? And, very importantly, how many days are you waiting before making a drop? If you're not waiting long enough, you won't be ready for a drop, and you will lose sleep.

Sorry Mkat71 but I didn't see your response till just now. Thanks for answering my post. My last drop was from 1.25 mg to 1.10 mg. and I've been holding for a month and a half

 

I'm in a bit of a pickle because the Risperdal is causing severe neuropathic pain in my feet. It so severe that I'm in intense pain all day long and nothing has worked for it including mag, ibuprophin, Tylenol, ect. That's why I had to drop from 1.25 to 1.10 to try to relieve the pain. So I believe my holds are long enough but this last drop is a little more than I wanted to cut.

 

I only have access to either pills or liquid and so far the liquid has been the best option.

 

Again thanks for your response but I very much afraid that i won't make it off of this drug. I'm also dealing with benzos the seem to be reaching tolerance but I don't want to hijack your thread.

 

I wish you the best of luck in beating this devil medication, you seem well on your way so I know you'll make it.

 

Adagiooo

[Altostrata]

Hello, mkat, how are you doing now?

 

It sounds like your nervous system did feel that small reduction in fluvoxamine, did that sort itself out shortly?

[mkat71]

Hello, mkat, how are you doing now?

 

It sounds like your nervous system did feel that small reduction in fluvoxamine, did that sort itself out shortly?

 

Hi Alto,

 

Sorry, didn't see your post. Yes, it did sort itself out. I'm down to 20 mg Luvox, from 25 mg. So far it's going very well.

 

My risperidone taper is also going well. I'm down to .75 mg now. The compounding has proven to be the way to go for me. I'm SO grateful to you for that suggestion. I can't thank you enough.

 

mkat71

[mkat71]

Hello everyone,

 

Been close to a year since I posted. I graduated from music school and have several music related jobs, so things are going well as I keep on with this endless tapering process.

 

I've been diagnosed for a second time (or third if you count the agreement of my pdoc) with Asperger Syndrome, which explains my whole life, and adds a new wrinkle to the tapering situation, as my nervous system is clearly uniquely sensitive.

 

I haven't made much progress with my risperidone. I am at .8203125 mg, and am stagnating. The compounded capsules are expensive, and I wish I could get down to .5 mg so I could hold steady at a affordable dose (the manufacturer makes .5 and .25 mg pills, which my insurance fully covers).

 

I have made a lot of progress with my Luvox taper, and am down to 2.5 mg from 25 mg at this time last year.

 

But I don't seem to solidly be at 2.5 mg yet. I've been making it a couple of days, then I will feel like I haven't quite made the drop, so I will take an extra 1.25 mg to "ease the fall" a bit, and proceed with 2.5 mg. This morning I woke up two and a half hours before morning dose time, and can't go back to sleep. I don't know whether this is withdrawal related, or some kind of underlying state of being.

 

I don't know whether to just wait and let this sort itself out at 2.5 mg, and put up with the lack of sleep, or to go back up to 3.75 mg. I need sleep, especially considering the sensory overwhelm I experience when tired.

 

Does anyone who has experience tapering antidepressants have any feedback?

 

Thanks.

[mkat71]

Hello everyone,

 

Been close to a year since I posted. I graduated from music school and have several music related jobs, so things are going well as I keep on with this endless tapering process.

 

I've been diagnosed for a second time (or third if you count the agreement of my pdoc) with Asperger Syndrome, which explains my whole life, and adds a new wrinkle to the tapering situation, as my nervous system is clearly uniquely sensitive.

 

I haven't made much progress with my risperidone. I am at .8203125 mg, and am stagnating. The compounded capsules are expensive, and I wish I could get down to .5 mg so I could hold steady at a affordable dose (the manufacturer makes .5 and .25 mg pills, which my insurance fully covers).

 

I have made a lot of progress with my Luvox taper, and am down to 2.5 mg from 25 mg at this time last year.

 

But I don't seem to solidly be at 2.5 mg yet. I've been making it a couple of days, then I will feel like I haven't quite made the drop, so I will take an extra 1.25 mg to "ease the fall" a bit, and proceed with 2.5 mg. This morning I woke up two and a half hours before morning dose time, and can't go back to sleep. I don't know whether this is withdrawal related, or some kind of underlying state of being.

 

I don't know whether to just wait and let this sort itself out at 2.5 mg, and put up with the lack of sleep, or to go back up to 3.75 mg. I need sleep, especially considering the sensory overwhelm I experience when tired.

 

Does anyone who has experience tapering antidepressants have any feedback?

 

Thanks.

 

bump

[nz11]

mkat thanks for taking the time to update.

Hey why you having such big gaps between postings.

 

You are doing amazingly well.

25mg to 2.5mg of luvox is a fast taper ...well a fast taper by sa recommendations. Are you able to put in your sig how you accomplished that?

Are you dropping 2.5mg per month? just a guess.

When did you do the drop to 2.5mg and from what dose did you drop ?

 

If you drop again to 1.25 that will be a 50% cut . That could well prove a too big a drop.   As you know it is rec to do a 10% cut of the previous dose not 50% cuts.

Maybe you have you been dropping at 10% drops of the 25mg each month ?

 

Many are finding these small doses tricky hurdles so i reckon you might like to do an extra long hold on current dose and when tapering again taper at 10%. People are taking it below 1mg before jumping off.

 

So yeah i would hold or if you did  a too big a drop in the last few days then maybe a slight updose is on the cards. Do you think this instability could have been due to a past respiridone drop?

 

Sorry you had to bump your thread to get a response ...intros are disappearing to page 2 at amazing speed these days! I see no sign of that slowing down either.

 

Hope you dont wait another 9months to post again.

[mkat71]

mkat thanks for taking the time to update.

Hey why you having such big gaps between postings.

 

You are doing amazingly well.

25mg to 2.5mg of luvox is a fast taper ...well a fast taper by sa recommendations. Are you able to put in your sig how you accomplished that?

Are you dropping 2.5mg per month? just a guess.

When did you do the drop to 2.5mg and from what dose did you drop ?

 

If you drop again to 1.25 that will be a 50% cut . That could well prove a too big a drop.   As you know it is rec to do a 10% cut of the previous dose not 50% cuts.

Maybe you have you been dropping at 10% drops of the 25mg each month ?

 

Many are finding these small doses tricky hurdles so i reckon you might like to do an extra long hold on current dose and when tapering again taper at 10%. People are taking it below 1mg before jumping off.

 

So yeah i would hold or if you did  a too big a drop in the last few days then maybe a slight updose is on the cards. Do you think this instability could have been due to a past respiridone drop?

 

Sorry you had to bump your thread to get a response ...intros are disappearing to page 2 at amazing speed these days! I see no sign of that slowing down either.

 

Hope you dont wait another 9months to post again.

 

Hello,

 

Thanks so much for your reply, and sorry for only now getting back to you.

 

I may have dropped out of sight for awhile because I was having trouble getting people to respond, so I just went my own way. I was also involved with graduation and getting some new jobs, so it's been a busy and exciting year.

 

I lost a friend whom I met on this site. We became friends and were helping each other (by phone) because our stories and situation were so similar. He tragically died in a car wreck two days after Christmas. He was struggling with a neuroleptic taper too, after having suffered a botched benzo withdrawal.

 

Anyway, to answer your question about the Luvox, yes, I started making drops of 2.5 mg a month, but would usually kind of split the month in two by going down roughly half the month by 1.25 mg. It has worked really well, but predictably, it has become more difficult the closer I get to the end. (I have found it much easier to get off Luvox than the risperidone, but I was at a comparatively higher dose of Luvox than I've been at with the risperidone throughout this year.)

 

I have temporarily gone back to 3.75 mg because I'm having a difficult time making it to 2.5 mg. I will hold for awhile, I don't know how long. I am using compounded capsules, and am down to the increment of 1.25 mg (either twice or three times a day), and thought I was very close to being done. But the home stretch is the toughest part.

 

I'm very anxious to be done with the Luvox because it's very expensive to use compounded capsules, and I am also working on the risperidone, and am down to an extremely expensive variety of compounded risperidone capsules, and am not making progress, but stuck at this expensive combination. (.125 mg capsules, .03125 mg capsules, .0078125 mg capsules.) And I need to get started tapering my perphenazine, which I haven't even started (4 mg). It is causing me the most misery regarding muscle stiffness.

 

So that is where I am at. I may have to make smaller drops from the 3.75 mg. I have actually not made a risperidone drop in almost a month. I always alternate between the two, so as to not do two at once, but with the drop down to 3.75 mg Luvox toward the end of January, I ended up doing both at about the same time. It just worked out that way that I had to do both, based on financial and physiological reasons.