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Whitelily: trying to withdraw from an antipsychotic (amisulpride)

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whitelily

I've been on antipsychotics for nearly 20 years after I had a psychotic breakdown whilst I was taking an antedepressant and experiencing several major life stressors.  I've tried to withdraw numerous times but have always become psychotic very quickly.  My memory has been affected, I now have diabetes and my weight soared as I put on 10 stone. 

 

I'm here because several people recommended this site.  I currently take 300mg amisulpride plus medication for diabetes, high blood pressure and high cholesterol.

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Jemima

Hello, Whitelily, and thank you for the intro post.

 

Our forum is about helping people get off of psychiatric drugs as safely and comfortably as possibly, so if you're looking to get off the amisulpride (usually called Risperidone or Risperdal here in the U.S.), you came to the right place.  Here is our topic on getting off that particular drug:  Tips for Tapering Off Risperdal

 

I'm sorry to see that you're suffering from some very common side effects of atypical antipsychotics, namely a large weight gain and diabetes.  These are well-known side dangers of these drugs.

 

I think that after you've done some reading on this forum you may begin to question the diagnosis of "psychotic".  Many of our members have suffered from such mislabeling of their condition, which has often been caused by going off psychiatric drugs too fast or being put on a drug cocktail with a bad mix of drugs.  Quite a few people here have been diagnosed as bipolar, when in fact, they were hyperactive due to antidepressant withdrawal syndrome. Most doctors don't know anything more about psychiatric drugs than Big Pharma tells them, and you can bet the drug companies downplay the bad side or just plain hide information about serious side effects including the difficulties involved in getting off these drugs.

 

When you have time, please put your drug history in your signature.  Directions here:  How To Add Your Drug History To Your Signature

 

Welcome to the forum.  You'll find lots of good information and friendly support here.

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Altostrata

Welcome, Whitelily.

 

Errrr...amisulpride is a different drug from risperidone -- but the principles are tapering are the same.

 

We recommend a cautious taper of 10% per month. Your first decrease would be to 270mg, dropping 30mg. The second decrease of 10% would be calculated on the last dosage, 270mg, for a drop of 27mg and dosage of 243mg. And so forth, the amount of decreases getting smaller.

 

This enables you to watch for symptoms and, if necessary adjust your dosage to keep your nervous system relatively stable.

 

I see that amisulpride comes in a liquid form in the UK http://www.drugs.com/uk/amisulpride-100-mg-ml-oral-solution-leaflet.html

 

Using the liquid to taper makes precise dosing easier.

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Petunia

Welcome Whitelily,

 

I'm sorry that medications have caused increasing health problems for you, its a common situation with many of our members.  As Jemima suggested, have a look around, you will find a lot of good information.

 

 I've tried to withdraw numerous times but have always become psychotic very quickly.

 

How have you tried to withdraw in the past?  When you say you become psychotic, what symptoms do you experience?

 

Petu

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whitelily

hi Jemima, thanks for your post.  I was going to write that Risperidone is a different drug, however, Altostrata has beaten me to it - amisulpride is not licensed in the US - I am in the UK.

 

I realise now that I should have put in my title the name of the drug amisulpride  do you or anyone reading this know If its possible to edit the title?

 

Thanks. 

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whitelily

Hi thanks for your replies.  I'm having a bit of pc trouble at the moment so I hope this reply posts ok.

 

Thanks Altostrata for your thoughts and advice.  Unfortunately my last psychiatrist would not prescribe amisulpride as a liquid because he said that it would not make any difference at such low doses.  Faced with this, I tried to taper by cutting down my tablets and got to 150mg before becoming very ill and suicidal.  I attempted suicide and after recovery, with some liver damage, a different psychiatrist bullied and coerced me into taking 600mg.  I immediately began putting on more weight and found it very difficult to function mentally. 

 

I am currently stable on 300mg which I have done myself by cutting tablets.  I am still trying to lose the weight that I gained.  However, I am concerned at the moment because I have an uncomfortable feeling in the left hand side of my chest, which I don't know if its related.

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whitelily

hi Petu - what's happened in the past when I've tried to withdraw is that when I've got to a certain dose, I've very quickly become mentally unwell starting with insomnia, waves of acute hearing and feeling very tense/alert, rapid onset of paranoia with ideas of reference and then full blown delusions.   

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Petunia

I changed the title for you Whitelily.

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whitelily

Thanks very much Petu - much appreciated.

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tezza

hi Petu - what's happened in the past when I've tried to withdraw is that when I've got to a certain dose, I've very quickly become mentally unwell starting with insomnia, waves of acute hearing and feeling very tense/alert, rapid onset of paranoia with ideas of reference and then full blown delusions.

 

This is an indication that you've been tapering faster than your brain can adjust to reductions. The brain (CNS) needs time between drug decreases to adjust.

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whitelily

Thanks for writing tezza.  I must admit that I became very down today because I haven't successfully found anyone on the internet who's managed to withdraw from a similar dose of amisulpride. 

 

I am going to keep to 300mg for another few weeks I think, because just recently I've noticed that I've been talking too much!  It's as if my brain has speeded up since I last reduced the dose several weeks ago, and I've felt more stressed.  This is despite the fact that I used to be on 200mg before the hospital psych upped the dose to a 600mg which was way too much, last year, undoing all the good work I'd done. 

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Jemima

I think what you've experienced is drug withdrawal symptoms, not psychosis. Just my personal opinion, but I suggest reading this topic and deciding for yourself:  What Is Antidepressant Withdrawal Syndrome?  You'll also find member intro topics in which a lot of members report similar symptoms.

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Jemima

Welcome, Whitelily.

 

Errrr...amisulpride is a different drug from risperidone -- but the principles are tapering are the same.

 

We recommend a cautious taper of 10% per month. Your first decrease would be to 270mg, dropping 30mg. The second decrease of 10% would be calculated on the last dosage, 270mg, for a drop of 27mg and dosage of 243mg. And so forth, the amount of decreases getting smaller.

 

This enables you to watch for symptoms and, if necessary adjust your dosage to keep your nervous system relatively stable.

 

I see that amisulpride comes in a liquid form in the UK http://www.drugs.com/uk/amisulpride-100-mg-ml-oral-solution-leaflet.html

 

Using the liquid to taper makes precise dosing easier.

 

 

hi Jemima, thanks for your post.  I was going to write that Risperidone is a different drug, however, Altostrata has beaten me to it - amisulpride is not licensed in the US - I am in the UK.

 

I realise now that I should have put in my title the name of the drug amisulpride  do you or anyone reading this know If its possible to edit the title?

 

Thanks. 

 

I apologize for the mistake. I Googled the drug yesterday evening and what the results actually said is that amisulpride is in the same class of drugs as Risperidone (atypical antipsychotics), not that it's the same thing.  Maybe I should turn off the computer after a certain numbers of hours sitting and staring.

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Rhiannon

hi Petu - what's happened in the past when I've tried to withdraw is that when I've got to a certain dose, I've very quickly become mentally unwell starting with insomnia, waves of acute hearing and feeling very tense/alert, rapid onset of paranoia with ideas of reference and then full blown delusions.   

 

That sounds like a nutshell description of withdrawal syndrome to me. I've been there, it's hell. I have to agree that you might want to question your diagnosis.  

 

The initial "psychotic breakdown" took place while you were on, or had been on, other psych meds as well (AD) it sounds like. I don't think it's possible to accurately diagnose a psychiatric condition in someone who is taking or has recently been taking mind-altering drugs.

 

I would highly recommend getting hold of a copy of Anatomy of an Epidemic (by Robert Whitaker), for yourself, to learn about these drugs, the history of how we ended up with them and why doctors and psychiatrists are so ignorant of (and in denial of) their dangers.

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Altostrata

That psychiatrist is wrong, as usual. You can continue to try to get him to prescribe the liquid so you might reduce your dosage -- point out the possibility of cardiac adverse effects.

 

Or, you can make your own. You can make a suspension with water -- amulsipride is somewhat soluble in water http://www.scbt.com/datasheet-203510-amisulpride.html

 

See How to make a liquid from tablets or capsules

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whitelily

Thank you for your replies.  It's such a relief to be understood by people who have had similar experiences or knowledge ofand not dismissed.  I have been trying to remember what happened when I originally had a psychotic breakdown and remember it was after being prescribed Prozac.  I think that I may have tried stopping the drug - it's so long ago I'm not sure.  I am not sure whether its worth getting copies of my medical notes - but it would cost a lot.  I am realising that this whole psychotic illness may have been triggered by a combination of stress and iatrogenic illness caused by the AD and then AP. Certainly, the psychiatrists seem to agree that I am on too low a dose for effective treatment of schizoaffective disorder which is what they diagnosed me with and yet I function better at this dose, but get into problems when I try and cut the dose, which I'm realising I probably did too quickly .

 

Three weeks ago  I started taking a high dose of Vitamin C - about 1500mg and noticed a significant difference - I felt much more motivated whereas before weeks and months and years had gone by in a haze of apathy.  Because this was so successful, I have been introducing vitamin B Complex in the hope that it will help with such awfully poor stress tolerance - at the moment its B-50 but I think that I will up it to B100 at some point, because I read that this a recommended dose on an orthomolecular website.  I have also started Omega 3 oils as I craved fatty foods like cream, cheese, and nuts.

 

However, I have found carb cravings really problematic (as I am diabetic).  Eating too many ultimately makes me feel ill although I really crave them, so I have been trying to fill up with more protein and have found out that a deficiency of Magnesium may be involved from searching online, so I am thinking of taking this. 

 

I'm hoping that all the above measures will stabilise my weight and give my body and brain a boost, helping with my overall recovery.   My current weight is 20 stones and because I had problems with chronic apathy and lack of motivation for so many years, I am extremely unfit. 

 

The only problem with implementing the above is the cost, as my budget is very restricted.

 

Thanks for your recommendation to go back to the psychiatrist Altostrata.  At the moment I have no confidence in my local mental health service.  When I write I am able to edit my posts to be more articulate, but when I've been in meetings with pdoc's and nurses I have frequently come away feeling stigmatised and I have found it very difficult to argue my case because I haven't been able to remember all the relevant facts.  I will have a look at what's involved in making a suspension with water - thanks for suggesting this.

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whitelily

oops - sorry, double post

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Altostrata

The drugs may very well have added to your blood sugar dysregulation.

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whitelily

Thanks for your reply.  Yes, I know that I became diabetic because of antipsychotics (it's not in my family other than very late age onset maternal grandmother) - in addition most of my weight gain has been on my torso, abdomen and upper arms (not my pre-drug natural shape).

 

Just to update,  I'm now regularly taking Vitamin C, Omega 3 fish oils and Vitamin B Complex.  I'm now feeling significantly more relaxed.  I have had some tummy trouble due to diet changes - more vegetables, berries, protein - less carbs.  Just waiting now to feel better for a couple more weeks before I try to cut the dose from 300mg. 

 

Not sure whether to try and use a digital scale or dilute the tablets.   

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Jemima

Thanks for your recommendation to go back to the psychiatrist Altostrata.  At the moment I have no confidence in my local mental health service.  When I write I am able to edit my posts to be more articulate, but when I've been in meetings with pdoc's and nurses I have frequently come away feeling stigmatised and I have found it very difficult to argue my case because I haven't been able to remember all the relevant facts.  I will have a look at what's involved in making a suspension with water - thanks for suggesting this.

 

You might try making a list of the relevant facts and take it with you.  I find I can usually only remember three important things at a time, even less when I'm tense, so I've often taken a list of questions along with enough space to jot down the answers.  My doctor doesn't seem to mind this at all.

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whitelily

Just to update.  I didn't manage to reduce my dose.  I don't know why I'm stuck on this level of antipsychotic now - it used to be that I managed on 200mg before a psychiatrist put me up to 600mg.  Now I don't seem to be able to get below 300mg.  When I reduced it to 270mg after some time I began having symptoms of psychosis, so I upped the dose.  Then after a while of taking 300mg again  I got a kind of brain fog where I find it more difficult to get things done and concentrate and I still get breakthrough symptoms which is very frustrating.

 

I have found taking a high dose of vitamin C helpful for motivation, but I'm having marked memory problems. 

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Altostrata

You may be able to tolerate a smaller decrease, 5% or less.

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Rhiannon

Did you manage to figure out how to make a liquid? If you can make a liquid you can try reducing by 1 mg at a time, very very slowly and with intermittent holds. 

 

I'm concerned about the long term health consequences that you are experiencing as well as these powerful cognitive side effects. Even if you end up staying on meds, it seems to me that you might want to find the lowest possible dose that you can be stable on. To do that, you may need to cut more slowly and in smaller increments.

 

As an example, I've tapered Lamictal from 200 mg to 57 mg over four and a half years. I've done it 1 mg at a time. It's possible to taper very slowly. If you're facing being on this medication for life, with its severe side effects, it might be worth considering trying a very, very slow taper.

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whitelily

Thanks for your replies Altostrata and Rhi  ... it's making me think that perhaps I could try again but with a much smaller reduction.  I can't help wondering and thinking what it could be that's causing these underlying symptoms though.  I have wondered about the possibility of brain parasites - an icky subject I know, but parasites are supposedly very common and I read an article somewhere in my research that said that perhaps antipsychotics actually reduce parasitic activity. 

 

I think I may try an herbal parasite cleanse like Humaworm as well as perhaps a much smaller reduction.  I was doing it by cutting the tablets before.  I've bought a digital scale so I could try crushing the tablet.

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Rhiannon

I would recommend looking into making a liquid, it's much easier to get accurate cuts that way. Cutting the tablet without using a scale will not give you accurate dosing--that may be part of your problem, your doses may be varying so much they're causing you problems.

 

With the scale, when I was using one, I used a nail file to file off part of the tablet. The math is complicated with a scale though and if you're having cognitive problems you'll need to be very careful with that. Be sure to get somebody to double check it, unless you're very confident about math, in which case double and triple check it yourself. (I am speaking from personal experience from back when I started my taper, not because I have doubts about you in any way.)

 

I would not do a reduction and a cleanse at the same time. Those cleanse things can be pretty strong. It depends on what herbs are in them. Herbs can be very potent.

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Meimeiquest

I've heard that celiac disease can cause psychosis. It happened to a friend, before I knew her. Do people get celiac in the UK?

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Rhiannon

Also, I work in medical lab, and I know medical science doesn't know everything, but brain parasites? very uncommon, even in the tropics where parasites are much more common than they are in more northern latitudes. I think that's probably one of the least likely explanations for your symptoms.

 

You're tapering an antipsychotic, in large increments, by cutting tablets (so hence getting wobbly inaccurate dosing). That alone would explain your symptoms quite well and I think is far more likely to be the problem. It's certainly easier to fix, so I'd address that first.

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whitelily

It's been a while since I've been here, just to update ... I'm at 250mg of amisulpride. 

 

I've made a couple of changes in my personal life where I was experience a lot of emotional and mental stress .... it has involved stopping social contact with a couple of people which has been a relief, and also giving up a religious belief.  I'm still looking at why these relationships and issues were so stressful, but I've noticed I feel more able to focus on recovery. 

 

I'm continuing to take omega oils, extra Vitamin C and a multivitamin and extra magnesium since in my own case these seem to have been beneficial - particularly the vitamin C and the omegas.

 

I want to see if there's anything extra I can take to aid detoxing (I have a lot of belly fat), and I'm considering taking something natural to help with sleep - I've read something about GABA being helpful.  I've also read on the website The Road Back that they recommend a supplement to support nerve function in the brain and am wondering if that would be a good idea.  It's also whether it's affordable. 

 

A month ago I switched to eating only whole foods and really reducing carbs (due to diabetes) and have lost 5lbs in that time.

 

It's frustrating when progress is so slow to withdraw and also lose weight, but I'm feeling much more positive having incorporated the above changes.     

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Meimeiquest

Congratulations! I was a Zyprexa girl......and a whole lot more. But I do know about weight gain on APs, and I gained even more after stopping Zyprexa and Wellbutrin. I think I have just been flooded with cortisol, and although my blood sugars go up at high-cortisol times, particularly first thing in the morning and after exercise, I haven't developed diabetes. In late June I started the paleo autoimmune diet and I have lost almost twenty pounds (around 10 kg?) and my brain fog and anxiety are much, much better. I have also been taking, like you, orthomolecular supplements. Of course, I can't really recommend till all the weight is off :). But I do feel your pain on this.

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whitelily

Hi Meimeiquest, thanks for your reply.  It's encouraging to hear of someone who's managed to withdraw from an antipsychotic. 

 

I noticed that you mention the Walsh Protocol - was that after you withdrew from all antipsychotics - I wasn't quite sure from reading your signature? 

 

I googled  Walsh Protocol and saw that there is a book out and wondered if you know whether it gives specific recommendations for diet or supplements if you have psychotic symptoms?

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Meimeiquest

I went to Walsh doctors in May of this year, I stopped Zyprexa in Dec. 2012. As you can see, I am still fighting it out with lithium and a benzo. Walsh's book was very interesting to me, but it is not a how-to book, it's more of an indexing of biological abnormalities that they deal with and how they are generally treated. I think they keep their formulas pretty close to the vest, which is probably wise since the doses are pretty high. If it is something you want to research for free, there are videos posted at mensahmedical.com. Walsh's website lists some practitioners they have trained. Another option is to order testing and a phone consult at Pyroluriatesting.com, I think they work internationally?

 

Based on blood test results, they do have some dietary recommendations, none for me. There are general recommendations in the intro packet for basically whole foods.

 

The supplements have really helped me, but my blood tests were not very abnormal, not what they expected. My biggest problem is that drugs and supplements that affect certain hormones and neurotransmitters make me crazy and are progressively affecting me more when I run into them, and like everyone here, it is really tough for my brain to have psychotropic drugs taken away. Obviously there is a cause, but I don't know what it is. I took Nuvigil on a Monday, a drug I used to tolerate, and went into an anxiety tailspin. Saw them on Thursday, still a mess, and I don't think they could believe a drug reaction was the cause. Nor my pdoc. Whatever.

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whitelily

Hi Meimeiquest, - Thanks for sharing about how you've been finding the Walsh Protocol.  I contacted a doctor in Ireland - Dr O'Flaherty and he said that if I went to see him it would cost about £400 which would include tests.  However, he said that in his experience people on antipsychotics have had to maintain a low dose.  I suppose a low dose is better than a higher dose, but it's not really what I want.  He mentioned that copper toxicity could cause problems with mental health and I'm just been reading a bit about this online. 

 

I have also been reading a bit more about amisulpride itself and, if I've got this right, it seems to be different from other antipsychotics because it switches at 200mg in the way that it affects the brain's receptors.  To be honest I have to admit that I'm having a lot of trouble understanding remembering and understanding the explanations for what happens (which I know years ago I would have been ok with and certainly would not forget 2 seconds after reading).  But I'm mentioning this for anyone who comes across this thread - as this seems to be key to why I hit so many problems when I drop below this dose. 

 

Symptoms I'm having at the moment are apathy and lack of motivation to shower and keep up with housework, as well as lack of interest in things, and I'm still waking up early with a dry mouth. 

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Meimeiquest

You've clearly done a lot of thinking and studying. I will write later when I have time.

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whitelily

Hi Rhi,

 

I'm sorry - I've just been rereading my thread and I've realised that I hadn't got back to you after you were kind enough to write.  I will get myself organised so I can make up amisulpride up into a liquid as soon as I get to 200mg so that I can taper much more gradually from then on in.  I did the Humaworm treatment as I had already bought it and it went ok - I just felt rough for a while.  I appreciate what you have said though, about parasites being unlikely to have caused psychosis - I just wanted to rule it out as I had such huge weight gain and had trouble controlling my appetite.  But I realise this is all bound to be due to amisulpride aswell as previous use of antipsychotics.       

 

Another thing I have forgotten to mention here was that I saw my GP last week and talked with her about whether I could be referred to psychiatrist Joanna Moncrieff in London who is linked with the Council for Evidence based Psychiatry which is reporting on side-effects of psych meds as well as the fact that antidepressants are no more effective than placebos.  My GP has written a letter, but thought that she may just say no as I'm out of her area.   If that happens, I'm not sure whether to try and contact her for a private consultation or see whether it's possible to see David Healy - although he's a long way away from me. 

 

I'm getting a bit more desperate to get support outside of my mental health team (who've totally undermined and blocked my efforts to get off the medication) as I'm very aware of memory problems I'm experiencing added to all the other side-effects.  I've read about antipsychotics inducing dementia.  I've got years and years that I can't remember which is obviously a concern and after twenty years of being on psych meds I'm wondering if I'm just getting my hopes up too much by wanting to completely withdraw but I think about this every day.  Because of memory problems, I can't recall a lot of my medical history so I think I might have to pay to get hold of copies of my notes.   

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Altostrata

Dr. O'Flaherty may have been unsuccessful getting people off antipsychotics because he didn't taper them gradually enough.

See http://www.washingtonpost.com/national/health-science/a-psychiatrist-thinks-some-patients-are-better-off-without-antipsychotic-drugs/2013/12/06/547f5680-48aa-11e3-a196-3544a03c2351_story.html

After 20 years, you may no longer have a condition that warrants medication.

 

If Dr. Moncrieff cannot see you, she might be able to recommend a colleague http://www.ucl.ac.uk/slms/people/show.php?personid=11975

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whitelily

Hi Altostrata, thank you very much for the link to that article - I was very interested to read about the man who found that he would experience something of a relapse after each reduction before becoming stable again and fine on the lower dose.  I think that's what's been happening to me up till now.  Perhaps it's because of I've been on meds for so long - I wouldn't be surprised if my brain has shrunk.  So everything points to me just having to accept that my taper needs to be really gentle in very small steps - perhaps smaller than 10%.  Because I'm so aware of some issues though like memory and the diabetes, plus the fact that I'm not working and getting nearer to age 50, I just keep wanting to rebel and in desperation make sudden cuts or stop dead - I feel very frustrated.  I have to keep reminding myself that a small drop that I can maintain, is better than a bigger drop which could lead to a relapse or hospitalisation. 

 

I really hope that I get positive news from Joanna Moncrieff.  I don't want to see the local mental health team again.  The last time I discussed changing my med with a psychiatrist there he arbitrarily decided that he would prescribe double the dose of another antipsychotic (Abilify) and from then on, I totally lost any confidence in him.  I was also uncertain about switching to Abilify because I thought that it affected more receptors than amisulpride and therefore might give me more issues on withdrawal - but having said that my hair is receding quite quickly lately and that keeps sending me into a panic. 

 

Thanks again for replying. 

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