Jasmine Risperidone Tapering / Withdrawal

[Jasmine]

     I am here hoping to find out a few answers for my son. He is 20 years old. He was on Risperidone 4.25mg for approximately 3 years. In January 2015, at my sons request it was reduced to 4mg and stayed there for 3 months. (positive results) His Psychiatrist wanted to reduce his Risperidone to 3mg, we felt that was to fast. I mentioned that most people reduce at 10% or less. He said your son is a good size 350lbs+ it won't be to much, a 1mg reduction. Well due to my hesitation, it got reduced to 3.5mg for 30 days and then the Psy wants it reduced to 3mg for another 30 days. It has been 33 days now, I feel the reduction is to much. Still at 3,5mg. There has been more positive results, answers his name more quicker now, laughing, been out on a few walks and has started to watch TV again, been about 3 years.......In the last week or so, he has started getting full of anxiety/worrisome, repeating questions over and over until he is sure of my answer, there is a bit of pacing too. So I am wondering perhaps if his reductions are to much?

[Petunia]

Welcome Jasmine,

Thank you for joining on behalf of your son. Its good to hear that your son has had some improvements from reducing his dose of Risperidone, but a concern that there seems to be what looks like the beginning of some withdrawal symptoms. Pacing can be a sign of akathisia, which can be a withdrawal symptom, along with being a side effect of some drugs. But if he has only just started pacing, then its more likely to be withdrawal.

 

Is your son taking any other medications?

 

My recommendation is to continue holding for now, and to wait for any withdrawal symptoms to subside before continuing with tapering based on the '10% of the current dose method'.

 

See:  

Tips for tapering off Risperdal (risperidone) - Surviving ...

 

Petunia.

[Jasmine]

   Hi Petunia, Thank you!

 I am sorry i have not gotten back sooner to you, still learning to navigate the site and the internet has been working terrible today here for me. (unusual) I was able earlier today to post my sons        medication history.....I do believe the best way to reduce a medication is to go down 10% or less....My son is now nervous about the reduction...I keep trying to asure him that things will be fine.  It  does not help though him knowing the Psy is disagreeing with me about staying at the 3.5mg Risperidone, the Psy wants it to go down further to 3mg....I am going to call his office again tomorrow  and hopefully he will return my call. My son is only taking Risperidone. I will be in touch and let you know, how we make out.

 

Jasmine

[Risperdrawlin]

Hello, I am also coming off Risperdal. My situation is probably different from your son's. Despite any differences, though, I have a recommendation-- try to get the psychiatrist on your side. I told my psychiatrist I would like to come off Risperdal and he said "Ok". After an incident in which I stopped almost cold turkey either because he said so or because we had a misunderstanding, he has basically let me do what I want and written me prescriptions for what I need. It has been incredibly helpful, and I think coming off the medication would have been much more difficult if I had only made choices after getting advice from him or had run every decision by him. I was on 2 mg in October 2014; I am now on 0.0625 mg and doing well. If you talk to your son's psychiatrist a lot, get frequent feedback from your son if possible and figure out what you want, and then bring those ideas to the psychiatrist. A lot of them do not have the same mindset or beliefs as the people on, say, this forum. My psychiatrist frequently does not agree with what I would like to do (reduce the medication slowly or take very small amounts before stopping), but he lets me do it and helps me. That is what you need. Of course, it's not a good idea to totally disregard what the psychiatrist has to say, and he or she might have good insights about the effects of the drugs, how they work, or side effects. But from both my own experiences and what I've read on here and elsewhere, it seems like many many many of them are not savvy about tapering psychiatric drugs. I would tell your son to constantly observe his symptoms and how he feels. From what I've been told and read, it's about the patient listening to his or her body and possibly working together with those around him or her. You see your son 7 days a week... the psychiatrist sees him for... an hour a month?

[Risperdrawlin]

Sorry, forgot to mention-- it would definitely be a good idea to have your son start filling out a daily mood chart or DBT diary card listing how he felt that day, what he did, and any drug- or withdrawal- related feelings or symptoms. This one looks decent: http://www.dbtselfhelp.com/html/diary_card_5.html Meditationand mindfulness have also been helpful for me.

[Jasmine]

Hi Risperdrawlin  Thank you for the reply...I tried to click on the link you shared and it would not work, I am going to try and type it into the address bar and see how it goes....I also tried calling the Psy office today... All I got was an answering machine..I will try again tomorrow morning...I am going to keep him at the 3.5mg dosage until I speak the Psy.  His first reduction was from 4.25mg to 4mg at a 6% decrease for 3 months and then 4mg to 3.5mg at a 12.5% reduction for 30 days (holding here) and now a 14.25% from 3.5mg to 3mg for another 30 days. I think to much to fast...I will let you know how it is going and if I am able to get onto the DBT website.

 

Jasmine

[Jasmine]

Hi Petunia, I tried calling the Psy office today. I only got the answering machine. I will try calling again tomorrow morning... I plan to hold my sons medication at 3.5mg, I believe it is for the best.

 

Jasmine

[Risperdrawlin]

The link is http://www.dbtselfhelp.com/html/diary_card_5.html, sorry, it seems to have messed it up. As far as the pacing, I don't know your son's situation or what his normal behavior is, but it's possible it's not something to really worry about if it goes down. Risperdal decreases agitation; pacing may be a sign of your son feeling more agitated or something similar because of being on less Risperdal. In my own time coming off Risperdal, I have had a lot of different effects from the drug, its side effects, withdrawal effects from the drug, the absence on the drug/ being stable on a lower dose, and being stable after holding and feeling similar to how I felt before I started tapering. When I'm on Risperdal or stable, I have flat affect sometimes. After cutting my dose, my affect will return a bit, and I may feel more anxiety for a few days. This is the effect of decreasing the dose/ being in withdrawal. A couple of times my symptoms have become unbearable and I have had to return to a slightly higher dose and/or hold for a while. Sometimes after I cut the drug I have felt sort of bad and thought, "Ok, I feel kind of bad now; if this gets much worse, I might have to go back up and hold for a bit. In five days I might be a mess, or I might be fine." During those times I have mostly been able to ride out the symptoms; they have not gotten much worse. Sometimes my symptoms or behavior get pretty severe or extreme; I might feel overstimulated and not want to speak to anyone or even watch a tv show or do anything involving human contact for a whole weekend. I also might feel so agitated that I hit my bed as hard as I can like 10 times. And then do it again a minute later. And again a minute after that. These symptoms can be difficult, but with effort and mindfulness they are not unbearable.

 

I really really really recommend pushing some mindfulness training hard on your son.  This book ( hardcover paper version) and my Mom played significant roles in getting me to try mindfulness and meditation seriously. The first time I learned to meditate was at a workshop given by this man (who runs this blog), and this is the script he gave to take home to continue to learn to meditate: http://practicingmentalillness.blogspot.com/2013/03/how-to-begin-meditating.html

 

Best of luck! I look forward to hearing how things go.