can anyone offer me advice on tapering?

I have to taper off my med (risperdone/risperdal) because it's causing me constipation, not going at all,my dr knows but they are hopeless.

Anyway I've been on just 1mg every night for 5months probably the longest I've ever been on a med.

I think I should be okay coming off it as I have very mild symptoms no voices or anything.

I had a flare up of mild paranoia two weeks ago and 2mg was added during the day that lasted for one week,then it was reduced to 1mg during the day again for one week.
I thought since I'd only been on this extra dose for two weeks it was perfectly okay to cut it down to 0.5mg this morning well I did and tonight I can't sleep.Even though I've taken my usual 1mg.
Should I have tapered more slowly even though I'd only been taking it two weeks??should I resume the 1mg and try and taper more slowly?

When coming off the 1mg I take at night for five months should it be a gradual 10 percent decrease?

Sleep problems are my biggest issue and fear with coming off risperdal since it seems to have really caused a dependency on the drug for sleep,and the main reason I took it was for sleep.

I had the same issue with risperdal.....what you want to do is not taper off but cross taper to something else, Abilify worked well for me.

i have been on 4mg initially and tapered it down to regular dose of 2mg (evening and morning dose both 1 mg). then i slowely tapered the evening dose down. tapering of was recommended in steps of 3 week per 0.25 mg. so very slow.

at this moment i am stuck. at 0,25-0,5 once a day. not in the evening because since my psychotic episode / i was put on risperdal , i didnt sleep more then 4 hours a night.

i believe risperdal to have a serioues influene on sleep. (for some obviously a good one, but for me the opposite, i had more problems with sleep.) i do have sleepmedication in addition to it. they also worked very well. but since i take risperdal its only 4 hrs of sleep a night .

to be honest the tapering off can be verry difficult. but its okay in slow steps (for me). i heard people who took over more then 1,5 years to taper off.
i am still having problems with symptoms when i taper down more. i dont know if i should taper more down or taper UP.

uhm. so what i wanted to say : slowly tapering in 3 wk of 0.25 mg down worked with me.
you can ask for sleep medication during the time, or maybe try valerian root high dose. (well i tried it, and it seems to work a little bit for me) Yes valerian next to my regular sleeping meds that brings 4 hrs of sleep to me. (while on risperidone, before i slept 9 hrs or so).

And i am curious of that cross taper way. what would be a right dose *LOW to cross taper to when yur just on 0.5 mg risperdone.? in the past i also had seroquel and a low dose of even so minumum of 12,5 mg *half a small tab. gave me hrs enough to sleep. but i also tapered that off.

goodluck and i wish you lots of strength.

Hello
It seems that the way doctors recommend is to add another med while they taper off the one that is causing problematic symptoms. Has your doctor recomemended another med to replace it with?

The abilify seems a good idea,thanks for the suggestion I should have discussed this with a pdoc,I don't have one.
but I remember I was on abilify once and it kept me up all night,waking up constantly.

The constipation happened when I withdrew from the med (risperdal) very similar to this woman it's the second time it's happened to me.I was still going every other day (incomplete) but once I restarted the risperdal again I was going only a little every few days so clearly the risperdal is causing the constipation (which I've never experienced in my life), and now I'm not going at all.Im not sure what I'm suppose to do.

I should add normally I just come off consta/depot without any withdrawl I sleep fine etc I just stop getting the depot so it's quite sudden but still I never experience withdrawl.Maybe because of the slow release or something? But as I said this time I came off the depot,slept fine,no withdrawl but became constipated.

Just going on depot and stopping it seems a bit too sudden to try again,but as I said I have little problems with sleep that way,I ended up sleeping last night I think I will try the 0.25mg over three weeks.But don't know how I will endure the constipation.

Thanks everyone for your help.

When I did speak to old pdoc he was hopeless he just kept reccominding laxatives to me.The ones he was reccominding don't work for me and laxatives are not a good long term solution.I meant to mention abilify to him but I remember I had sleep problems and stomach problems on it.

I just need to probably get off these meds,my schizophrenia is pretty mild,no voices,no real outlandish thoughts just a belief in signs,and sort of intuit things constantly etc.

I'm 1/4 African the rest is European and in the tribe I'm from they have tradtional healers/shamans called imiquirras I dreamt twice that I was one,so I'm probably suppose to be having visions etc (which I do have if I don't sleep) and all this.I may come off the meds and see a healer from my tribe.I don't believe these drugs that cause so much damage are the answer but at the same time I don't want to endure symptoms and do want to be reasoned too.

There are many different laxatives out there and it wouldn't be a long term solution, but a short term one whilst you taper of risperidone and onto something less consitpating. If the laxative that your pdoc prescribed isn't helping, I suggest seeing your GP as they probably know more about treating constipation than a pdoc would.

Also, if you feel that you don't need an AP but just need something to sleep, there are many non-AP options. There's herbal ones mentioned above, and melatonin, or niacin (vitamin B3). Then there's prescribed meds like small doses of antidepressants that work for sleep e.g. amitriptyline, lofepreamine, trazodone etc. I don't recommend zopiclone/zolpidem/benzos as this sounds like a chronic problem and those are all very addictive and cause rebound insomnia when you stop them.

I hope you find something that helps both the constipation and the sleep issues

*Willow*

Thank you so much willow for your advice I'm so glad I posted as I tried zopiclone and wasn't completely aware how addictive or problematic it was and if it would make things worse.Its really good to know.

The pdoc wanted me to just stay on risperdal and take laxatives forever.

Sleep is my biggest problem and the main reason I went on risperdal.I only really have schiz symptoms when I don't sleep.The majority of the time I'm normal.I would honestly take valerian but I had a bad reaction to it.I guess I'm just very sensitive and only 50kg(110 pounds) so react to everything.I was prescribed some melatonin but am afraid it would not work and would mess up my natural melatonin levels.

I never had any sleeping issues before taking risperdal when I was diagnosed in 2011 I think it completely messed up my sleep cycles,esp being on and off it.I use to sleep perfectly every night.

try a stool softener as opposed to a laxative it might work better...

That's what the pdoc is recommending and sorry if this is tmi,but I don't have any hard stools or any problem going ,I go normally without issue it's just incomplete.
So I don't think the stool softners will help,but I think I will try prune juice today,I heard someone who had this issue and started Metamucil and it helped,I don't even feel constipated.Its more like some receptor or switch that runs bowel movements has been switched off.

Thanks for all the advice.

Figs also work....

There is no healthier sleep aid than Melatonin. I wouldn't be afraid to use it. I'm sorry you're having problems with Risperdal. I would only go to the bathroom ever few days. It was so bazaar. I went from Risperdal to Geodon when I tapered and I've been on Geodon since, which has been over 4 years. Geodon is known for making you tired so I just take it at night and it use to help me sleep, however my system got use to it and everything is back to normal. I sleep naturally now.

However, once they wanted to increase my Geodon dosage they had me take it during the day. That was a total disaster, for I would seep at work. The bosses daughter thought it was cute and would snap photos of me with my mouth open dead asleep. lol

Abilify is a great choice to cross taper with, and Geodon is a great choice too for what it's worth.
Best of luck!

I might look at changing to another med but I will need to find a pdoc to do that.Is cross tapering very hard?
I am just too anxious now about coming off the med,I'd definately not be sleeping and having psychosis.if I don't sleep I start having visions(hallucinations) I get paranoid,I end up walking the streets for days I just can't go through it again.Im fine and normal as long as I sleep.But staying on this med and not going to the toilet at all is just not an option at all either.Im truly stuck between a rock and a hard place.

I think I have no option but to try abilify.I heard one woman say on oral tabs she was very constipated and on depot she wasn't so I might need to discuss that.Going to look for a pdoc now,ok I just saw they cost 275 to 390 dollars per consult I can't afford that.It looks like switching meds is not an option.My gosh how do people get help? Most people with schiz are not working.

Thank you for the advice about melatonin it was really an intuitive feeling of no about it,I feel it will mess up my natural melatonin levels and stop my body from producing it naturally and I've heard it can cause depression.But youve definately made me ponder it and If I get desperate I need to consider it.

I tried to get zopiclone from my dr because I wanted to know I had something in case of emergency to stop any possible psychosis but he wouldn't perscribe it,but I'm sort of glad after what willow said about it.

Thanks for all the advice this is a really difficult time,I need all the advice/help I can get.

1mg isn't very much,
I tapered off risperdal and onto abilify (which didn't work for me) when I was 18, i tapered from 4.5mg

I think it helped that i was in the hospital while I was tapering but I tapered from risperdal to abilify then abilify to Invega in the hospital

I think if you are taking .5mg of risperdal at a time just cut the dose in half and keep cutting it in half each week or so that's what I ended up doing in the hospital

So I am staying on the 1mg at night too scared to come off it.

But the 2mg I was put on for one week and then down to 1mg the second week just during the day I'm trying to come off that,so just to clarify I was on it for only two weeks.

I halved it to 0.5 for seven days,didn't experience withdraw,then I halved that to 0.25 for five days felt okay slightly off,I should have probably tapered a bit slower after that but felt my body would become more dependant on the med the longer I'm on it.

so I then reduced it to 0.12 percent or I just mean half of 0.25mg, and I feel completely fine but I suddenly have Anhedonia for three days,the Inablity to feel pleasure I'm experiencing it mostly with just food,no reaction to food,I look at food and it's like looking at a rock.I understand this is something to do with dopamine release it may go away.Very strange withdrawl symptom Ive been devastated about it,but I read the brain changes can rebuild and adjust so I may be ok.

Right now I need to come off this last o.12 percent, I feel otherwise normal.Should I just keep taking the 0.12mg for another two weeks to be on the safe side, or is this tiny amount probably not making any difference.Will taking it for another two weeks just cause further dependance.Im stuck as to what to do and don't have a pdoc.

Everything I've read says 10 percent reductions for four weeks,slow is best but to me it just seems my body will become even more dependant so that when I finally drop it it will be even worse! I was only on it for two weeks! Any advice welcome.I loathe these meds.

When I have come off depot by just not having it again I have had no withdrawl symptoms,but it seems the oral form causes issues.

Maybe it's not the drug maybe it's your body saying you don't get enough fruits and veggies? Apple juice will make ya go or it will do the opposite effect for some people but I get risperdal can be sending ya for a trip I never did it orally I did it IM or depot! But abilify doesn't make relax and fall asleep it makes me restless and only get 5-6hours a night! Zyprexa makes ya sleep like 12-13hours a night but it also makes you gain weight!

I was eating an almost entirely vegetarian diet on risperidone and it still caused this side effect that's actually why I got off of it. I was really kind of ticked when my doc suggested I eat more fruits and veg. The depot didn't exist back then but supposedly it bypasses all that stomach stuff.

Okay good point

Hi wildlavender, sorry to hear of issues you've been having with tapering and symptoms.

There is a site online which specialises in withdrawal support and if you would like me to pass details to you do pm me.

I can only share what helped me (on a different antipsychotic) - I tried cutting 10% of the current dose using a digital scale and holding dose for minimum two weeks, but then ran into problems with symptoms reemerging and felt very shaky and it happened very quickly. In the end, after many errors and with several relapses, I have switched to making tiny cuts each week of the current dose and holding for at least a week until I'm sure Im stable.

This is what has been working for me (as I check in with the site i mentioned) - but this has been also at the same time as getting support for the reasons which led me to becoming unwell in the first place.

Would definitely urge caution - they are very strong drugs and its your brain chemistry afterall.

Rispiridone made my mood worse and I had awful side effects. First I couldn't sit still, then my calf muscles constantly contracted and throbbed, my face and lips quivered, it paralysed my tongue. And the doctor thought I was just non-compliant. Oh and my prolactin level stopped my periods. I have heard it does something to the bones in long term too. I hated it.
Only two weeks, you shouldn't face too much withdrawal. I am going through quetiapine reduction - by 200mg and that was after 5 years! So it has not been easy. 90 days is prediction for a proper recovery and I am about halfway. I am still on 300mg my doc just took away the 200mg at once. Headaches, migraines, sweats and fever you name it. Anti-histamine has subdued it surprisingly and some ibuprofen, you could try them.
Doctors won't prescribe sleeping tablets for more than seven days in uk unless it is the psychiatrist.
Abilify didn't help me sleep or rispiridone. But I have a friend who did nothing but sleep on both abilify and rispiridone. I have had psychosis too. The only ones that helped me sleep were - quetiapine, olanzapine and clozapine but the last two had too many side effects.