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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Wean Off Risperidone?

I want to get off risperdone and am on 2mg. I have been on it for 3 and a half months. I also take Vyvanse 40mg. How can I start lowering the dosage and eventually get off it and how many days do I stick with the lowered dosage until lowering it again?
Tue, 9 Jul 2019
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General & Family Physician 's  Response
Hi,

2 mg of risperidone is not a small dose because antipsychotics are pretty heavy medications that operate by causing an alteration in the physiology of brain and body.

Such doses are enough to cause a lot of dysfunction and all psychiatric drugs involve a fostering of physical dependence. Because of that physical dependence, many people experience withdrawal syndrome when tapering off or trying to quit their medications even if they only took them for a short period and only took the smallest clinical doses.

These drugs may even cause new symptoms or new problems if you decide to stop taking them. They have even been seen to cause epigenetic changes which can last indefinitely.

Tapering, like normal dosing, is something that should be tailored to your personal experiences and adapted around how you respond to particular rates and changes. This should be best done by your clinician. A common, and rather responsible, baseline is 10% reductions of your previous dose every month. The Risperdal would go 0.05 mg down every month. Not everyone needs to taper this slowly so if you find that you can speed things up after a while, it may be alright to do so. Remember that reinstating your last stable dose might help you regain your footing if you taper too quickly but that reinstatement is not always going to solve your problem and sometimes a too-fast taper cannot be fixed and reinstatement causes problems to get worse instead of better.

On the other hand, some people need to taper slower or even much slower than 10% per month. It is ok to take months off from reducing to recover or stabilize and you should be warned that many people hit a "drop-off" point where their symptoms suddenly become unbearable even if they were mild or completely non-existent before that particular reduction. If you are breezing through a tapering, and decide to speed it up, you should be careful about the potential of hitting it so hard you spin out of control. Let your clinician have the final word.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. AJEET SINGH, General & Family Physician
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How To Wean Off Risperidone?

Hi, 2 mg of risperidone is not a small dose because antipsychotics are pretty heavy medications that operate by causing an alteration in the physiology of brain and body. Such doses are enough to cause a lot of dysfunction and all psychiatric drugs involve a fostering of physical dependence. Because of that physical dependence, many people experience withdrawal syndrome when tapering off or trying to quit their medications even if they only took them for a short period and only took the smallest clinical doses. These drugs may even cause new symptoms or new problems if you decide to stop taking them. They have even been seen to cause epigenetic changes which can last indefinitely. Tapering, like normal dosing, is something that should be tailored to your personal experiences and adapted around how you respond to particular rates and changes. This should be best done by your clinician. A common, and rather responsible, baseline is 10% reductions of your previous dose every month. The Risperdal would go 0.05 mg down every month. Not everyone needs to taper this slowly so if you find that you can speed things up after a while, it may be alright to do so. Remember that reinstating your last stable dose might help you regain your footing if you taper too quickly but that reinstatement is not always going to solve your problem and sometimes a too-fast taper cannot be fixed and reinstatement causes problems to get worse instead of better. On the other hand, some people need to taper slower or even much slower than 10% per month. It is ok to take months off from reducing to recover or stabilize and you should be warned that many people hit a drop-off point where their symptoms suddenly become unbearable even if they were mild or completely non-existent before that particular reduction. If you are breezing through a tapering, and decide to speed it up, you should be careful about the potential of hitting it so hard you spin out of control. Let your clinician have the final word. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. AJEET SINGH, General & Family Physician