Posted by SLS on May 18, 2005, at 8:28:58
In reply to Re: risperdal withdrawl causing more symptoms, posted by jjj on May 17, 2005, at 23:16:53
Hi.
> Perhaps it was a mistake,
It is no mistake that you should want to live your life not being tethered to and dependent on medication. I would like to be healthy and free of medication as well. I understand your desire to experiment in order to determine your true treatment needs.
> if things become unbearable I can always start up with it again.
What condition are you diagnosed with?
Are you sure that you would be able to recognize a need for treatment once the psychosis becomes severe enough? For the few times that I have become manic (psychotically), no one was able to convince me that I needed help. It is good that you have someone close to you whose judgement you can trust.
> Actually, it was my idea to lower dosage, not my pdoc's. He believes that the symptoms will reduce over time at the lower dosage (basically that short term withdrawl of risperdal leads to a short term increase of psychotic symptoms, even in previously non-psychotic patients)
I did a quick literature search regarding antipsychotic discontinuation rebound psychosis. It seems that this occurs only if psychosis or a biological vulnerability was present prior to treatment. For example, certain medications used to treat Parkinsons Disease produce psychosis as a side effect, even though there had been no prior history of a psychotic disorder. Antipsychotics are frequently used to treat this side effect. If the antipsychotic is removed while the patient is still on the same Parkinsons medication, a rebound psychosis is possible wherein the psychotic symptoms are temporarily worse than before it was introduced. However, this is not an example of a rebound psychosis being produced where none had been there before. If someone using an AP only for sleep whom is otherwise healthy and has no risk factors for psychosis were to become psychotic upon the discontinuation of that AP, this would be an example of what your doctor had intimated.
In your case, a rebound psychosis is quite possible and might be worth waiting to see in what direction it goes. I hope that you use this time of experimentation to come to a conclusion one way or another, and that you don't find yourself in a vicious circle of compliance and non-compliance. You might want to journal your experiences so that you can reflect upon them in the future should this issue become prominent in your thoughts again.
Do what you gotta do to convince yourself. I myself have discontinued certain medications in the past to see if I really needed them or not. In your situation, I would not consider a negative outcome to be a mistake, but rather the results of a reasonable experiment.
If you respond well to Risperdal at dosages of 2.0mg or less, you can consider yourself fortunate. These are dosages that are low enough to avoid many of the unwanted effects that you are concerned with.
- Scott
poster:SLS
thread:499279
URL: http://www.dr-bob.org/babble/wdrawl/20050424/msgs/499374.html