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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by xbunny on June 12, 2006, at 21:37:41
I am considering completely stopping my antipsychotic drug, I currently only take a low dose of a medium potency drug. I have discussed this with my wife and she is ok with it and it has already been suggested by my psychiatrist. Apart from the chance of relapsing some months or years later what are the possible consequences of this? In a previous post Ed implied that stopping antipsychotics can be difficult, would anyone like to comment on this? what difficulties might be anticipated? Has anyone any personal experiences of stopping antipsychotics they might like to share?
Best regards, Bunny
Posted by pseudoname on June 12, 2006, at 21:37:42
In reply to whats so bad about stopping antipsychotics?, posted by xbunny on June 12, 2006, at 8:58:54
Posted by xbunny on June 12, 2006, at 21:37:42
In reply to What were you taking it for? (nm) » xbunny, posted by pseudoname on June 12, 2006, at 11:36:03
Paranoid schizophrenia!
Posted by ed_uk on June 12, 2006, at 21:37:42
In reply to whats so bad about stopping antipsychotics?, posted by xbunny on June 12, 2006, at 8:58:54
Hi Buns
I was meaning that withdrawal symptoms sometimes occur.
Regards
Ed
Posted by pseudoname on June 12, 2006, at 21:37:42
In reply to Re: What were you taking it for? » pseudoname, posted by xbunny on June 12, 2006, at 12:42:15
Posted by xbunny on June 12, 2006, at 21:37:42
In reply to Oh, thanks. Good luck! Best wishes (nm) » xbunny, posted by pseudoname on June 12, 2006, at 14:14:43
Thanks :-) I hope good fortune comes your way too.
Posted by blueberry on June 12, 2006, at 21:37:42
In reply to whats so bad about stopping antipsychotics?, posted by xbunny on June 12, 2006, at 8:58:54
What is so bad about stopping antipsychotics is how long you've been on it and at what dose. The longer the time and/or the higher the dose, the more problems there will be getting off. Antipsychotics block dopamine and serotonin receptors. Those receptors are accustomed to having that blanket around them. They are not accustomed to working naked and will friek out when the blanket is removed.
Anyway. I was on 5mg zyprexa 5 years. I weaned to 2.5mg over 2 months, then to zero over 2 more months. Each step down was hard. I got waves of nausea, increased free-floating fear and paranoia that didn't exist before, anxiety that didn't exist before, cramps, muscle spasms, and ringing in the ears, and several days of deep despair sobbing type depression.
After finally being off of it, all of these things hit like a ton of bricks on day 4. The cramps and muscle spasms went away after a few weeks, but the loss of appetite continued, waves of anxiety, terror, and depression kept coming, and I was easily startled and scared by small everyday noises like footsteps or setting something on a table or shutting a car door, and sleep was absolutely lousy and sometimes not possible. Like I said, those receptors were just frieking out with all the stimuli they were not accustomed to receiving.
I went 10 weeks drug free. No sign of improvement. I finally gave up and restarted zyprexa at 2.5mg. Now I am in a very treacherous situation of finding other meds to stabilize on so I can again wean off zyprexa...this time a lot slower and in much smaller steps, like maybe even just crumbs for the last few weeks.
Anyway, you asked. It really depends on how long you've been on it. For me, 5 years was a long time.
Posted by Phillipa on June 12, 2006, at 21:37:43
In reply to Re: whats so bad about stopping antipsychotics?, posted by blueberry on June 12, 2006, at 19:02:56
Why would a doc suggest a paranoid schizophrenic stop his meds unless he wants to try another one. The same symtoms you had will come back. Do you want to be paranoid again? Love Phillipa
Posted by med_empowered on June 13, 2006, at 0:42:46
In reply to Re: whats so bad about stopping antipsychotics?, posted by Phillipa on June 12, 2006, at 19:17:24
I say do it, especially if your doc backs you up on it. Here's the thing, though: there really is a neuroleptic withdrawal syndrome, so tapering should be gradual. Your doc might want to try sedatives, like Valium, for a while, possibly also mood stabilizers, to ease the transition.
Some people experience a "withdrawal psychosis"--basically, when the neuroleptic is withdrawn, the pyschosis re-occurs with greater intensity than before. Also, some patients who were never psychotic (say, they were taking neuroleptics for bipolar or something) may become psychotic for the first time ever.
Sooo...I guess I'd say by all mean, go for it, but try to go for it carefully. From what I understand, if you can avoid a relapse your first 6months med free, you stand a good chance of not turning psychotic ever again.
Good luck!
Posted by xbunny on June 13, 2006, at 7:29:55
In reply to Re: whats so bad about stopping antipsychotics?, posted by Phillipa on June 12, 2006, at 19:17:24
> Why would a doc suggest a paranoid schizophrenic stop his meds unless he wants to try another one. The same symtoms you had will come back. Do you want to be paranoid again? Love Phillipa
The explaination is that I have had acute episodes several years ago (and those were a few years apart) and residual psychosis since then. He beleives that my anxiety and paranoia are probably largely resistant to antipsychotics and an ingrained part of my personality - though he streses not a personality disorder. His assessment is that no ammount of drugs will benefit these symptoms much when weighed against the costs of drug side effects and quality of life. The residual psychosis has been gradually declining over many years and the psychiatrists beleives that at least trying stopping antipsychotics is worth a try now that the residual is close to zero.
Bunny
Posted by xbunny on June 13, 2006, at 8:03:41
In reply to whats so bad about stopping antipsychotics?, posted by xbunny on June 12, 2006, at 8:58:54
So I met with the psychiatrist today and had a very long and detailed discussion. As a side note I was very impressed with him given he is an NHS psychiatrist, he had put aside half an hour to talk with me and we were in conference for nearly an hour and covered many topics. He had studied my notes, had researched my current drug regiem and seemed very easy to talk to. To cut a long story short his plan is that he wants to replace my current regiem of pericycazine with a different drug and wean off that over the course of nine months to a year. He has made me an appt for 6 weeks which will give him time to study my notes more and formulate a plan of which drug he thinks is most appropriate. I am fine with this but it does seem a slightly roundabout route, are some antipsychotics more suitable for withdrawal than others? to be honest I think the psychiatrist is slightly biased against older meds, though after explaining to him my experiences with zyprexa, risperdal and amisulpride he said he could see why I prefered drugs that didnt make me feel that way.
Bunny
Posted by ed_uk on June 14, 2006, at 14:15:39
In reply to stopping antipsychotics - update, posted by xbunny on June 13, 2006, at 8:03:41
Hi Buns
>To cut a long story short his plan is that he wants to replace my current regiem of pericycazine with a different drug and wean off that over the course of nine months to a year.
Given that you're doing well on pericyazine, replacing it with a different AP seems remarkably illogical. A new drug could cause a whole host of new side effects and problems. Pericyazine is available as 2.5mg tablets which are suitable for use during withdrawal. You could reduce your daily dose by 2.5mg every few weeks.
Regards
Ed
This is the end of the thread.
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