Risperdal (Risperidone) is an antipsychotic drug that is primarily used to treat schizophrenia as well as bipolar disorder. In some cases it is used to help manage schizoaffective disorder as well as irritability among individuals with autism. It is considered an atypical antipsychotic due to the fact that it is newer and is supposed to have less side effects than the first-generation “typical” antipsychotics.
This drug functions as a dopamine antagonist, but also inhibits serotonin, epinephrine, and histamine to an extent. In some cases, this drug is even used as an antidepressant augmentation strategy. In other words, a psychiatrist may add on Risperdal to a preexisting antidepressant treatment to assess whether it provides additional relief from depressive symptoms.
As with any antipsychotic though, the longer you take it to treat your condition, the more difficulty you will have coming off of it and dealing with the discontinuation symptoms. I personally never recommend taking an antipsychotic for anything other than treating schizophrenia. Why? Because the side effects are pretty significant and upon discontinuation, most people experience powerful withdrawal symptoms.
The bottom line is that you should never take this drug unless you have schizophrenia or bipolar disorder that doesn’t respond to mood stabilizers. Additionally it should be mentioned that many people end up withdrawing from this medication due to unbearable side effects including: weight gain, metabolic changes, type 2 diabetes, tardive dyskinesia, and neuroleptic malignant syndrome.
Factors that influence Risperdal withdrawal
When taking any psychiatric medication, there are factors that influence the severity of withdrawal and symptoms. Various factors that play an important role in discontinuation include: time you took the drug, your dosage, how quickly you tapered, as well as other individual factors (i.e. environment, individual physiology, etc.).
1. Time Span
How long did you take Risperdal? In general, the longer you take an antipsychotic, the more difficult it is to withdraw from. People that have been on an antipsychotic for a couple months should have an easier time withdrawing in comparison to those who have taken one for years. Additionally the longer you are on a drug, the more dependent you become on it for everyday functioning.
2. Dosage (.25 mg to 16 mg)
How much Risperdal did you take? People that take this medication for schizophrenia tend to need higher dosages to help manage symptoms. For schizophrenia, the average daily dose ranges between 4 mg to 16 mg. Individuals who take it for bipolar disorder generally take anywhere from 1 mg to 6 mg. Additionally those who have autism may take a very low dose from .25 mg to 3 mg to manage irritability.
Obviously the higher the dose you take, the more you are becoming dependent on the drug for functioning. Therefore it is always recommended to be on the minimal dose for symptom management. Being on the minimal dose makes withdrawal easier and also helps minimize unpleasant side effects. If you have been taking large amounts of Risperdal over an extended term, it is likely going to be much more difficult to withdraw from.
3. Cold Turkey vs. Tapering
It is never advised to quit a powerful antipsychotic drug like Risperdal “cold turkey.” If you quit without conducting a gradual taper, you may end up with an array of symptoms that are overwhelmingly difficult to cope with. By conducting a conservative gradual taper, you are allowing your nervous system to adjust to very small decreases in medication over time until you are down to 0 mg.
For Risperdal, it is recommended to reduce your current dose by 10% every 2 to 4 weeks depending on how well you are dealing with these decreases. If you are extremely sensitive to medications and withdrawals, it is recommended to stick with 10% decreases every month. Therefore if you were taking 2 mg of Risperdal, you would cut to 1.8 mg for the next month.
4. Individual Factors
Other factors that play a role in determining withdrawal symptoms include: individual physiology, environment, habits, and other drugs that you are taking. Someone who is on an array of psychiatric drugs in addition to Risperdal may have an easier time coping with the withdrawal and/or may not even notice when they taper down from this drug.
Additionally it should be noted that some people are less sensitive to withdrawal symptoms than others. Having good dietary habits, staying busy, and a social support network can go a long way to help cope with the withdrawal experience.
Risperdal Withdrawal Symptoms: List of Possibilities
Below is a list of common symptoms that people experience when they stop taking Risperdal. Understand that you may not experience all of these symptoms and the intensity of each one may vary. Your discontinuation process will be completely unique to you based on your circumstances.
- Anxiety: Many people experience significant increases in overall anxiety. When withdrawing from any antipsychotic, if you notice that you become very anxious, understand that this is normal. Antipsychotics tend to sedate people and reduce feelings of anxiety. When you discontinue, you may notice that your arousal and anxiety spikes.
- Appetite changes: A common experience on Risperdal is to gain weight while taking it. You may notice that when you discontinue, your appetite changes and you become less hungry and/or your appetite stabilizes.
- Bipolar relapse: Individuals that take this medication for bipolar disorder may notice that their symptoms reemerge. In order to prevent this from happening, work closely with your doctor and consider conducting a more gradual taper. If a gradual taper isn’t working, you may want to try transitioning to a different medication.
- Concentration problems: Antipsychotics are known to cause concentration difficulties while taking them. Additionally when you stop taking Risperdal, you may notice that you are unable to focus on anything. Just know that poor concentration is very common especially during the early phases of withdrawal.
- Confusion: The combination of poor focus and memory problems can lead some individuals to experience a state of confusion. This confusion may be overwhelming and may lead a person to panic. If you feel confused as a result of your withdrawal, just know that it’s another fairly normal withdrawal symptom.
- Crying spells: During withdrawal, you may experience spells of uncontrollable crying as a result of deep depression. The depression tends to be most severe during the first few weeks of withdrawal, therefore your crying spells should gradually improve.
- Delusions: Some people experience delusions when they withdraw from Risperdal. Although this may signal a relapse for those diagnosed with schizophrenia, non-schizophrenics can also experience delusions during withdrawal. This has to do with changes in dopamine levels and receptor activity.
- Depersonalization: When withdrawing from any antipsychotic, a person may experience feelings of depersonalization. In other words, they may feel unlike their normal self and as if they have been robbed of feeling “natural.” It is common to feel stressed, void of emotion, and almost robotic during withdrawal.
- Depression: Many people actually take Risperdal to help ease depressive symptoms. Regardless of why you took this drug, experiencing deep depression during withdrawal is common. Most people feel severely depressed during the first few weeks of withdrawal.
- Dizziness: Feeling dizzy is one of the most reported symptoms when withdrawing from any psychiatric drug. This symptom can be minimized by conducting a gradual withdrawal as opposed to quitting cold turkey. Some dizziness may last for weeks following your last dose, but should improve over time.
- Fatigue: Many people report having little to no energy during the first couple weeks being drug-free. If you feel very lethargic and unable to get out of bed in the morning, the acute withdrawal is a likely culprit. Give your body and brain time to readjust and relearn how to function without the drug.
- Hallucinations: If you have schizophrenia, you may experience hallucinations during withdrawal. Your brain becomes especially sensitive during withdrawal and this increased sensitivity and dopamine activity alteration could trigger hallucinations in susceptible individuals.
- Headaches: Another extremely common symptom to experience when you quit taking Risperdal is headaches. You may experience minor headaches or very severe migraines – especially in the event that you taper too quickly.
- Insomnia: In some cases this drug is actually prescribed off-label to help with insomnia. Withdrawal can lead to increases in anxiety, arousal, and sensitivity. It can also trigger uncontrollable insomnia. Some recommend taking melatonin if the insomnia is severe.
- Irritability: You may notice yourself become increasingly irritable and edgy around others. Do your best to recognize that this irritability is caused by neurotransmitter fluctuations. Your brain is no longer operating under the influence of a drug that may have helped keep you calm – this can lead to irritability.
- Memory problems: Some people report major memory problems after taking this drug. Antipsychotics are known to cause difficulties in cognitive processing and memory retrieval. Usually after a few weeks of withdrawal, your memory should start to improve.
- Mood swings: You may experience mood swings during your withdrawal. Here I’m referring to crazy mood swings, but not “bipolar disorder.” One minute you may feel alright, the next you may feel very angry, the next very anxious and depressed. Understand that these changes in mood will improve the longer you are off of this drug.
- Nausea: If you feel nauseous upon discontinuation, just know that you are not alone. Many people feel as though they are going to vomit. Feeling nauseated should gradually go away after the first week or so.
- Panic attacks: The anxiety that people experience during withdrawal can be very intense. In fact it can be so intense that it triggers a panic attack. If you experience panic attacks, your best bet is to learn some relaxation exercises to lower your arousal.
- Psychosis: It is known that withdrawal from antipsychotics can cause psychosis – even among people who are non-psychotic. Keep in mind that if you have schizophrenia or another illness with psychotic features, it is best to work with your psychiatrist to manage symptoms by transitioning to a different antipsychotic.
- Sleep changes: You may notice changes in your sleep patterns when you initially withdraw. Some people report sleeping more than usual, others have difficulty sustaining a healthy amount of sleep. Understand that your sleep may be affected, especially during the first month or two after discontinuation.
- Suicidal thoughts: It’s pretty common to experience suicidal thinking when you quit taking an antipsychotic. Many people that have been through withdrawal realize that the most intense suicidal thoughts are accompanied by anxiety and/or depression. These should gradually improve as your neurotransmitter levels adjust.
- Sweating: Some individuals report profuse sweating all day for the first week(s) of withdrawal. If you notice that you are waking up during the night covered in sweat and/or are sweating intensely at work, it’s probably your body going through withdrawal.
- Vomiting: The withdrawal period from this drug can make some people sick. Many exhibit flu-like symptoms for up to a full week as they readjust to functioning without the drug. This is more common in people who withdraw from higher doses that don’t conduct gradual tapers.
- Weight loss: Since this is a medication that can lead to significant increases in weight, many people lose weight when they come off of it. This weight loss is usually not immediate, but may occur gradually over the course of a few weeks.
Risperidal Withdrawal: How Long Does It Last?
Although it would be nice if there were an exact Risperdal withdrawal timeline that could be followed, there’s not. Withdrawal lengthy and symptoms will vary based on the individual. Some people don’t really even notice much of a withdrawal when they come off of this drug, while others experience every symptom in the book. Just know that when it comes to withdrawing from any psychiatric medication – especially an antipsychotic, there are no “normal” symptoms.
If you experience something that you know is from withdrawal, trust your experience. Many people withdraw from Risperdal and report some pretty crazy symptoms, report them to their psychiatrist and the psychiatrist insists that these are not normal to experience during withdrawal. I cannot emphasize enough that it is important to trust your own instinct – you know more than anyone if the withdrawal created unwanted symptoms.
In most cases, people should start feeling more “normal” and have less withdrawal symptoms after they have been off of the drug for a full 90 days. I’m suggesting that it takes 3 months before most long-term antipsychotic users start to feel their discontinuation symptoms subside. If you have gone through Risperdal withdrawal and could share your experience in the comments section below, I’m sure someone would greatly appreciate some additional insight.