Risperdal (risperidone) Withdrawal Symptoms
Please Note: Risperdal withdrawal is recommended to be done gradually rather than attempting sudden cessation unless the latter is needed to avert death due to allergic or other severe reactions.1
Risperdal (risperidone) withdrawal symptoms include:
- Somnolence, sleeping for inordinately long periods or unusually deep sleep
- Akathisia, a motor movement disorder that causes relentless internal unease, characterized by repetitive marching, rocking, pacing, or other compulsive motions
- Dystonia, spasms, or distorted muscle postures caused by drug therapy
- Abdominal pain
- Parkinsonism looks like Parkinson’s disease but is drug-induced, rigid muscles, slow movements, shuffling walk, etc.*
*Parkinsonism usually presents within a short time of starting antipsychotic medications according to Shin and Chung’s 2012 study on the subject.
Coming off an atypical antipsychotic drug can be difficult. Seek medical guidance and consult with your prescribing physician to help navigate through the process.
If your prescribing physician is unwilling to help or simply unable to guide you because of unfamiliarity with the problem, it is always a good idea to seek a second opinion. It is not at all unusual to meet with such resistance, because physicians are typically not trained during their schooling in drug tapering. Realize the problem needs expertise for your best way forward.
Gradual Risperdal Withdrawal (risperidone)
As with all other psychoactive medications, the gradual cessation of this medication is the safer approach. There are a few exceptions to this general standard rule, however.
When a patient develops a life-threatening adverse reaction such as tardive dyskinesia, NMS, Stevens-Johnson syndrome, organ failure, interactions with other drugs or substances, or other high-risk events, the drug must be withdrawn immediately in a clinical setting, to save the life of the patient.
It is believed that Risperdal has the ability to block dopamine at the D2 dopamine receptor and by reducing dopamine availability, reduce manic symptoms. Most psychiatric medications are limited due to the neuroadaptation of the synapse. The synapse, in response to a perceived dopamine deficiency, can then increase the receptor’s binding power to dopamine.9
This increased D2 dopamine binding and upregulation is a potential mechanism for the development of tardive dyskinesia. This receptor upregulation is most likely a central component in the manifestations of Risperdal withdrawal. For some, antipsychotic withdrawal can be extremely challenging, more so than any of the drug classes including benzodiazepines and even opiates such as heroin.
As the antipsychotic medication is lowered during Risperdal withdrawal, dopamine flow will begin to return. This previously restricted dopamine coming into contact with upregulated receptors may clinically present as an abrupt onset of manic or psychotic symptomatology. It is common for the patient to become enamored with what they are feeling. The sense of reward they may experience could be likened to winning the lottery, In other words, it can be extreme. This newfound reward could leave them resistant to either increasing the medication to assist in regaining stability or slowing down the medication taper. This aversion to proper guidance can make this situation very hard to manage.
It is advised that when attempting Risperdal withdrawal, to make clear early in the process, that this is a possibility. And, furthermore, that the individual is encouraged to make a pact that they will listen to at least one person without question. If they sign something saying that they will take this trusted person’s direction in the event that their own judgment cannot be trusted, it can be presented to them if things start to run awry. Obviously this will not work for everyone in this situation, but for some, especially those with a strong family alliance, this can be a successful agreement.
Another form of preemptive strategy is to enlist a doctor or center that has hospital admitting privileges. Should things get to the point where restabilization is necessary, a doctor that has the ability to admit the patient to the hospital can help things go in a humanistic way so that future Risperdal withdrawal efforts may be safely resumed.
It should also be noted that there should be a strictly adhered to restriction of stimulants such as coffee and other forms of caffeine, etc., during this time. Even medications like Wellbutrin, Effexor, and SNRIs may pose challenges during antipsychotic medication withdrawal, and having a conversation with your doctor about this potential would be advisable.
Risperdal (risperidone) is an antipsychotic medication used to treat autistic children age 5-16 diagnosed with irritability and is prescribed to patients age 13 and up for schizophrenia. This drug is also prescribed to treat acute mania of bipolar and similar conditions, for both adults and children from age of 10 up.
This potent medication should not be used in elderly patients with signs of dementia as Risperdal has been shown to increase mortality rates in this population. The FDA approval for use in children as young as 5 years of age was preceded by very short-term (4 weeks to 12 weeks) trials. Again, caution is always prudent as stated in FDA Risperdal labeling information.1
There are a host of known side-effects and warnings concerning Risperdal (risperidone) issued by the FDA that apply to various age groups. More information can be found below.