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Fanapt Withdrawal Symptoms, Iloperidone Side Effects, Treatment Help

This entry was posted in Antipsychotic on by .
Medically Reviewed Fact Checked

Last Updated on August 1, 2022 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr John Motl MD

Fanapt withdrawal is best managed with careful medical oversight and may require inpatient treatment. Fanapt is an atypical antipsychotic medication used to treat schizophrenia in adults.

 

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Why Consider Fanapt Withdrawal?

Fanapt (iloperidone) is a relatively new (FDA approved in 2009) “second generation” atypical antipsychotic medication used in the treatment of adult schizophrenia. Often, a medication may not be providing the level of relief of symptoms that was hoped for, and the decision may be considered to stop the drug. Researching more information about such a drug, as well as recommended methods of safely and gradually tapering the drug may be helpful.

The class of medications called antipsychotics presents a wide and variable mosaic of potential adverse effects, and Fanapt is no exception. Fanapt can affect the heart, and the blood, and in certain cases can introduce new symptoms such as seizures, movement disorders, and other reactions while taking the drug (listed further in the article) and also when attempting Fanapt withdrawal, as listed below.

Psychiatrists often “vote” in panels or in surveys, on the best way patients should be treated, and with what drugs, possibly due to the lack of actual clinical research on the topic. Do not discount the value of your own assessment when it comes to selecting a treatment that seems right for you.7

Below is an overview of medical research-based information that may help understand more about the drug’s characteristics, dosing and withdrawal information, and other commonly searched information.

Fanapt Withdrawal Information — Important Note

The FDA advises that one should never abruptly discontinue an antipsychotic medication as the reaction can be severe with serious risks to health, and may incur life-threatening consequences. If you find yourself considering Fanapt withdrawal, always seek trusted medical assistance in making such changes.

Fanapt Withdrawal Symptoms

Below is a summary of some of the Fanapt withdrawal symptoms that have been documented in clinical studies and published medical literature. As the list shows, some of these are of high medical concern and may be best attended to in an inpatient setting. Please bear in mind this may not be a complete list but is a compilation of the most documented material found.4,5

Fanapt withdrawal symptoms may include:
  • Return of psychosis symptoms
  • Anxiety
  • Agitation
  • Mood swings
  • Impaired cognitive ability
  • Nausea
  • Vomiting
  • Flu-like symptoms
  • Insomnia
  • Interrupted sleep
  • Heart palpitations
  • Changes in weight
  • Diarrhea
  • Sweating
  • Fatigue

Fanapt Withdrawal — Discontinuing/Quitting Safely

The decision to discontinue Fanapt is best done in consultation with your primary caregiver who can advise you on proper tapering protocols and can provide options for adequate monitoring of your health throughout the process. Clinical evidence shows that withdrawal accompanied by neurotransmitter precursors can shorten the withdrawal period considerably.1

In general, one should never abruptly stop taking antipsychotic medication. The only exception to this rule is where potentially fatal allergic or other reactions occur that may lead to stroke, coma, or death. Where these extreme adverse effects present, the patient should be transported to a medical facility for immediate intervention, which will require supervised cessation of Fanapt supported by a respirator, oxygen delivery, and other means of critical life support.

If you do miss a dose accidentally, the label advises you to either take it when you remember, or if it is very close to your next scheduled time, skip the one missed, and take only one pill as usual. It is not recommended to take a doubled dose.

The problems of Fanapt withdrawal can be challenging, as with all antipsychotic drugs. Some consider the process to be even more challenging than coming off heroin or benzodiazepines, neither of which are easy to navigate through easily.

fanapt dopamine effectsWhen Fanapt is taken, it deflects dopamine at specific receptors, counteracting any excitatory effect. Reducing the dosage, as in a taper, can release a flood of dopamine that was previously restricted, and this can present as clinical mania. If the increased expression of dopamine is too excessive, it may be necessary to regain control of the situation by temporarily managing symptoms in a hospitalized setting, under the care of a trusted doctor to regain stability. This makes it possible to re-introduce a slow taper later. This is especially pertinent where Fanapt has been taken for many years, and this may be the safest way to navigate through any such difficulty while tapering off the drug.

Our goal is to help the person transition to being medication-free, or at the lowest dose possible which provides the best possible quality of life.

What is Fanapt Used For?

The FDA approved Fanapt in 2009 for the treatment of schizophrenia in adults.

While it has not been unheard of for this class of drug to develop a history of off-label uses, none have been found in the medical literature we reviewed for Fanapt to date.

How Does Fanapt Work?

It is believed that Fanapt deflects dopamine at certain receptors, which reduces mania. But it is expected that the body begins to adapt or compensate by creating new dopamine receptors. This could be, at least in part, why drugs like Fanapt seem to stop working after a period of time, and why some quite dramatic Fanapt withdrawal symptoms are likely to present.

Fanapt (iloperidone) Alternative Names and Slang

Fanapt was previously called “Zomaril,” and iloperidone is the generic name.

Fanapt has not acquired slang names and is not known as a street drug.

Fanapt Side Effects

Fanapt side effects are similar to other antipsychotic medications. According to the black box label that the FDA put on the packaging, Fanapt is not approved for use in patients with dementia-related psychosis, due to increased risk of death.2

Please note that symptoms of orthostatic hypotension are associated with the drug. According to the FDA drug label information, and published research, starting Fanapt at a low dose and titrating up slowly can help mitigate possible dizziness, tachycardia, syncope, and other side effects.2,6

Fanapt side effects that are serious can include:
  • Tardive dyskinesia: a potentially irreversible movement disorder characterized by involuntary tongue rolling, facial grimaces, and fast or erratic motions of limbs or extremities.2,3
  • Allergic reaction: a life-threatening condition characterized by swelling of the face, throat, tongue, etc., hives, and difficulty breathing that requires immediate medical intervention.
  • Severe nervous system reaction: sudden weakness, muscle rigidity, high fever, profuse sweating, heart palpitations, feeling faint, confusion, flu-like symptoms, sore throat, painful skin sores, or sores in the mouth.
  • Chest pain, headache, dizziness, fainting, pounding heartbeat.
  • Inability to urinate.
Other more common side effects include:
  • Cognitive impairment, slowed thinking processes, slowed reactions and movements
  • Other “psychiatric” symptoms
  • Changes in menstrual periods
  • Swelling in the breasts, discharge
  • Orthostatic hypotension: a significant decrease in blood pressure, associated with fainting, dizziness, or lightheadedness that happens when you stand up from a sitting or lying position.
  • Hypersensitivity to temperature (hot or cold)
  • Nausea
  • Stomach pain
  • Joint pain
  • Diarrhea
  • Decreased sexual ability in men
  • Drowsiness
  • Drooling, excess salivation
  • A painful erection lasting four hours or more
  • Trouble swallowing
  • Tremors, shakiness
  • Spasmodic muscle movements
  • Dizziness
  • Dry mouth
  • Weight gain
  • Cold-like symptoms, i.e., stuffy nose, cough, fever
  • Note:  this is not a complete list. Always seek medical attention for a symptom that seems unusual or uncomfortable.

Fanapt FAQs

The following provides some additional information that is frequently searched for regarding Fanapt. We can give more information on these or other topics on request.

</p> <h3>What Drugs Should Be Avoided When Taking Fanapt?</h3> <p>
According to the drug label, there are serious drug interactions that can cause multiple cross-reactions. Avoid taking the following drugs and do ask your doctor about the matter before making any adjustments to your medication regimen. Your doctor may or may not be aware of these restrictions, so be sure to get your prescriber to actually check the label and see if any potential problems may need to be considered.

  • Blood pressure medications
  • Antidepressants
  • Sedatives
  • Alcohol
  • Sleep medications
  • Tranquilizers
  • SSRIs
  • SNRIs
  • Mood stabilizers
  • Recreational or street drugs including marijuana
  • Other medications for mental illness treatment
</p> <h3>What is a typical dose for Fanapt?</h3> <p>
The typical dose for treating schizophrenia with Fanapt is 1 mg taken twice daily.
</p> <h3>Is Fanapt safe for children?</h3> <p>
There are no studies that show how safe Fanapt is for children, nor are there in utero studies done, except on rats, where it was shown that the drug did pass the placenta barrier and was excreted in the breast milk of nursing rats.

Treatment for Fanapt Withdrawal, Abuse and Addiction?

Some psychiatric practitioners have described the subject of treating mental illness as trying to fix something when you don’t exactly know what is broken. It is not 100% known what might lead to psychosis or strange voices in the head, delusions, or other unwanted symptoms. The popular use of drugs as therapy in contemporary medicine might be the quickest approach and has its place in patient care, especially when a person’s symptoms put themselves or others at risk. However, it is clear that drug-therapy alone may not always be able to provide the most permanent or complete answers that are being searched for.

fanapt holistic treatmentsAt Alternative to Meds Center, our approach is simply to help a person in holistic ways, by introducing non-drug-based therapies to improve natural mental health as well as many other benefits involving the physical aspects of health. Physical health and mental health might be considered symbiotic. If that is true to any degree, it might make sense not to disregard either side of the equation.

One of the methods we are pleased to be delivering is called neurotransmitter replacement therapy, which allows our clients to take giant steps toward their individual goals for health and wellness. The process is gentle and well-tolerated. Bioaccumulation of toxic waste material (heavy metals, chemicals, food preservatives, other drug residues, and others) can be tested for, and gently purged from the system and may provide surprising benefits and reduction of one’s original symptoms.

For some clients, withdrawal from medications is desired as a step along the way to regaining robust health, energy, and zeal for life. In addition to our Fanapt alternatives, we have many therapies in place that our clients have found beneficial in achieving their personal health goals. Please ask us for more information about our treatments and holistic therapies, and how we design Fanapt withdrawal programs for each unique individual’s specific needs.


1. Tomkins DM, Sellers EM “Addiction and the brain: the role of neurotransmitters in the cause and treatment of drug dependence” NCBI, 2001 Mar 20 [cited 2022 Aug 1]

2. FDA label Fanapt 2009 [cited 2022 Aug 1]

3. Aquino CC, Lang AE. “Tardive dyskinesia syndromes: current concepts.” Parkinsonism Relat Disord. 2014 Jan;20 Suppl 1:S113-7. doi: 10.1016/S1353-8020(13)70028-2. PMID: 24262160. [cited 2022 Aug 1]

4. Moncrieff J. “Does antipsychotic withdrawal provoke psychosis? Review of the literature on rapid onset psychosis (supersensitivity psychosis) and withdrawal-related relapse.” Acta Psychiatr Scand. 2006 Jul;114(1):3-13. doi: 10.1111/j.1600-0447.2006.00787.x. PMID: 16774655. [cited 2022 Aug 1]

5. Moncrieff J. “Why is it so difficult to stop psychiatric drug treatment? It may be nothing to do with the original problem.” Med Hypotheses. 2006;67(3):517-23. doi: 10.1016/j.mehy.2006.03.009. Epub 2006 Apr 24. PMID: 16632226. [cited 2022 Aug 1]

6. Montes AB, Rey JA. Iloperidone (Fanapt): An FDA-Approved Treatment Option for Schizophrenia. P T. 2009 Nov;34(11):606–13. PMCID: PMC2810169. [cited 2022 Aug 1]

7. Keks N, Schwartz D, Hope J. Stopping and switching antipsychotic drugs. Aust Prescr. 2019 Oct;42(5):152-157. doi: 10.18773/austprescr.2019.052. Epub 2019 Oct 1. PMID: 31631928; PMCID: PMC6787301. [cited 2022 Aug 1]

8. Alexopoulos GS, Streim J, Carpenter D, Docherty JP; Expert Consensus Panel for Using Antipsychotic Drugs in Older Patients. Using antipsychotic agents in older patients. J Clin Psychiatry. 2004;65 Suppl 2:5-99; discussion 100-102; quiz 103-4. PMID: 14994733. [cited 2022 Aug 1]


Originally Published Sep 13, 2018 by Diane Ridaeus


This content has been reviewed and approved by a licensed physician.

Dr. John Motl, M.D.

Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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Fanapt Withdrawal Symptoms, Iloperidone Side Effects, Treatment Help
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