Is Tapering Rexulti Right for You?
Rexulti was developed and approved in 2015, and is marketed as a second-generation or atypical antipsychotic medication. The FDA approved a daily dose of 4mg Rexulti to treat schizophrenia and 3mg daily as an add-on medication if your antidepressant (or other medication) didn’t resolve your symptoms of major depression.
FDA Warning: Please remember you should not abruptly discontinue taking Rexulti, even if you feel it is, or is not working well for you.
Rexulti may not have proved as effective as hoped. For example, if your doctor prescribed it to treat major depression, you might have found that it did not provide the desired lift in mood for you.
Important to understand, antipsychotic medications have been used “off-label” for everything from Autism to eating disorders, anxiety, insomnia, substance use disorders, and even to treat ADHD. Some researchers feel this practice leaves the patient at great risk as the mechanics for how these drugs work in each of these and other scenarios are incompletely known.6
You may have experienced undesirable side effects such as akathisia (2X placebo in trials) or weight gain (also 2X placebo). According to the drug manufacturer, elderly people have experienced stroke or death. Some persons report blood sugar spikes that can lead to coma or death. In others, Rexulti caused seizures, suicidal thoughts and behaviors or other adverse events after taking Rexulti.
Some patients taking Rexulti have developed pathological gambling or other compulsive behaviors, muscle movement disorders, blood disorders, and other major consequences. Perhaps there is concern that these types of reactions could develop in the future, so you are hoping to transition to non-drug treatments before that happens.9
Perhaps you wish to reduce your dosage to the barest minimum possible, while still managing your original symptoms.
Psychosis or other schizophrenia symptoms may have stabilized, and you might feel the drug has done its job, but you want to regain a more natural sense of reward and joy in life. Antipsychotic medications block dopaminergic transmission which dampens those sensations. But remember, the tapering process must be done very very gradually for safety and stability.6
Each individual will have personal reasons to consider whether Rexulti tapering is right for them. In each case, one should always consult with a trusted prescriber or caregiver who can help guide you to the best decision for your health needs and goals.
Notes on Sugar Metabolism and Antipsychotic Medications
Recent research indicates that virtually all antipsychotic medications, including Rexulti, can alter sugar metabolism in the brain and body. As a result, metabolic diseases such as diabetes, hyperglycemia, dyslipidemia (elevated lipids or fats in the blood that can lead to cardiovascular disease), and obesity have been linked to the use of antipsychotics.
Glucose (sugar) is the main energy source for brain function, and its disruption, in turn, is directly associated with the physiology behind disordered brain function. Healthy cell reproduction, maintenance of living brain cells, regulating blood flow in the brain, the production of neurotransmitters and many other vital functions all depend on proper glucose metabolism.14,15
Why is Gradually Stopping Antipsychotics Safer than Quitting Cold Turkey?
Not everything is known about antipsychotic medications. But medical consensus agrees that antipsychotics dampen the distribution of dopamine. Antipsychotics may also affect other types of neurotransmitters such as serotonin, to varying degrees. This is largely considered why they are effective at reducing mania or psychotic symptoms. And these drug responses, especially over long-term use, also explain what occurs when antipsychotics such as Rexulti are reduced or stopped.
For example, in response to taking Rexulti, the number of dopamine receptors built by the body itself will tend to increase. So any dopamine that does get transmitted will have a greatly enhanced effect. This condition is called dopamine supersensitivity or supersensitivity psychosis. Abruptly stopping antipsychotic medication “cold turkey” can produce unmanageable effects including tardive dyskinesia, psychosis, mania, and others.7,8,13
How Long Does it Take to Taper Off Rexulti?
Each person will have a unique health history, and a unique set of treatment needs and preferences. But a fairly reliable gauge for estimating a timeline is to allow some weeks to months or more for each one year of taking antipsychotic medications. Research shows that cuts should decrease very gradually over time, sometimes to 1/40th of the therapeutic dose, allowing for a gradual normalization after the severe dopamine blockage that is linked to antipsychotic medication.
Adequate time must be given for the body to gently re-set without introducing changes that can overwhelm the natural healing process. Rexulti tapering done too fast will typically end up in chaos and relapse due to the returning surge of dopamine that results from too rapid discontinuation.1
Rexulti Tapering Guidelines to Discuss With Your Doctor
Before you begin the Rexulti taper:
- Are you sleeping well, eating regularly? If not, seek guidance to improve these points stable before starting a Rexulti taper.
- Have you arranged a trusted family member or friend to be your co-pilot? Have you considered a “Ulysses contract” — a voluntary agreement that you sign, so that if things become unmanageable, or an emergency occurs, you have someone to help you, and you agree to be hospitalized if necessary? 10
- Have you found a doctor to work with who is familiar with antipsychotic tapering, and who is sympathetic to your goals? Ask questions so this point is well established for your own confidence.
Additional Strategies to discuss:
- Nutritional support, including avoiding sugars or refined carbs that can spike blood sugar
- Complete avoidance of caffeine in coffee or energy drinks, no marijuana, alcohol, stimulants or other recreational drugs
- Calming environment, choose pleasant activities that do not overly stimulate
- Aerobic exercises and other physical activities
- A system to report changes or concerns in a time-sensitive manner
- Help with cutting the pills, or a way to accurately reduce the dosage
- How to manage other drugs if you are taking more than just Rexulti
- Ask about bridge medications if an impasse is reached
- Keeping a daily log may be useful for your doctor to determine when to reduce or hold dosages
Importance of Nutrition During Medication Cessation and Recovery
Nutritional support is effective, and is one of the most fundamental tools in recovery of health after medication use. It shouldn’t be neglected.
Over the course of a day, opt for 4-6 smaller meals consisting of healthy proteins, fats, and plant-based fiber. Start the day with eating a good breakfast. This will provide consistent slow-burning fuel for energy, as well as avoid blood sugar spikes that can occur with sugary high carb or junk foods. It’s all about keeping things even during the Rexulti taper process. A low-carb-based diet has been clinically proven to be helpful during medication withdrawal.11
Adequate fiber from fruits (in moderation) and vegetables will also help where the digestive tract has been compromised. However, best to avoid grapefruit juice as it may interact with some antipsychotic medications to raise blood sugar to dangerous levels, or cause other undesirable effects.
Other nutritional aids during Rexulti tapering can include:
- Omega-3 fatty acids (healthy fats such as wild-caught salmon, flaxseed oil, chia seeds, etc.)
- Daily portions of yogurt, kimchi, sauerkraut, probiotic supplements to help facilitate gut repair
- Get lab testing to see if you have any vitamin or mineral deficiencies. This is important as clinical research shows that some diagnoses of mental illness could have actually been vitamin or mineral deficiencies in the first place.12
Neurotoxin Removal
An important facet of the Alternative to Meds Center treatment plans for Rexulti tapering and improving mental health naturally is the gentle removal of neurotoxicants from the body.
Neurotoxin overload is linked to many undesirable symptoms, and can be overcome in safe and effective removal methods. You can find out more by reviewing more detailed information on the importance of neurotoxin removal and how it is comfortably accomplished.19
Where to Find Help for Rexulti Tapering?
We understand that not everyone is in a position to enroll in inpatient treatment. A good resource to find a physician to help you is IMMH.org which offers listings for both the US and Europe for the type of integrative help you may be looking for. Do not try to taper Rexulti on your own. Get help to assist you.
Find Out More About Inpatient Rexulti Tapering at Alternative to Meds Center
At Alternative to Meds Center, our approach is to carefully design a program that is tailored to the uniqueness of each client. This can involve a vast number of variables which are determined by the person’s medical history, current symptoms, and personal goals. Some main pillars of treatment are supporting the client with diet and correct supplementation, repairing the neurochemistry, and removal of neurotoxic burden so the person can achieve a return to a state of balance. Lab testing is used extensively to guide the process.
Natural substances are used to stabilize the neurochemistry. This is the goal of orthomolecular medicine principles used in treatment. We also seek to remove accumulated environmental neurotoxins, to provide nutritional therapy, IV + NAD therapy, therapeutic use of amino acids, nebulized glutathione, and physical exercise, including yoga and Qigong.
On our services overview pages you can find out more about these and other services such as art therapy, peer support programs, massage and other spa services, Equine therapy, acupuncture, and many other nontoxic therapies that can be blended in a program to efficiently rehabilitate natural neurochemistry.
The center offers an environment of comfort and calm, so the client can relax and focus on achieving their personal goals in a welcoming and supportive atmosphere. Our medical team include licensed and holistic-minded psychiatrists, therapeutic practitioners, nutritionists, counselors, and caregivers, all of whom are dedicated to you and your health.16-18
Please reach out to us for more detailed information on these protocols and how they may provide effective solutions. We are happy to help you with exploring insurance coverage and other logistics that can make enrollment smooth and stress-free. We look forward to hearing from you.
