Insomnia, somnolence, sleeping for inordinately long periods or unusually deep sleep14,16
Akathisia, is a motor movement disorder where a relentless internal sensation of unease drives repetitive marching, rocking, pacing, or other compulsive motions11,12,16
Dystonia, spasms, or distorted muscle postures caused by drug therapy16
Parkinsonism looks like Parkinson’s disease but is drug-induced causing rigid muscles, slow movements, shuffling walk, etc.17
Coming off an atypical antipsychotic drug can be catastrophic if it’s not done carefully and slowly. Seek medical guidance and consult with your prescribing physician to help navigate through the process.
If your prescribing physician is unwilling or simply unable to guide you because of unfamiliarity with the problem, you may want to seek a second opinion. Such resistance is to be expected because physicians are typically not trained during their schooling in techniques of antipsychotic tapering. We must realize the problem needs expertise. Choosing the right medical help will be your best way forward.
Risperdal (risperidone) withdrawal can be challenging. Professional guidance and help can be hard to find. And, you may feel it is the drug itself that is the major part of the problem.
Atypical antipsychotic medications are generally prescribed in a crisis situation. A crisis may have multiple contributors that were overlooked. Drug use, toxic dietary habits, toxic exposure, poor sleep, genetic factors, are some issues that if never addressed, may have preceded an imperfect diagnosis and less than successful treatment.
Do Your Symptoms Require Risperdal?
Alternative to Meds has led the world regarding antipsychotic withdrawal and Risperdal alternatives for 15 years. We have published evidence regarding our success. Considering the potentially debilitating side effects of atypical antipsychotic medications, it begs the mental health profession to consider less toxic options and lifestyle changes that might be applicable for successful treatment.
Watch this video of a young man who was in and out of psychiatric wards, looking very much like he had permanent mental health problems. After doing the Alternative to Meds Center program, he became medication-free and is now a well-accomplished author and international speaker. His situation was largely food allergies mixed with depletion and recreational drug-induced psychosis that was misdiagnosed as schizophrenia.
15 Years Experience by Professionals Who Understand Your Journey.
As with all other psychoactive medications, gradual cessation of this medication is the FDA-recommended approach.1 In most cases, it has been found necessary for the safety of the patient to taper antipsychotic medications very slowly and always under careful medical observation. In addition, a number of research papers including a case study published in the Pharmacological Bulletin in 2019 reported the onset of akathisia and rebound psychosis after abrupt Risperdal cessation.11,16
Medications can be tricky and can cause unpredictable reactions. So it is important to note that there are a few exceptions to this general standard rule, however.
When a patient on antipsychotic medication develops a severe or 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 which must be carried out in a clinical setting.18
Risperdal and Dopamine
According to Silvestri et al in their study published in the BerlinJournal of Psychopharmacology, it is believed that Risperdal has the ability to block or bind dopamine at the D2 dopamine receptors. The authors suggest that reducing dopamine availability reduces 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 subsequent upregulation are thought linked to the development of tardive dyskinesia and other drug-induced reactions. Such responses can occur on initiating or discontinuing neuroleptic medications, and sometimes these can emerge long after an antipsychotic medication was stopped. 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.13-18
Managing Risperdal Withdrawal Challenges
As the antipsychotic medication is lowered during Risperdal withdrawal, dopamine flow will begin to return. This previously restricted dopamine coming into contact with upregulated (super-sensitive) receptors may clinically present as an abrupt onset of manic or psychotic symptoms.13 As a result, the patient may become enamored with what they are now feeling. The sense of reward they may experience could be compared 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 medical guidance can make this situation very hard to manage.
It is advised that when attempting Risperdal withdrawal, one should understand early in the process, that aversion to medical guidance is a very real possibility. Have a discussion with your medical caregivers and your support team about this. And, furthermore, one is encouraged to make a pact, sometimes called a “Ulysses Contract” that they will listen to at least one person without question should they become resistive to medical guidance.19 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 go awry. While this may not work in every case, for some, especially those with a strong family alliance, this can be successful protection for the patient and can be put in place early in the process.
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.
What Risperdal (risperidone) Is Used For
There are three uses for Risperdal.1
Autistic children age 5 to 16 for irritability
Teens aged 13-16 and adults with schizophrenia
Adults and children aged 10 and older for manic or mixed episodes of Bipolar 1 disorder, excluding elderly dementia patients.
In September 2011 the government issued a review on what had become known as off-label uses for atypical antipsychotic medications, including OCD, ADHD, social phobias, anxiety disorders, mental retardation, insomnia, eating disorders, PTSD, addiction, Tourette syndrome, and others. The board concluded that none of these off-label uses were justified nor were they effective.21
Off-label uses for drugs can arise without clinical trials, or as a result of drug advertising claims to popularize uses that were not backed up by bonafide research or safety trials. As one example, in 2012 and again in 2013 the makers of Risperdal, Johnson & Johnson, and a subsidiary, Janssen Pharmaceuticals, were sued across 36 states for misleading claims promoting that Risperdal was effective for the treatment of anger management, and anxiety.
Other cases brought against the drug makers were settled after the company promoted Risperdal as effective in the treatment of dementia, a practice that is now banned by the FDA due to the dementia patient’s risk of death. Lawsuit claims resulted in fines of over $2.5 billion that J&J was forced to pay for their overreaching claims attributed to Risperdal. Even the sales of legal painkillers led to J&J lawsuits based on similar “sales over science” marketing techniques. Despite government advisory board disapproval, it appears the practice has remained systemic in the pharmaceutical industry.7
Risperdal Side Effects (risperidone)
Pre-sales trials for Risperdal oral tablets were 4 to 8 weeks long. Long-term (1-2 year) follow-ups are mentioned on the label, but no details are provided beyond a statement that schizophrenic participants experienced longer times between relapses compared to the participants who received a “comparative activator,” which is not identified.1
A “black box” warning is placed on Risperdal packaging against prescribing to elderly patients with dementia due to the risk of death, stroke, and other cerebrovascular adverse reactions. NAMI reports side effects for women to include loss of period, and for males, loss of sexual function.23
Many thousands of lawsuits are pending for Risperdal causing male breast enlargement.23
Additional FDA-issued warnings include these:
Tardive dyskinesia, typically irreversible loss of motor control, is characterized by distorted repeating muscle movements or fixed twisted postures, drooling, rolling tongue motions, facial spasms, grimaces, etc.
Loss of consciousness
Syncope, brief loss of consciousness due to a drop in blood pressure
Tremors, shakiness, stiffness
Anemia, low red blood cell count
NMS, neuroleptic malignant syndrome: potentially fatal reaction to drugs characterized by sudden fever, rigid muscles, mental impairment, cardiac arrest, coma, etc.
Orthostatic hypotension, sudden lowered blood pressure especially after rising from a sitting or lying position
Hyperglycemia, high blood sugar
Extrapyramidal effects, i.e., jerking or spasmodic muscle movements involving the eyes, limbs, hands, feet, facial muscles
Hyperprolactinemia, breast growth in male patients
Diabetes mellitus, a form of diabetes that prevents collecting energy from food ingested
Leucopenia, low white cell count
Dysphagia, difficult or painful to swallow
Priapism, a condition of persistent and painful penile erection
Below is a collection of information about Risperdal and how it works, what it is and is not FDA approved for, and many other topics of interest on this atypical antipsychotic medication.
It is highly recommended to thoroughly research a drug before starting or stopping it so your health questions can be fully addressed. The work can be tedious, and it could be well worth enlisting others in your support group to help you with the task. Knowledge can increase your ability to reach the best solutions to mental health issues because such solutions are supported by science rather than perhaps overzealous advertising claims that may conflict with documented evidence.
What Does Risperdal Do to the Brain?
Taking antipsychotic medication has a dampening effect on emotions, energy, and the capacity to experience feelings of reward or pleasure. This dampening effect is associated with the restriction of dopamine and other neurochemicals along the CNS and brain. An individual with a lessened capacity experiences the sensation of reward may be attracted to stimulants. To contrast this effect, those with an excessive flood of reward neurochemicals may present as manic, or overstimulated.
How does Risperdal Work?
How antipsychotics and atypical antipsychotic medications work is as yet not completely known. What is theorized is that Risperdal affects certain neurotransmitters in the CNS and this influence is proposed to have a corrective effect.
What can be observed clearly, however, is that patients who are prescribed Risperdal become quieter, less active, sleep more, and show cognitive impairments. While effective during a crisis situation, this may not be tenable for the rest of one’s life.
Can Risperdal Be Used to Treat Anxiety?
According to one pharmaceutical company-funded research article,24 Gao et al report that these potent drugs are slightly more effective than placebo (which means no treatment in this case) when used off-label to treat anxiety, panic disorder, generalized anxiety disorder, and other mood disorders. In contrast, the majority of studies found reported a larger body of adverse effects, and negative or questionable treatment outcomes in treating anxiety and other mood disorders such as MDD, BiPolar, PTSD, etc., with antipsychotic medications. The vast majority of researchers called for more caution and suggested that more studies should be done.25-27 Further research revealed that treating anxiety with Risperdal generated many legal suits against the makers of the drug who promoted the drug for anxiety. Currently, there are 16,900 lawsuits pending against the drug makers of Risperdal for adverse effects.28 Treating anxiety and mood disorders with Risperdal are not FDA-approved uses. The aforementioned drug trials were short-term, which means a few weeks in length. No published studies were found on the long-term effects of these medications, nor did they at the difficulties involved in withdrawal from atypical antipsychotics like Risperdal.
Can Risperdal Cause Aggression or Aggressive Behaviors?
A double-blind study published in the British Journal of Medicine studied adult aggressive traits after traumatic brain injury and the trial found placebo-treated participants had better results than those treated with risperidone.29 There is also evidence in a published study by Ostanelli et al, that showed aggressive or irritable behaviors actually worsened after a short period of time on Risperdal.30
The studies that were done on Risperdal to get it approved for the treatment of very young children with autism showing irritable behavior were extremely short, i.e., 4-week and 8-week trials.1
Equally concerning is the fact that no trials were found that showed safety or efficacy results for off-label use of Risperdal on non-autistic young children for ADHD or other behavioral reasons. Yet, this has become a shockingly common practice. Some physicians and caregivers have raised concerns when non-drug-based treatments, such as nutrition, tailored education strategies, and counseling for behavioral issues in autistic or non-autistic children have not been explored before resorting to medication.2
Emotional dysregulation is a term used to describe the behavior of children that goes into the “red zone”, i.e., fighting, breaking things, tantrums, etc. While it can be a source of great anguish for parents and families to have a child presenting these kinds of reactions, Dr. Laura Prager, director of the CPE (child psychiatry emergency services) at Mass general hospital, says “Kids who may not have words to express their feelings or because no-one is listening to them might manifest their anxiety with behavioral dysregulation.” 3 Simply medicating a young child with limited vocabulary and articulation skills may not be the best first choice.
Best Practices for Prescribing Risperdal to Young Children
Best practices would follow the revised 2017 recommendations given in the DSM which clearly indicate that specific criteria need to be met to properly diagnose and treat mental disorders including ruling out psycho-social stressors, such as family or school stressors, etc.) Particularly relevant to considering medicating children being diagnosed with Autism, the criteria for a correct diagnosis as well as a need for more studies on the effectiveness of nutritional therapies as part of treatment protocols should be well considered. 5,10
Does Risperdal Make you Feel Sleepy?
Yes. According to clinical trials, a significant percentage of patients no matter their age group being given Risperdal experienced drowsiness and somnolence to a marked degree. The FDA warns against driving or operating machinery or other tasks requiring alertness while taking Risperdal.1
Does Risperdal Help with ADHD?
Risperdal use for ADHD would be considered an off-label (not FDA approved) use. No studies could be found that actually compare risperidone-based therapy with non-drug therapy. However, nutritional therapy has been widely reported to be extremely successful in treating children as well as adults where deficiencies in vitamin D and omega-3 fatty acids, for example, were corrected and led to major improvements in mood and cognitive function.8,10
A review by Auclair et al published in Sante Ment Quebec concluded that only 2% of adults with ADHD receive effective treatment, and that pharmacological treatment is insufficient. When reviewing an enormous amount of information, the reviewers found that CBT (cognitive behavioral counseling) provided a significant reduction in adult ADHD symptoms without the debilitating side effects of pharma-based treatment. 31
How Long Does Risperdal Stay in Your System?
Risperdal metabolites can be detected for between one and four days. The clearance time may have very little to do with withdrawal manifestations–there is a likelihood that receptors have upregulated themselves in response to the drug.9
The length of time that it may take for the receptors to return to premedicated states may vary from weeks to months and even to years depending on the unique metabolic and health profile of the person. The length of time it will take for an upregulated dopamine transport system to downregulate will largely depend on how long the drug was taken, other drugs that were taken, general health, genetics, metabolic function, the effect of any other medications that may be in use, and even certain diet. These are important factors to consider when choosing Risperdal withdrawal treatments.
Removal of Neurotoxins
At Alternative to Meds Center, we offer a Risperdal withdrawal program that is individually designed, for a minimum amount of discomfort and maximum health improvements, including neurotoxin removal in a safe and gentle way.
There are some studies that have found that chelation to remove heavy metals from the body has been beneficial in some cases of childhood autism, though published comprehensive studies on this subject are not easy to access.5 However, the chelation (removal) of toxic levels of heavy metals has been documented as helpful for many conditions in the adult population.6
We designed our program to address numerous health issues that may have been overlooked before a prescription of Risperdal. Protocols we use include is heavy metal toxicity removal. First, the presence of toxins is tested and analyzed. The offending contaminants are then gently removed as part of a series of cleansing steps that aim to clear the pathway to regaining natural mental health. Cleansing steps include nebulized glutathione treatments, the use of sauna, bentonite clay treatments, specific food-grade supplements, a clean, correct diet, mild exercise, and various other adjunctive therapies. The purpose of these steps is to improve overall health and well-being before, during, and after withdrawal is completed.
Stimulants such as caffeine should be restricted during Risperdal withdrawal. Stimulants such as Wellbutrin, Effexor, and SNRIs may also pose challenges during antipsychotic medication withdrawal. If you will doing Risperdal withdrawal outpatient, discuss all the medications you are taking with the physician who will be assisting you.
Risperdal Withdrawal Treatment at Alternative to Meds Center
We hope you have found the above information useful in understanding some important and useful information concerning Risperdal withdrawal. If you decide on outpatient treatment, feel free to share the information with your prescriber. In any case please call us for more information on our programs and protocols. You may also be interested in insurance coverage, and we can provide that to you as well as answer any other questions you may have about Risperdal withdrawal treatment at Alternative to Meds Center.
26. Maglione M, Maher AR, Hu J, Wang Z, Shanman R, Shekelle PG, Roth B, Hilton L, Suttorp MJ, Ewing BA, Motala A, Perry T. Off-Label Use of Atypical Antipsychotics: An Update [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2011 Sep. Report No.: 11-EHC087-EF. PMID: 22132426. [cited 2021 May 11]
Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.
Medical Disclaimer: Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.