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I'm wondering, for people with schizoaffective, about staying on an AAP. Before my diagnosis changed, and I was diagnosed with bipolar, pdoc was telling me that after I was stable, I could go off of Risperdal. I'm wondering if now that my diagnosis changed that is still the case, or if I'm most likely going to always have to stay on an AAP. I'm pretty much symptom free, and have been for a month or two. I'm slightly depressed, but it's situational, and I still have some anxiety at night, but that's it. I'm currently supposed to be taking 2mg Risperdal at night, but for the past 2 weeks I've been cutting them in half and taking only 1mg because I'm so tired of being so tired in the morning. I see my pdoc on Friday and I'll ask to go back down to 1mg and about coming off completely, but I'm just wondering if I'm getting my hopes up for nothing. Does anyone come off of their AAP when stable and then go back on if symptoms start back up? I'm still not totally sure what all this diagnosis means for me in the long run I guess.

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Schizoaffective means you have both schizophrenia and a mood disorder. So you will definately need an antipsychotic for life to treat the schizophrenia. When your diagnosis was bipolar with psychotic features you were told you could come off it because psychotic features subside once the mood comes down. Not the case with schizoaffective which involves chronic psychosis.

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Despite my dx, I do have psychotic feature outside of mood swings and I agree - you will probably need something to manage your psychotic symptoms on an ongoing basis.

Is it worth it to go off and then spend the time, when they reoccur, re-stabilizing yourself? Not to mention the damage that may happen in your life in the meantime, the cognitive damage, etc. I just think the risks aren't worth it.

Maybe you need to look at another AAP that doesn't have the same sedation issue?

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Thanks guys. That's kind of what I figured, but was hoping I was wrong. I'm going to see if pdoc is okay with me going down to 1 mg (I'm pretty sensitive to meds, and I've taken myself down to 1mg anyways) and see how I do with that. I like that it helps me sleep, since without it I will lay in bed for hours not able to sleep. I'm sleeping 7.5-8 hours per night on the week days (all I can get with my work schedule), but I don't use my alarm on the weekends and I tend to sleep 9-10 hours. I feel much better when on weekends. I also seem to be unable to lose weight, and have zero sex drive. Pdoc has been reluctant to change my AAP for some reason, but I guess it's because the side effects have been very minor and it's taken good care of my symptoms. I just hate that I have to take meds and would like to be on as few as possible, but I also don't want to be crazy.

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Just to chime in with the others, I have heard this from a hospital pdoc too. He said that with bipolar with psychosis you can usually come off the AP when the episode ends. With schizoaffective, it's a different story and you need to remain on the AP indefinitely unfortunately.

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Guest Vapourware

I have to agree with everyone else, you will probably have to remain on a AP indefinitely. Otherwise, there is a good likelihood of your psychotic symptoms re-emerging.

When my pdoc thought I was bipolar last year, I tried maintenance therapy with just sodium valproate and no AP. I flamed out spectacularly in a few months and had a nasty psychotic episode with voices and delusions.

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I'd agree with everyone here but also add that some of your side effects don't seem THAT minor to me and if they are really intefering and this is the first AAP you've tried it might be worth trying a different one to see if you can get sx control with less side effects.

And not all bipolars come off their AAPs when not in acute episodes. I certainly do not and would never dream of trying it.

Anna

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There is a major paradox in the health field, especially within psychiatric patients: a tendency to decide to stop medications when symptoms subside without realizing it is the medicine that is inducing the remission being experienced. Typically patients with psychotic disorders are kept stable on some sort of AP even when asymptomatic. Sometimes when someone is in a sustained remission, medication dosages are lowered in expectation that the patient's remission is not being sustained solely due to the medication.

Your pdoc probably will be opposed to completely taking you off an AP at first. I would expect that he/she will think more along the lines of either maintaining your current dose or lowering it.

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So my pdoc said that I can reduce my Risperdal, as low as 0.5 mg as long as I don't start having symptoms. She said for me to monitor it and move between 0.5-2mg, so I'm going to do that. She said that once I've been stable for a while, we can slowly get me off of meds for the sole purpose of having a child but then I'd have to go back on for sure. I don't hate being on my meds, because I do feel so much better now, I just hate that I feel so sleepy. Hopefully I will be able to get down to 0.5mg Risperdal without the symptoms returning and maybe not be so tired. I've been doing good on 1mg for the last couple of weeks, so I'm hoping for the best.

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