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Chances of coming completely off meds from psychosis?


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Well, I am tapering off the max dose (30 mg) of Abilify right now, down to a lower dose, hopefully 12 mg. However, my pdoc asserts that I will be on an antipsychotic probably for the rest of my life. So, I can't say what it's like to get off an antipsychotic. 

 

What I can tell you though is, approach your doctor. They will probably want to take into consideration how long you've been well (psychosis-free), and any residual symptoms you might have. 

 

Have you considered maybe asking about reducing your dose of your antipsychotic first, just to see how you tolerate a lower dose for a while? 

 

Also, I'm just curious, why do you want to come off your antipsychotic? Are you having a lot of side effects? If so, switching antipsychotics could be an option. 

Edited by Parapluie
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Well, I am tapering off the max dose (30 mg) of Abilify right now, down to a lower dose, hopefully 12 mg. However, my pdoc asserts that I will be on an antipsychotic probably for the rest of my life. So, I can't say what it's like to get off an antipsychotic. 

 

What I can tell you though is, approach your doctor. They will probably want to take into consideration how long you've been well (psychosis-free), and any residual symptoms you might have. 

 

Have you considered maybe asking about reducing your dose of your antipsychotic first, just to see how you tolerate a lower dose for a while? 

 

Also, I'm just curious, why do you want to come off your antipsychotic? Are you having a lot of side effects? If so, switching antipsychotics could be an option. 

 

 

I will be asking my pdoc next meeting and I want to get off because I have sexual problems (cant ejaculate and orgasms arent intense anymore) I take 100mg invega sustenna injection every 4weeks

Edited by revv
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I've discontinued numerous times, but not tapered off under supervision. Given that's been disastrous each time if advise against.

Saw the bit about your invega concern. I'm female and invega didn't do shit for me. There are others you can try abs might want to ask doctor about a switch.
Sorry I can't be of more use but saw your message and ...voila
Good luck

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I was off meds for a while - about 6 years or so. I did pretty well, until various stressors started getting ramped up and things started getting bad again. So I'd say its possible, but you have to be viligant about relapses.

I have schizophrenia.

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People can and do come off medication for psychosis without detriment, but usually tha is due to factors like:

 

* having had early intervention/achieving long term stability on medication they taper off from

* having coping skills and stress management

* having a support network

* taking good care of their physical health

* being able to identify when their symptoms start early on and treat them.

 

Psychosis can be something that affects people in a very severe, enduring way which requires medication no matter how much of the above they have, which is unfair but a fact. Some people need medication for a while, or stay on a medication but change the dose, or use medication for episodes and self management skills the rest of the time. It's impossible to know which in advance you are (with certainty) without working with a doctor who has your history and doing some safe testing to see how well you fare without medication. Often coming off medication is a stressful phase for your mental health in itself, so if it takes you a few months to come off a medication, it can take over six more months to get an accurate idea of how likely it is to stay stable without any medication at all.

 

I hope the plan works and you can manage things or find a med that won't affect your sex drive.

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I was on Zyprexa and tapered off it very very slowly for several months.  

Shortly after stopping it I had an episode and immediately went on Zyprexa again.

 

Now I am confident I will be on meds forever.

My suggestion is if you want to come off work with your doctor, get off of it very slowly, and be attentive to the returning of symptoms.

 

Good luck hope everything works out.

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I have been on and off APs for 8 years coinciding with periods of mania and psychosis. In retrospect I think the reasons I kept relapsing is because I wasn't on some firm of AP long term. BTW it was really hard to write that last sentance. Anyway I read this thread with great interest as I have been wondering the same thing. Will I ever be AP free?

I have been trying to reduce my Abilify and gotten it down to 15mg from 30mg in gradual steps. Each step was hard in itself but I got used to the process and knowing what to expect. What ever you decide and for whatever reason it has to be gradual! For me that was 5mg increments every two months but your doctor would advise you. At the moment I'm stuck on 15mg... Every time I go down to 12.5mg I break down in terms of depression and holding it together.

For myself, personally, my doctor will not support me reducing the Abilify to 0 and I am reluctant to go it alone. My hope is that in about 2 to 3 years I will be able to get off it but as another poster pointed out if I am exposed to the right (the wrong?) triggers I would be vulnerable to becoming psychotic/manic even after that time without the appropriate meds.

Edited by nightbutterfly
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It's common to report that taking AAP's 'blunts' emotions and experiences of pleasure.

 

In some cases, the medication is making that experience more difficult to obtain, often because a high dose is needed to take someone down from a crisis episode. The thing about psychosis is, it takes away someone's insight. Which would have been easier for me if I had known I didn't have insight. But as I was crawling on the ER floor telling people the world had ended and we were all empty shells, I also TOTALLY believed that I was functioning and responsible for myself. By the time I got to ER, I had a couple of weeks of not eating, abusing alcohol, not sleeping and my body being fuelled on caffiene, booze and adrenaline. On a physical level alone, anyones body would have been exhausted, I was psychotic to boot.

 

When that happens, helping keep someone safe and regaining their insight is the priority. And with AAP's, that starts with a hefty dose. To make it worse, the negative symptoms of psychosis (lack of coherent thoughts/speech/lack of motivation/withdrawn or numb manner) can combine with that hefty dose and make you feel zombified. I have been there, drooled through six months, stopped the meds and gone crazy and had to rinse and repeat.

 

The other problem in my case was that, for a good five years, I had managed to mostly hide my psychosis. This was partly because the secrets in library books to me not to talk. Being psychotic was nightmarish, yes. But when I was psychotic, I knew the secrets of the world, I was chosen by God, I walked with armies of demons and ravens, I could control things with my mind, everything morphed in front of my eyes. It could be hellish, but also beautiful, and exciting.

 

So being medicated, pulled out of normal life, living on a ward or with my folks with no money was DULL. Realizing that I had been out of my tree mad made me feel embarrassed. I had lost my thread with life and I was starting all over again, all my prior life plans had gone to shit. The few year or so being medicated was boring. I didn't feel bliss or terror or any kind of specialness. I lost touch with my friends, pop culture seemed irrelevant to me now I was in the psych system, my world was one of waiting rooms and wards.

 

Psychosis is an incredibly stressful chemical phenomenon in the brain. It exhausts the body, it scrambles the mind. Even if the meds weren't sedating (they are) I would have felt burned out after an episode. I see a lot of people assuming that the way they feel post crisis is how they will feel forever, unless they rush off the meds. Reducing meds or swapping for something less heavy duty can help, looking at coping skills and therapy can also help. But some of what people call 'losing their emotions' is actually just their body and mind being exhausted and the reality that, after a holiday in psychosis land, ordinary life is pretty dull at first.

 

When acting bizarre in public is your norm, it takes time to regain your social skills and enjoy a night out. When everything you see is communicating a secret message to you, it takes a while to feel interested in ordinary life were you're not that special. 

 

I started Risperidone in 2006 after a psychotic breakdown. I took it faithfully until 2010, where I tapered down, had a relapse and titrated back up a few mgs. It took till 2012 to come totally off and stay off, even now I use it PRN in a crisis. If I had to take it again, I would. An AAP is a tool, like anything else, you weigh up what it will do vs the cost of it and make your choice. In 2006, I couldn't dress myself or leave the house. Now I work, live alone, hold down a job, write, campaign nationally and have a rocking social life, even with a PRN AAP. Many of those charming and fascinating mentally ill celebs we praise take AAPs.

Edited by Titania
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