The lowest dose of ap i’ve been on was 3mg risperdal. On every ap i have been on i have had breakthrough symptoms. I think I might be very treatment resistant or I just suffer short intermittent episodes regardless of which ap im on. Ativan so far has been the only thing which really erased my symptoms.
I am also toying with the possibility of having a more ocd based disorder. My only symptoms are intrusive thoughts, intense anxiety and transient cognitive impairment. Maybe these issues don’t point to paranoid sz.
Getting to the point, i want to see what i would be like on lower doses of medication. I am thinking of asking my psychiatrist to gradually wean me off abilify, very slowly like 5mg per month and see what happens. That way we will know what my threshold is rather than just guessing more is better.
What do you think? The ultimate goal woul be getting to the lowest therapeutic dose or lower (10-5mg). Will this be a disaster?
It can’t hurt to ask. The goal for everyone should be to be on the lowest effective dose. How long have you been stable on your current dose for? I think they like a year and a half of stability before they expirament with reducing.
I have only been “stable” two months or so on abilify. As for other aps I have been stabilized for about two years.
Thinking back to the beginning, the delusions actually went away or got really weak before I was put on medication. Maybe that points to me not really needing it?
I’ve never heard of the one year of stability being needed for experimentation with the doses. Maybe I could convince my pdoc to do it regardless by framing the reductions as being in response to side effects and not just how low can you go. You know?
I messed up when they lowered my dose of Haldol a long, long time ago. I was doing large amounts of ephedrine and caffeine, though. If they lower your dose be careful about ingesting any other mind altering substances.
The reason they do it like that is to give your brain a chance to heal from the literal physical brain damage that psychosis causes. The brain is capable of repairing itself, but it needs the help of the meds. Statistically, people who try to lower their dose after only two months of stability tend to relapse and then need an even higher dose to achieve the same stability as before. This is for life, so you want to make sure you do it right. I screwed myself over this way. I was stable on 40 mg of Geodon for six months, so I tried stopping on my own. And now, I’m stuck on 80 mg with more side effects.
Definitely don’t lie to your doctor about having side effects. It could come back to bite you in the ass. For one thing, if she figures out you were lying, you will lose all credibility with her and you might no longer be trusted to accurately report your symptoms.
The side effects thing is only sort of a half lie. I am suffering from intolerable anxiety on aripiprazole.
I am not planning to go off the meds altogether to clarify. I just want to steadily, gradually reduce them, maybe down to 20mg maybe lower.
As for brain damage, I recognize that is a possibility and will opt to remain in contact with my pdoc at all times as well as keeping prn’s on hand.
I think studies have shown that some of us function better off medication. Remember darksith? Some of us can manage without. I would like to see whether I can manage on less or without.
Well darksith was one of my favorite posters, but even he would admit he wasn’t functioning as well as someone who takes medication. I mean, he once put all his furniture in a pile in his backyard and lit it all on fire. I know you’re starting school soon. It just might be a better idea to wait to change your dose until you know how the stress of a new school will affect you.
But hey, it sounds like your plan is reasonable. If you and your doctor do decide to do this, make sure you lean heavily on your support systems during your transition.
Thanks for the advice, This idea just popped into my head this evening and I needed to think it out, i’ll pose the idea to my pdoc and see what he says. With him it is usually a very strong no or a very strong yes.
It’s pretty much the main strategy my doctors are using. I’ve got some voices and delusional thinking, but I have the insight and coping strategies needed to deal with them and maintain a high level of function. Too much medication and my cognition just plummets.
I don’t think it will be a bad thing to try this so long as it is done with medical oversight and you’ve made sure you have a support network in place if things go sideways.
