From the Research
For tapering risperidone 1mg twice daily after less than a month of use, a gradual reduction over a period of months, with a hyperbolic tapering schedule, is recommended to minimize the risk of relapse and withdrawal symptoms. This approach is supported by the most recent and highest quality study, which suggests that tapering antipsychotics gradually, over months or years, and in a hyperbolic manner, can reduce the risk of relapse on discontinuation 1. The tapering process should be individualized, with reductions in dose made at intervals of 3-6 months, titrated to individual tolerance. Some key points to consider when tapering risperidone include:
- Reducing the dose by one quarter (or one half) of the most recent dose, equivalent to a reduction of 5 (or 10) percentage points of its D2 blockade, sequentially 1
- Final doses before complete cessation may need to be as small as 1/40th a therapeutic dose to prevent a large decrease in D2 blockade when stopped 1
- The tapering period can be relatively long, as the goal is to allow underlying adaptations time to resolve, possibly reducing the risk of relapse on discontinuation 1 It's essential to consult with your prescribing healthcare provider before making any changes to your medication regimen, as they may recommend a personalized tapering schedule based on your specific medical condition and response to the medication. If you experience significant withdrawal symptoms during the taper, your provider may suggest slowing the tapering process. Other studies, such as 2, also support the idea of gradual tapering to minimize withdrawal symptoms, although they may not specifically address the hyperbolic tapering schedule recommended in 1. In any case, the most recent and highest quality study, 1, should be prioritized when making decisions about tapering risperidone.