Can I taper Latuda (lurasidone) to Risperdal (risperidone)?

Tapering Lurasidone (Latuda) to Risperidone (Risperdal)

Yes, you can taper Latuda to Risperdal using a gradual cross-tapering approach to minimize withdrawal symptoms and maintain symptom control. 1

Cross-Tapering Protocol

• Begin with a slow, reasonable, collaborative taper with adjuvant treatments as needed for withdrawal symptoms 2
• Avoid abrupt discontinuation of Latuda, as sudden cessation of antipsychotics is considered unacceptable medical care 2
• Follow this specific cross-tapering schedule:

Week 1-2:

• Continue full dose of Latuda while starting Risperidone at a low dose (0.5-1mg daily) 1, 3
• This overlap period helps prevent withdrawal symptoms and maintains symptom control 3

Week 3-4:

• Reduce Latuda by 25% of original dose 4
• Increase Risperidone to 2mg daily if tolerated 1

Week 5-6:

• Reduce Latuda by another 25% 4
• Adjust Risperidone to target therapeutic dose (typically 4-6mg daily) 1

Week 7-8:

• Discontinue Latuda completely 4
• Continue Risperidone at therapeutic dose 1

Monitoring During Transition

• Schedule regular follow-up appointments (every 2-4 weeks) to assess for:
  • Return of original symptoms that prompted antipsychotic treatment 1
  • Withdrawal symptoms including anxiety, insomnia, irritability, and restlessness 2
  • Side effects from Risperidone, particularly extrapyramidal symptoms 1

Managing Potential Challenges

• If withdrawal symptoms occur during tapering, consider temporarily returning to the previous dose before attempting a more gradual reduction 2
• If side effects from Risperidone emerge, slow the upward titration while continuing the Latuda taper 1
• For patients experiencing difficulty with the transition, extending the overlap period between medications may be beneficial 3

Important Considerations

• Document baseline symptoms and functioning before initiating the taper 1
• Percentage reductions should not be understood as a straight-line taper; each new dose should be a percentage of the previous dose 2
• Be prepared to adjust the tapering schedule based on the individual patient's response 1
• Consider adjunctive medications to manage specific withdrawal symptoms if they occur 1

Common Pitfalls to Avoid

• Abrupt discontinuation of Latuda, which can trigger withdrawal symptoms 2
• Starting Risperidone at full therapeutic dose while still on higher doses of Latuda, which increases risk of adverse effects 4
• "Cold referrals" to clinicians who have not agreed to accept the patient during medication transitions 2
• Failing to monitor for both withdrawal symptoms and potential side effects of the new medication 1