How long do side-effects of risperidone take to wear off in elderly dementia patients?

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Does anyone know how long it takes this stuff to wear off when it's stopped in elderly dementia sufferers? I see from internet searches that the half-life is only supposed to be about 20 hours, but I'm doubtful about this.

I'm the legal guardian of an 80-year-old friend suffering from multi-infarct dementia, who was given this terrible drug without my knowledge or agreement about three weeks ago, after she became violent with a member of staff at her retirement home. She was put on 2mg twice a day - combined with the Seroxat and Remergon she was already taking - and turned overnight from a strong, vigorous woman capable of pushing a fit young man down the stairs (the reason they prescribed it) to a catatonic husk, unable to talk or move.

After three doses the nursing staff panicked, reducing the dose to 0.5mg once a day, and she immediately went into a terrifying psychotic episode. For 72 hours she ran around the place non-stop screaming with terror, without eating, drinking or sleeping, until the dose was increased to 1mg twice a day. She then returned to a catatonic state, lying in bed completely immobile, and barely able to swallow food or liquids.

In the ten days since then, the dose has been reduced slowly and the drug has now been stopped. My friend, who now has multiple bedsores as a result of the ten days of immobility, is beginning to move a little, but has become extremely restless and deluded - far more so than when the drug started - with the result that she constantly tries to run around and then falls over.

The Parkinson's-type symptoms are slowly improving so I'm hopeful that no permanent damage has been done. I understand that the increase in her psychotic symptoms is due to withdrawal of the drug. My question is: how much of this damage is likely to be permanent?

I'm heartbroken at seeing her in this awful state.


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4 Replies

  • Posted

    Hi, it took a full three months for the effects of rispiridone to wear off for me. It is not the half life of the drug, it is the disrupted underlying brain chemistry that takes so long to recover.
    • Posted

      Thank you for your reply. Sadly my friend died 18 months after my post from the side-effects of various other antipsychotic drugs, including clozapine and olanzapine. I believe it was the latter that put the final nail in her coffin, totally paralysing her hands and feet, thus depriving her of the last vestiges of her autonomy.

      This is a terrible indictment of the off-label use of antipsychotics to control aggression in elderly people who become aggressive as a result of mismanagement of dementia. I am particularly incensed by the tendency of unspecialised general practitioners to start these frail elderly patients on the maximum dose of these powerful drugs without even trying them on a small dose.

    • Posted

      While I agree with your sentiments, I'd point out that psychotropic drugs are badly over prescribed from preschool age upward. The problem is treating symptoms with no attempt to understand cause - modern medicine in a nutshell.


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