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Doctor not Tapering medications
Hello sir/mam
My mom is a long term patient and has been on psychiatric drugs from her teenage years.
After a long duration of usage she is showing the effects recently also she has diabetics hypertension.
So she takes Loricon 1 Riscon LS Clonam IR 0.25 this is her optimal dosage
And her General medicines Glimy MV1 Tazloc 40 pregaba 50
Recently one day she started having stiffness all over body and mouth can't able to speak but she was conscious
So after consulting her diabetic doc and psychiatrist we took an MRI and everything was fine
Her diabetic doc asked for blood test all fine
So he ruled out seizure and said it could be EPS after sharing the case with his friends and suggested a taper
But her psychiatrist is not going on with this even after suggesting taper as I know my mom is mentally doing very well
I really want to get her out of this gradually and I pay this here to get opinion from different docs
Thank you in advance
Answers (9)
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Kindly get a second opinion if you are doubtful. Stopping Psychiatric Medications may lead to relapse of symptoms. So it has to be done cautiously. Good luck
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From what you have described, your mother’s sudden stiffness, difficulty speaking, and preserved consciousness could indeed be extrapyramidal symptoms (EPS), which can occur as side effects of antipsychotic medications like Riscon LS (risperidone) especially after long term use. EPS risk increases with age and in those with medical comorbidities. If her MRI and blood tests are normal, medication induced EPS is a strong possibility. The safest approach is to discuss again with her psychiatrist about either gradual dose reduction, switching to a lower EPS antipsychotic, or adding anti EPS medication (like trihexyphenidyl), while closely monitoring her mental stability. Since she is currently psychiatrically stable, a slow, supervised taper might be reasonable, but it must be done under her psychiatrist’s guidance to prevent relapse.
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Hello,
I understand your concern regarding your mother’s recent episode and her long-term psychiatric medication use. Based on the details you shared, here are some thoughts and next steps:
1. Possible cause:
• The stiffness, difficulty speaking, but preserved consciousness could indeed be Extrapyramidal Symptoms (EPS), which are possible side effects of some antipsychotics like Risperidone (Riscon).
• Since MRI and blood tests were normal and seizures have been ruled out, EPS becomes more likely, especially in someone on long-term antipsychotic use.
2. • Do not abruptly stop any psychiatric medication — sudden discontinuation can cause withdrawal symptoms or relapse.
• Discuss the possibility of gradual dose tapering or switching to an antipsychotic with lower EPS risk — this must be done under psychiatric supervision only.
• Ask about adding medication short term to relieve EPS symptoms if confirmed.
Next Steps
Tips to support her health during this phase:
• Monitor symptoms daily — note any stiffness, tremors, slowness, facial expression changes, or speech difficulty.
• Maintain stable blood sugar and BP control — uncontrolled diabetes or hypertension can worsen neurological side effects.
• Encourage gentle physiotherapy/stretching to maintain mobility.
• Ensure adequate hydration and nutrition.
• Keep stress levels low — emotional stability supports physical recovery.
4. When to seek urgent help:
If she develops high fever, confusion, severe muscle rigidity, or inability to move — seek emergency care immediately (possible Neuroleptic Malignant Syndrome, though rare).
Health Tips
Please consult psychiatrist before making any medication changes. A slow, monitored taper or switching to a lower-risk alternative may be possible if her mental state is stable. EPS symptoms can often be managed or reversed with timely action.
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As per my opinion, medications as resperidone should be optimised or tapered since eps may be associated with it
Second, Clonazepam and lorazepam should be tapered and other medication as zolpidem or melatonin should be prescribed for sleep
On tapering resperidone, if symptoms reoccur, other medications should be prescribed at low dose to minimise EPS
You must consult other psychiatrist with all records and investigations for proper selection of medication as per patient's symptom, side effects profile
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Hello,
It looks like the person is posting on a medical opinion platform, sharing their mother’s long psychiatric medication history and asking for guidance about tapering off medications after experiencing stiffness and inability to speak (possibly extrapyramidal symptoms).
Next Steps
1. Emphasize that only a licensed psychiatrist should adjust psychiatric medications.
2. Suggest seeking a second or third opinion from another psychiatrist, especially one experienced in managing long-term psychotropic use and withdrawal.
I should point out a thing that her diabetes and hypertension medications could interact with psychiatric drugs, so a coordinated care plan between specialists is best.
Health Tips
Encourage keeping a symptom diary to track any side effects and changes during treatment discussions.
For more queries, Reach out for an online or in-person consultation:
📞 NEURONAL FIX CLINIC, RAMPRASTHA COLONY, Ghaziabad, (near Shreshtha Vihar, Delhi)- +91- 74XX52XX97XX67XX61
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Hello Sir
For sure, the symptoms looks like EPS only
And since your mother is doing well with Psychiatric illness she was suffering, the medicine dosage can be reduced and stopped depends on illness and it's duration (need further brief history on that)
And with that the side-effects (EPS) will also come down
Next Steps
kindly consult online for further management and treatment
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Dr. Seujee Goswami
Psychiatrist
13 yrs exp
Bangalore
From the description, your mother may have experienced extrapyramidal symptoms (EPS), which can occur with long-term use of certain psychiatric medications such as Risperidone (Riscon LS). EPS can present with stiffness, difficulty speaking, and muscle rigidity while remaining conscious. Even if MRI and blood tests are normal, such side effects need careful consideration. However, medication tapering in a long-term psychiatric patient must be done very gradually and under close supervision, as sudden or rapid changes can risk relapse. The psychiatrist’s hesitation may be due to concerns about destabilising her mental health, especially with a long history of illness.
Next Steps
• Discuss with her psychiatrist about the possibility of side effects and whether any dose adjustment or change of medication might help.
• Ask if a simple CPK (creatine phosphokinase) blood test is needed as a precaution to rule out rare conditions like neuroleptic malignant syndrome (NMS).
• Keep a note of when and how symptoms appear.
• Consider a second opinion if you want a fresh review of her treatment.
Health Tips
• Do not change medicines without medical guidance.
• Report promptly if she has ongoing stiffness, fever, unusual sweating, or confusion — these can be early signs of rare medicine reactions like NMS.
• Keep regular follow-ups for both psychiatric and physical health.
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Dr. K L Tejaswini
Psychiatrist
7 yrs exp
Guntur
Hii
As ur mother has been doing well for a long time and was on a minimal dose of antipsychotics..
With age even a minimal dose may cause EPS so, we can taper the drug slowly and observe whether any reemerging psychotic symptoms happen..
Also ur mother is on 2 benzodiazepine which might already become addiction to her and there is need for handling that too..
If only recent subside of psychotic symptoms were observed and had previous recurrent psychotic symptoms after tapering of medication better to switch the medication to lower EPS causing newer generation antipsychotics..
Next Steps
consult Psychiatrist for further assessment and treatment
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