Hi everyone, and thank you to those who keep this website running.

 

I’m a 33-year-old female who has been taking various psychiatric drugs since I was 20. It started with an antidepressant in 2013, and then I had to continuously take antipsychotics and “mood stabilisers” after my hospitalisation with psychosis in 2015.

 

I made multiple attempts at tapering off the drugs under my doctor’s supervision. However, each ended with a psychotic episode (apparently caused by the antipsychotic-induced dopamine supersensitivity), subsequent hospitalisation and being put on higher doses of drugs.

 

I described this in more detail in my intro topic on SA. It was posted in January 2025 but wasn’t updated since (I apologise to @Jane318, who kindly took the time to welcome me, for my lack of further engagement).

 

~~~

 

Since making that post, I went on to lower the dose of aripiprazole while keeping lamotrigine at 150 mg. I went from aripiprazole 11.25 mg in January 2025 to 10 mg in March, 7.5 mg in April, 5 mg in May and 3.75 mg in June 2025.

 

There were several reasons why I decided to do a faster taper instead of 10% reductions from the latest dose:

 

1) I consulted supplementary materials to this study about tapering antipsychotics by Horowitz et al. (link to supplementary data at the bottom of the page). There were two tables showing how aripiprazole dose relates to dopamine D2 receptor occupancy. According to the data provided (link to the relevant table), 11.2 mg of aripiprazole corresponds to about 85% D2 occupancy, while 2.9 mg corresponds to about 80% D2 occupancy. Thus, I assumed that going from 11.25 mg to 3.75 mg of aripiprazole over 6 months would correspond to less than 5% change in D2 receptor occupancy overall. This seemed like a safe decrease over half a year, and I planned to substantially slow down my taper moving forward.

 

2) There was a time in the past when I was taking 3.75 mg of aripiprazole, and another time I was taking 2.5 mg of aripiprazole for months without issues.

 

3) Before and throughout my last taper, I was on a high dose of lamotrigine (150 mg), and I hoped its calming effect would support my aripiprazole taper.

 

Alas, despite the above considerations, I had another psychotic episode leading to hospitalisation in July 2025.

 

~~~

 

I am currently (April 2026) taking aripiprazole 10 mg and lamotrigine 62.5 mg. My tentative plan is to reduce lamotrigine to 50 mg over the next ~3 months, hold, and then start a careful taper of aripiprazole.

 

The smallest strength of generic aripiprazole tablets I’m taking is 10 mg. Luckily, there’s also a 1 mg/ml oral solution of aripiprazole available where I live. As the first step of my aripiprazole taper, I was thinking of cutting 10 mg pills in half and adding 4 ml of oral solution for a total of 9 mg.

 

I have now accepted that it might take ~5 years to completely come off aripiprazole if I stick to the 10% per month rate (I aim at the final dose of 0.01 mg). I would then move on to tapering my 50 mg of lamotrigine.

 

Strangely, I don’t feel disheartened by my earlier unsuccessful attempts. There’s something within me that five involuntary hospitalisations and around a dozen different drugs over the years couldn’t destroy. I wish for myself and for everyone here to see our strong, vibrant and resilient part grow as we move towards a drug-free life.

 

( ◡ ‿ ◡ ) * : ･ ° ☆

Hi @SofterLine

 

Welcome to the forum!

 

I think you might be our first Ukrainian! 🙂 Very nice to have you hear.

 

This is a volunteer-run, community forum aimed at helping those who are tapering and/or experiencing difficulties with psychiatric medications and withdrawl syndrome. We are not medical professionals and cannot offer medical advice. We simply offer support and opinions which you could use as talking points with a medical provider knowledgeable in withdrawing off psychiatric medications.

 

Please familiarise yourself with the forum rules and the disclaimer located here: Guidelines

 

Please make sure your signature is kept up to date with your drug history. This will allow members to see some basic information about your drug history and situation so that they may help you best. Information on how to do this is located in the FAQs section above, but here is a direct link: Update Signature

Once this is done, future posts made by you will have this signature turned on by default. For this reason please keep it clear but condensed as possible.

 

14 hours ago, SofterLine said:

Hi everyone, and thank you to those who keep this website running.

Pleasure

 

14 hours ago, SofterLine said:

I’m a 33-year-old female who has been taking various psychiatric drugs since I was 20. It started with an antidepressant in 2013, and then I had to continuously take antipsychotics and “mood stabilisers” after my hospitalisation with psychosis in 2015.

 

I made multiple attempts at tapering off the drugs under my doctor’s supervision. However, each ended with a psychotic episode (apparently caused by the antipsychotic-induced dopamine supersensitivity), subsequent hospitalisation and being put on higher doses of drugs.

 

I described this in more detail in my intro topic on SA. It was posted in January 2025 but wasn’t updated since (I apologise to @Jane318, who kindly took the time to welcome me, for my lack of further engagement).

Thanks for the update on your past. Im sorry to read you have had a hard time. Unfortunately it sounds like a lot of what you have experienced has been caused by these drugs and the terrible effects they can have on us.

 

14 hours ago, SofterLine said:

Since making that post, I went on to lower the dose of aripiprazole while keeping lamotrigine at 150 mg. I went from aripiprazole 11.25 mg in January 2025 to 10 mg in March, 7.5 mg in April, 5 mg in May and 3.75 mg in June 2025.

 

There were several reasons why I decided to do a faster taper instead of 10% reductions from the latest dose:

 

1) I consulted supplementary materials to this study about tapering antipsychotics by Horowitz et al. (link to supplementary data at the bottom of the page). There were two tables showing how aripiprazole dose relates to dopamine D2 receptor occupancy. According to the data provided (link to the relevant table), 11.2 mg of aripiprazole corresponds to about 85% D2 occupancy, while 2.9 mg corresponds to about 80% D2 occupancy. Thus, I assumed that going from 11.25 mg to 3.75 mg of aripiprazole over 6 months would correspond to less than 5% change in D2 receptor occupancy overall. This seemed like a safe decrease over half a year, and I planned to substantially slow down my taper moving forward.

 

2) There was a time in the past when I was taking 3.75 mg of aripiprazole, and another time I was taking 2.5 mg of aripiprazole for months without issues.

 

3) Before and throughout my last taper, I was on a high dose of lamotrigine (150 mg), and I hoped its calming effect would support my aripiprazole taper.

 

Alas, despite the above considerations, I had another psychotic episode leading to hospitalisation in July 2025.

It sounds like you have read alot about all of this. I don't disagree with your approach here at all. In theory you are right (although I have not checked your workings out!) that we can taper these drugs much quicker in the higher dose ranges.

 

Im not sure if your hospitalisation here has any correlation to your your taper actually being too quick though?

 

14 hours ago, SofterLine said:

I am currently (April 2026) taking aripiprazole 10 mg and lamotrigine 62.5 mg. My tentative plan is to reduce lamotrigine to 50 mg over the next ~3 months, hold, and then start a careful taper of aripiprazole.

 

The smallest strength of generic aripiprazole tablets I’m taking is 10 mg. Luckily, there’s also a 1 mg/ml oral solution of aripiprazole available where I live. As the first step of my aripiprazole taper, I was thinking of cutting 10 mg pills in half and adding 4 ml of oral solution for a total of 9 mg.

 

I have now accepted that it might take ~5 years to completely come off aripiprazole if I stick to the 10% per month rate (I aim at the final dose of 0.01 mg). I would then move on to tapering my 50 mg of lamotrigine.

 

Strangely, I don’t feel disheartened by my earlier unsuccessful attempts. There’s something within me that five involuntary hospitalisations and around a dozen different drugs over the years couldn’t destroy. I wish for myself and for everyone here to see our strong, vibrant and resilient part grow as we move towards a drug-free life.

Thanks for the update on your taper plan. Happy to help where we can too.

 

It is really important to not switch drug types around without making a transition taper between the two first. We outline that in our DIY Small doses topic.

 

I would look into getting a set of scales and simply dry cut your dose down for the minute. Cutting a 10mg pill in half would need a set of scales to do this accurately, and then it is better to not add in a liquid to make up the rest of your dose, without crossing over that portion of your dose first, as descibed in the link below.

 

Dry cutting or a DIY liquid would be a better route here I think.

 

I love your spirit very much 🙂 

 

Here are some useful links for you to read:

 

Tapering Information

 

Preparing Doses for Tapering - Weighing & DIY Liquids

 

Using Manufactured Liquid Antidepressants

 

Micro Tapering

 

In the mean time this is what I would do if I were you:

 

-Stay Hydrated 

 

-Eat a good clean whole food diet, avoiding processed foods and sugars.

 

-Stay away from caffeine, alcohol and antihistamines and any other psychoactive substances.

 

Supplements are to be avoided initially, as they often irritate our nervous systems. Try to get your nutrition through food.

 

Down the line, you may wish to introduce Fish Oil and Magnesium. Those who can tolerate them have found them calming to the nervous system. Be careful try one at a time and start low and see how you get on should you choose to try them.

 

A daily walk is very important as much as you can manage, if you can manage it. Gets you your fresh air and Vitamin D does wonders for your mind!

 

You are very welcome here and I hope you find the site supportive.

 

Chippy

 

 

Thank you so much for your warm welcome and helpful suggestions @Chippy! I appreciate it.

 

1 hour ago, Chippy said:

I think you might be our first Ukrainian! 🙂

 

I'm not surprised 🙂 I was living in the UK at the time of posting in SA, but have returned to my home country since.

 

1 hour ago, Chippy said:

Please make sure your signature is kept up to date with your drug history. This will allow members to see some basic information about your drug history and situation so that they may help you best. Information on how to do this is located in the FAQs section above, but here is a direct link: Update Signature

 

I didn't find detailed signature guidelines in the FAQ section, so I just wrote what I saw fit 🙂 If my signature needs alterations, please let me know.

 

1 hour ago, Chippy said:

Im not sure if your hospitalisation here has any correlation to your your taper actually being too quick though?

 

I'm not sure either. It's possible my nervous system had become too sensitive from previous attempts at tapering and reinstatements (what I understand is referred to as "kindling"), so it couldn't handle my faster taper well. Another thing is that I used a pill cutter without scales. Cutting a 15 mg aripriprazole pill into quarters (for 3.75 mg doses) could've been too imprecise for a smooth taper.

 

It's also likely that my moving back to Ukraine a few months prior was a stressor for the system, overlapping with dose reductions.

 

2 hours ago, Chippy said:

It is really important to not switch drug types around without making a transition taper between the two first. We outline that in our DIY Small doses topic.

 

I would look into getting a set of scales and simply dry cut your dose down for the minute. Cutting a 10mg pill in half would need a set of scales to do this accurately, and then it is better to not add in a liquid to make up the rest of your dose, without crossing over that portion of your dose first, as descibed in the link below.

 

Dry cutting or a DIY liquid would be a better route here I think.

 

These are all very valid points, thank you. I haven't considered the need for a crossover to a liquid solution. And while doing it, I would need scales anyway, so it's probably better to get the scales and stick to dry cutting for the time being.

 

Before tapering aripiprazole, I'd first like to reduce lamotrigine from 62,5 to 50 mg (mostly for convenience, and I will then likely hold this dose for years to come), and it's better to do so having scales as well. I feel a bit under the weather currently, so I'll look into the dry cutting method and using scales in more detail later. 

 

2 hours ago, Chippy said:

I love your spirit very much 🙂 

 

😊 I'm very lucky in that so far, I haven't had any debilitating symptoms during my taper attempts except for eventual psychosis itself. That helps me stay fairly positive while tapering. My heart goes out to those who suffer under the weight of withdrawal symptoms.

 

Again, thanks a lot @Chippy for taking the time to read my post and respond to me, for the links and all the suggestions.

2 hours ago, SofterLine said:

Thank you so much for your warm welcome and helpful suggestions @Chippy! I appreciate it.

Pleasure

 

2 hours ago, SofterLine said:

I didn't find detailed signature guidelines in the FAQ section, so I just wrote what I saw fit 🙂 If my signature needs alterations, please let me know.

 

That is ok, I should do one at some point. I think yours if fine. You seem very to have your doses under control, so not a bit issue. If you can just keep it upto date that would be great 🙂 

 

2 hours ago, SofterLine said:

'm not sure either. It's possible my nervous system had become too sensitive from previous attempts at tapering and reinstatements (what I understand is referred to as "kindling"), so it couldn't handle my faster taper well. Another thing is that I used a pill cutter without scales. Cutting a 15 mg aripriprazole pill into quarters (for 3.75 mg doses) could've been too imprecise for a smooth taper.

 

It's also likely that my moving back to Ukraine a few months prior was a stressor for the system, overlapping with dose reductions.

 

Yes i think this is very likely. As you point out, pill cutters just are not accurate enough for a taper.

 

It all adds up I think.

 

2 hours ago, SofterLine said:

These are all very valid points, thank you. I haven't considered the need for a crossover to a liquid solution. And while doing it, I would need scales anyway, so it's probably better to get the scales and stick to dry cutting for the time being.

 

Before tapering aripiprazole, I'd first like to reduce lamotrigine from 62,5 to 50 mg (mostly for convenience, and I will then likely hold this dose for years to come), and it's better to do so having scales as well. I feel a bit under the weather currently, so I'll look into the dry cutting method and using scales in more detail later. 

It is a pleasure. I think for many getting scales and just cutting is best, at least till you get lower. But a liquid now is fine too. Scales can be handy when making a lquid, as it allows you to weigh peices of a pill, or ground pill/powder to make up liquid (best to not store liquid) so either way its good to have them.

 

Makes sense to get to a whole pill. Yes good to hold where you are if you aren't feeling right atm. Any questions ask here won't you. 🙂 

 

2 hours ago, SofterLine said:

😊 I'm very lucky in that so far, I haven't had any debilitating symptoms during my taper attempts except for eventual psychosis itself. That helps me stay fairly positive while tapering. My heart goes out to those who suffer under the weight of withdrawal symptoms.

 

Again, thanks a lot @Chippy for taking the time to read my post and respond to me, for the links and all the suggestions.

Good to see. Lets keep it that way by staying in touch and being nice and methodical. WD is no fun.

 

Honestly, Im happy to try to help. Good to have you hear. Hope things at least ok for you at home, tough few years for you guys. Slava Ukraini 🙂 

3 hours ago, Chippy said:

Any questions ask here won't you. 🙂 

 

Thanks, I will!

 

3 hours ago, Chippy said:

Lets keep it that way by staying in touch and being nice and methodical.

 

👍

 

3 hours ago, Chippy said:

Hope things at least ok for you at home, tough few years for you guys. Slava Ukraini 🙂 

 

Thankfully, it's okay in my region. Your support is much appreciated. Heroiam slava 🙂

10 hours ago, SofterLine said:

Thankfully, it's okay in my region. Your support is much appreciated. Heroiam slava 🙂

Good to hear. One day I’m coming to visit! Your country has a bright future, I’m sure of it. I’m impressed by the whole nation!
 

Heroiam slava!

Your maths checks out. I too used the data from Mark Horowitz's papers when they were first published as it was the only info I could find that informed how antipsychotics should be tapered safely. I was on the sister drug rexulti which is even more potent than abilify on some of the receptor affinities if I recall correctly. Although my ill informed tapering advice given to me by the very bad psychiatrist I was assigned landed me with seriously bad protracted withdrawal that reinstating did not really help that much other than stopping the WD getting worse with time. I followed the halving rule each 3 months for single digit receptor activity decrease with good success (relatively speaking)

This approach actually worked pretty well, I was able to reduce by the half each 3 months until I got to 1/156th of the initial 2mg dose (compounding pharmacy couldn't even grantee the accuracy as this small amount, so that was as far as I went) , this I calculated to be around that 5% occupancy, from about 1/32 of the dose I felt less and less additional WD symptoms over my existing protracted one and even some improvment. However, even after nearly 2 years of re-tapering, that final jump off 0.013 ish mg was still hell. I learned that APs bind to the neuromelanin in dopamine receptors that effectively accumulate the drug, this can take another 9-12 months to clear out after the drug is removed and is otherwise fully excreted from the blood.

To complicate things I had complex WD from the MAOI WD too, which was a nightmare as I kept having paradoxical adverse reactions to the dose itself that got worse with tapering, that is the one instance where I firmly believe that going cold turkey early enough in the taper probably would have spared my vision and not resulted in even worse PWS after continuing to taking it/tapering.

Because I tapered them with a decent separation I was able to experience the distinction of the two drugs. APs are evil, but MAOIs are even more so if you already have WD.


In my experience, tapering APs is not the worse during the actual majority of the taper, but they have this effect that abrupt severe acute WD still happen at the very end or unexpectedly long after you seemingly taper off successfully the first time. I think it might be related to the super long halflives of these two APs and the potential for APs to accumulate long term in the brain, so when it finally runs out long after tapering or towards the end, it just hits like a ton of bricks out of no where.

This is what happened to me, the acute phase was very tame compared to the protracted phase and for me, the acute was immediate and primarily psychiatric symptoms and dizziness that lasted only a few weeks.

Then the severe physical symptoms hit me like a ton of bricks extremely abruptly over a span of hours some 8 weeks after my last dose. I went from working at work and fine in the morning, to having some weird nerve like discomfort behind my knee in the afternoon, to hospitalization the next morning due to extreme pain, loss of feeling in my legs and genitals and inability to stand and walk properly and bowel and bladder retention, it only got worse from there with even more physical symptoms.

Interestingly I never had psychosis, TD or any of the other expected AP WD symptoms, mine were nearly all physical in other ways.

Thank you for stopping by and sharing your experience, @6Eggs !

On 6/18/2026 at 8:22 AM, 6Eggs said:

I followed the halving rule each 3 months for single digit receptor activity decrease with good success (relatively speaking)

Regarding the halving rule, are you referring to this quote from the Horowitz paper?

We, therefore, suggest that when antipsychotics are reduced, it should be done gradually (over months or years) and in a hyperbolic manner (to reduce D2 blockade “evenly”): ie, reducing by one quarter (or one half) of the most recent dose of antipsychotic, equivalent approximately to a reduction of 5 (or 10) percentage points of its D2 blockade, sequentially (so that reductions become smaller and smaller in size as total dose decreases), at intervals of 3–6 months, titrated to individual tolerance.

Reducing the most recent dose by half sounds very risky in my case, but I wonder if reducing it by one quarter every 3 months would work. Perhaps I should just stick to the good old 10% taper to be safe.

On 6/18/2026 at 8:22 AM, 6Eggs said:

In my experience, tapering APs is not the worse during the actual majority of the taper, but they have this effect that abrupt severe acute WD still happen at the very end or unexpectedly long after you seemingly taper off successfully the first time.

I have a similar experience: each dose reduction of aripiprazole was unnoticeable until I was hit with acute psychosis.

On 6/18/2026 at 8:22 AM, 6Eggs said:

Then the severe physical symptoms hit me like a ton of bricks extremely abruptly over a span of hours some 8 weeks after my last dose. I went from working at work and fine in the morning, to having some weird nerve like discomfort behind my knee in the afternoon, to hospitalization the next morning due to extreme pain, loss of feeling in my legs and genitals and inability to stand and walk properly and bowel and bladder retention, it only got worse from there with even more physical symptoms.

That surely sounds rough :( I didn't notice any physical withdrawal symptoms in my case, other than increased energy and lack of sleep, which was closely tied to developing psychosis within a couple of days.

Yep, halving was from the Mark Horowitz paper if I recall that correctly, was quite a few years ago now. 1/4 was also recommended too iirc.

Nothing wrong with going slower if needed, 10% is a good rule, but if you can tolerate it faster, then that's ok too.

Given it hits you out of nowhere, I think it might be how antipsychotics accumulate in the brain tissue unlike other psych drugs, this is separate to half live. It is my understanding that APs bind to the neuromelnin in the striatum nigra and related areas, and remain for many many months, 9 months was stated as average elimination time in some papers I read somewhere.

It also doesn't help that either drug we were taking from this manufacture has a stupidly long half life, which is what I think triggered my 2 month delayed WD after thinking I successfully tapered off it completely. So it might be some combo of super long half live and brain accumulation that allows tapering to appear relatively smooth and easy, then hit like a ton of bricks out of nowhere as the drug actually runs out in our blood and brain long after a reduction or cessation had occurred.

Yes, the physical symptoms I have are absolutely crippling with no real way to get relief. Reinstating early on did nothing and not a lot has improved with the most unpleasant symptoms in the last 5 years, mainly the burning and aching pain, visual impairment and sexual symptoms. Like some cruel game, the symptoms I could have lived with to trade places with the ones that are torturing me the most, are the ones that resolved :( and the most upsetting ones are the ones that have persisted or even got worse in some cases. Sucks so bad!