How hard is it to get off Perphenazine?

[twyleskyles]

I haven't heard much about getting off this drug. I was on 6 mgs for 3 years and now on 2 mgs. Any ideas?

 

[Swimmingdancer]

I haven't been on perphenazine myself, but I can tell you what I know about it.

Withdrawal symptoms for perphenazine include psychosis and hallucinations, which may at first be worse than they were before, plus symptoms like nausea/diarrhea, dizziness, and shakiness. It is not recommended to stop taking it abruptly, doctors generally decrease the dose gradually over several weeks and sometimes prescribe other medication(s) for you to take for a few weeks after you stop taking the perphenazine. The drug info says it is best to taper off of this medication slowly even if you are replacing it with another medication.

Perphenazine is a dopamine receptor blocker. If you take it long term, your cells will respond by producing more dopamine receptors (and increasing the receptors' sensitivity) in an attempt to get the level of dopamine receptor signalling it is used to. If you then discontinue taking it, the dopamine receptors will no longer be blocked and instead be fully exposed. So any dopamine released will bind to the increased numbers of extra sensitive receptors, leading to increased dopamine transmission, over and above what would have occured before you started taking the perphenazine. So when they quit taking it some people develop psychotic symptoms, due to over flooding of dopamine receptors. Even people who had no psychiatric history who were given a course of treatment with a neuroleptic have developed psychotic symptoms when the neuroleptic was abruptly withdrawn. The good news is that your brain should respond to this constant flood of dopamine by decreasing the number of receptors and their sensitivity, so this withdrawal-induced psychosis shouldn't last too long. However if you had chronic symptoms that the perphenazine was effectively treating, you may experience a return of those symptoms.

The fact that you have tapered it should really help, as your brain has been getting used to having less and less dopamine perphenazine. I would suggest you continue tapering it lower before jumping off completely. What does your doctor say about all this?

Generally perphenazine is not widely known for having severe withdrawal symptoms and when people taper it gradually they may get little to no noticeable withdrawals, but of course it varies from person to person.

 

[deewallace]

I was taking 16 Mgs. I had such bad akathasia that now I'm on 4. Its been about two weeks and I'm having some psychosis. Any advice?