Brief Answer:
Gradual dose reduction would prevent any significant withdrawal symptoms.

Detailed Answer:
Hello thanks for choosing HCM for your health related queries

I can understand your concern. You are a 42 years old healthy female with no current severe psychological stressor. You are on Depakote 250 (Divalproate), Paliperidone 1.5 and Buspirone 5 mg since about 2 years. You are currently stable and settled now, but when ever you try to stop medicines you get bad headaches and weakness as withdrawal symptoms.

First of all I would like to tell you that the doses of medicines you are taking are very low doses and withdrawal from these doses would not be very severe. You have already reduced the doses and with proper tapering you can stop using these medicines easily. The symptoms of withdrawal you are having are probably due to psychological dependence and not due to physical dependence. So you have to accept this thing before tapering the doses that you might have some withdrawals but these withdrawals will not progress to severity, and are due to psychological dependence most likely.

You are taking three medicines so first goal to stop these medicines should be to stop at least one drug out of these three. In my opinion you should start with Depakote. Continue to take the doses of other drugs as per your regular dosing and reduce the dose of Depakote to 125 mg for at least 4 weeks. After 4 weeks stop taking Depakote. Then wait for at least 2-4 more weeks and then reduce the dose of Paliris by taking the tablet on every alternate days for at least 4 weeks and then stop the drug completely. Lastly reduce the dose of Buspirone in same manner. If during course of tapering the doses you suffer worsening of any symptoms then medicines like low dose benzodiazepines can help. Low doses of Etizolam or Oxazepam can help you to beat the withdrawal symptoms. Take these drugs on SOS basis. Consult your doctor for prescription of these drugs.

Tapering of doses in this manner will be easier and you can come out of dependence. Try to understand the fact that the doses you are taking are very low and tapering the doses would not cause any serious harm to you.

During course of tapering of doses take healthy food rich in proteins and complex carbs and low in fats. Concomitant use of Omega-3-Fatty Acids will also lessen the symptoms.

Thanks, I hope this helps you. Please don't hesitate to ask again for more doubts or if you want to clarify something from my answer.

Take care

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Brief Answer:
Depakote at high dose may cause liver toxicity in some individuals

Detailed Answer:
Hello again and thanks for asking a follow up

It is not usual to get abdominal pain with doses of Depakote you are taking. You were taking 250 mg and now reduced to 125 mg and these are very low doses to cause any significant side effect. Epigastric distress can be seen with the drug but localised right sided abdominal pain is seen usually at high doses. Still if you want to be on safe side get your liver function tests done. Slight elevation in liver enzymes is commonly seen with Depakote and in some rare individuals it can cause hepatotoxicity. Take plenty of water and if pain worsen visit your doctor. OTC antacids can help you in reducing the pain.

Thanks, I hope this helps. Please ask again if you have more doubts.

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Brief Answer:
Fatty liver is a reversible condition

Detailed Answer:
Hello thanks for asking again

Grade 1 fatty liver is not a serious issue. Even with short term intake of any drug that is metabolised by liver slight fatty changes in liver can be seen. The condition is totally reversible and no need to worry. You have reduced the doses already so in follow up USGs everything will come normal.

For liver herbal medicines like Liv 52 can be used. This is a syrup formulation and when taken regularly this will help to quick recovery. Discuss with your doctor regarding this.

Thanks, Still have more doubts please ask again.

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Brief Answer:
Yes the doses can be stopped after proper tapering

Detailed Answer:
Hello again

Yes taper the doses and then you can stop the drugs completely. Please if possible discuss with your old psychiatrist.

Thanks

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