Cross tapering between antipsychotics?

[ryerica22]

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Hi,
I was wondering is it absolutely necessary to cross taper antipsychotics? I'm moonlighting in an inpatient setting and seeing a patient on Risperdal 4 mg BID. I want to switch pt to Zyprexa to minimize chances of EPS. Can I just drop the dose of Risperdal by 1 mg BID each day while I'm increasing his zyprexa?

It's this kind of stuff that I don't miss in outpatient clinic as a PGY3.

Thanks

 

[thoffen]

Sure you can do that. In an inpatient setting, I go much faster unless there's a compelling reason not to. You only get so much time, so I'd rather maximize time on the treatment I intend to make as sure as I can that it's efficacious and tolerated.

Separately, I wouldn't switch effective risperdal treatment because of concern for EPS unless the patient has EPS or significant history of it.

 

[Mass Effect]

Does the patient have EPS?

 

[TexasPhysician]

Unless already with EPS, I don’t understand the switch. If no benefit, inpatient is the time for quick adjustments.

 

[SourceOfDenial]

Personally, I'd take EPS over metabolic syndrome.