Q. How long should I stay on the treatment for psychosis?

Answered by
and medically reviewed by Dr.Nithila A
This is a premium question & answer published on Jul 12, 2019

Hello doctor,

I am a 35 years old male. I had an episode of psychosis for the first time four months ago and is treated with Risperidone and Escitalopram. For how long should I stay on the treatment?



Welcome to

For psychosis, Risperidone is considered the right drug. However, Escitalopram is given for depression. So if at present you do not have any depressive symptoms you can discontinue Escitalopram. However, Risperidone should be continued at least for a year in the first episode of psychosis. Suppose if you get one more episode of psychosis, then I will recommend continuing Risperidone for a lifetime. Please update me about the psychotic events you had and the dose of Risperidone.

Thank you doctor,

I had depression with psychosis. The diagnosis is depression with psychotic features, although it is not certain. I take risperidone gradually increased to 4 mg, then tapered to 3 mg. But because of akathisia, I lowered the dose to 2 mg. I also take Escitalopram 15 mg. My concern is what is the final diagnosis, although I understood that sometimes it is difficult to pinpoint a specific diagnosis. My doctor also raised the possibility of delusional disorder.



Welcome back to

You are correct. The final diagnosis in psychiatry is always a challenge. It requires a lot of time with the patient and family members. So I cannot comment on the definitive diagnosis of yours at present. But as you are saying you were diagnosed as depression with psychotic symptoms then you have to continue both the tablets lifetime, you can taper the dose of risperidone, but there will be chances that your psychosis can reoccur.

If you have developed akathisia, then I will prefer changing risperidone to other drugs like Aripiprazole or Olanzapine. Kindly get in touch with your treating psychiatrist, or you can consult me here. Feel free to ask any other query.

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