Spice: My Intro

[Meimeiquest]

It sounds like you are coming along as would be expected. I know it's not easy. Regarding the suicide thoughts and all, Alto recommends Changing the Channel. Acknowledge that they are abnormal thoughts from a struggling brain, yet really normal in your situation of drug withdrawal and find something else to do or think about...listen to music, play a random game on the computer, knitting, plan menus for the week, especially walk outside if possible. There is a thread under symptoms entitled Suicide Ideation. You'll make it!

[Spice]

Ok things are getting worse and worse and we're trying to keep her safe and get her stable and keep out of hospital. We've decided to increase prozac from 0.9mg to 5mg. She usually takes it at night but we took 5mg this morning to try and get it back into her system. She is suffering with mental torture, displaying symptoms of psychosis, rocking, pacing, actively suicidal - I know its from all the mental anguish shes in.

 

Sadly had to take extra lorazepam today and now its the weekend again so all the NHS "help" won't be available.

 

Will this prozac increase take a long time to have effect? Is the 5mg a high enough dose?

[Altostrata]

Sorry, it's impossible to predict. It may be too high a dose. Or it may help.

[Spice]

Good morning all, we had a continuation of the negative effect to the 5 mg of Prozac and kinda got scared by it. We reduced it to 4 mg the next day - 2 mg the next and back down to the 0.9mg that she was taking before and have been there since. The akasthesia continues with some out of control moments of rolling on the floor (not the lol kind).

We are not sure whether the Prozac had a negative effect on the Fluanxol and had to cut back as riding that out gave us no guarantee that the restlessness would abate.

We have an appointment with the same psychiatrist today (2 weeks on) and will show the, now, restless Hana and see if she has any ideas.

Our aim would be to reduce the Fluanxol and the Mirtazipine one at a time as there has been no improvement by up dosing and reinstating these two even after 7 weeks.

Hana is prepared to take a new AD with sedating effects - perhaps one of the older Tricyclics (Amitriptyline ) to get stable then work on the others singly and slowly tapering. We need stability the most as she is difficult to look after and she is not a happy person at the moment.

My work as a nurse working 12 hour shifts has not been affected but having to provide cover to look after Hana with the parents is difficult as they live a way away (2 hours). I will ask about outside help and anything that may be available but mostly I want to keep her out of hospital.

Any thoughts on a new AD that may be suitable - Hana has tried a lot so has memories of some.

Any other ideas re Fluanxol/ Prozac reaction?

Will let you know results of the meeting. Sorry that we are all going through these hard times, Rob

[Rhiannon]

I just want to say how sorry I am, to both of you. Your situation is so complex with so many meds that I don't feel I have any advice to give, other than what I've already said (try to stop switching meds around as soon as you can). Which is pretty basic and probably not very helpful at this point.

 

Please tell Hana that my thoughts and prayers are with her. I've been in some truly bad and desperate places over the years due to drug and withdrawal effects, including being extremely suicidal, and I know how absolutely hellish that suffering can be.  

 

My heart breaks for you both.

[Altostrata]

Hana may be hypersensitive to all psychoactive drugs. Although psychiatry wants to believe it can counter adverse effects of one drug with another, this is not always the case.

[Spice]

Then what do we do?? She's in such hell she took an overdose this week, she's in psychosis, out of touch with reality completely, suicdally depressed, can't eat, cant do anything. We have to do SOMETHING.

As Mirtazipine and fluanxol only seem to have made matters worse and now the prozac has taken us further down we can't just stay like this.

[Altostrata]

I agree, it's a terrible situation. You should not be in this position -- making medication decisions.

 

Medicine's ignorance about adverse effects of the drugs has endangered us all.

 

You'll have to work with the doctors as best as you're able. Hana's nervous system has to settle down.

[Spice]

Thanks to you all, psychiatrist 10am so will post decisions made, stay well, Rob

[Skyler]

Hi Spice... just to let you know you are in my thoughts. I'm wondering how you made out with your psych apt., and how you folks are in general.  Your path is more difficult than I can imagine, and my heart goes out to you.  Big warm hugs to both you and your wife.

[Spice]

I'm in hospital at the moment, they have me on a higher dose of lorazepam to try and cope with the akathisia and loopiness. They have reduced my Flupenthixol down to 0.5 from 1mg as the increase clearly hasn't helped and may prob made things worse as with the Mirtazipine. They want to start me on sertraline but I think I want to push for Amitriptyline - any thoughts?

I'm in such a state of instability, derealisation and depersonalisation and anxiety extremely bad. This is hell.

Thanks

[Altostrata]

Very sorry you're going through this. Unless they understand you're experiencing an iatrogenic reaction, any further medication is experimental.

[Spice]

We're hoping that because the flup and Mirtazipine reinstatement have made things worse taking them out after the 6 weeks I've been back on them may help

[Skyler]

Warm soothing {{{{HUGS}}}} headed your way, with a sincere wish I could do more. 

 

Skyler

[Rhiannon]

All I've got is what I've had all along: I doubt switching meds around is going to lead to a stable improvement. You can't stabilize while continually perturbing the chemistry. There are no magic fixes.

 

These drugs aren't like Advil, they don't just work while they're in you and then go away when you take them out. These drugs disrupt the chemistry of your nervous system (as well as endocrine and digestive) and the body reacts by trying to re-balance its chemistry. Your brain basically reshapes itself around the drugs, like a plant on a trellis. If you keep yanking out the trellis then shoving in another one then yanking that one out, etc. at some point the shape of the trellis becomes irrelevant, it's the damage done by the yanking that's the problem, and the plant really needs to just recover.

 

This undoubtedly sounds overly simplistic, but the fact is that our brains are complex living things which behave much more like plants than like machines or computers or whatever overly simplistic mechanistic model modern psychiatry seems to be based on. (Certainly these drug treatments do not take into account modern neuroscience and the now-proven existence of neuroplasticity.)

 

However, at this point stabilization is not a realistic short term goal, so I hope they find something that will suppress the worst of your symptoms and give you some rest. 

[Rhiannon]

Thinking of you...please keep us posted when you can.

[Spice]

They've reduced the flupenthixol to 0.5mg down from 1mg which we updosed 7 weeks ago and looking at bringing the Mirtazipine down by half this week which we also reinstated 7 weeks ago and things had got so much worse after doing that.

I'm in agony with akathisa and mental restlessness, bizarre thoughts and mental torment all the time - lorazepam is doping me out and I feel completely out of touch with reality. The depression is sucking the soul out of me and I can barely breathe or talk its so bad. People kept telling me to stabilise on the doses we'd added back in but I was getting worse week by week and not stabilising at all.

We're at a complete loss as to know what to do.

[Spice]

Would procylclodine help with the restlessness, do I I need an antipschotic, another antidepressant - what the hell do we do????

[Spice]

What if we incresed Mirtazipine to 15mg from 7.5 and see if it helps as my body already knows it but it has made me worse putting it in at 7.5. Sorry I'm in such a state, I'm terrified

[Spice]

Oh and they stopped the 0.9mg prozac a week ago

[Altostrata]

Spice, it's impossible to say what to do. Probably as little as possible, and very cautiously at that.

 

Mirtazapine has a noradrenergic component that is stimulating and can cause agitation. If your symptoms increase after taking it, that's a sign the drug is aggravating them.