my son is still having severe anxiety along with racy mind constantly.
friday he was put on zyprexa 10 mg, has built up to 300mg valporic acid over the w/e....but still needs 100mg seroquel and 14mg zoplicone to settle down at night....the doctor refuses to put him on benzo's because of his FORMER addiction problem.....but he NEEDS something to settle him down during the day. Are there any options that are OTC and not addicting??
You know thats a lot of different medications. I think this is disturbing, why add another medication and not adjust the doses of the ones he's already on. 300mg of valproic acid is a very low dose, perhaps he can just be increased, that is if his blood levels are okay to increase. This will help with his racing thoughts. An increase in the zyprexa might be beneficial, maybe 20mg or maybe he can switch from zyprexa to respiridone. Maybe he can try Buspar for anxiety, it is non-addictive.
even if there are other options available, i advise that you consult a pdoc ONLY and not address such question to the forum except for thinking loudly. The no of drugs for psych illness is huge and you just can't pick one that another pt told you it's ok at random. Besides what is convenient for one may not be for your son. He is too young to be experimented upon.
As to the benzo, i use it myself 0.375mg subdivided, look how small it is because one is cautious of addiction. my pdoc says don't ever exceed 1mg. of course i know pts taking up to 4mg but this is hazardous.
I am not familiar with Buspar, yet many are on it. Ask your pdoc 1st.
in my country there are some tea bags for anxiety and to calm you down. Sure in western countries it exists, why not exhaust those alternatives first. The less the no of drugs your son is taking the better. I am not sure whether you are aware of BP, you are under continuous monitoring of doses sometimes and on and off of some meds. So by the time you are in your 5th year of illness most of us has completed trying the whole shelves in the pharmacy. So no need to overdose the pt, unless he exhausts the therapeutic dose of each. Less no of drugs with therapeutic doses is better than an amalgamation of mood stabilizers and antipsychotics.
ask your pdoc 1st, or change your pdoc. Again every combo needs time to try it. For some it took several months, so don't give up
incidentally why does he need 100mg seroquel. who decided this? I take 25mg seroquel only and probably i am older than your son. Again zyprexa and seroquel are both atypical antipsychotics so why combining both?. the therapeutic dose of seroquel is 400 and the max dose of zyprexa i remember 20 if i am not mistaken and the minimum is 5. the valporate dose is 750-1500.
still who can tell which is which except a pdoc ONLY. I know it looks like trial and error sometimes, but no one here is supposed to advise. Again the valporate some people put on weight with while some don't, the zyprexa is supposed to increase the weight, seroquel i added weight with. So the pdoc when advising a certain drug, he investigates all the possibilities, pro and con of the pt, his age, his work,...
try to reach him/her on the phone when taking a decision especially of your most beloved
thx for all the comments.........I know this is confusing, I was not looking for advice..he does have a good psych..trouble is son went off his seroquel last summer as he was feeling good and thought of course that he was CURED..
He went back to the doc in May and was put on seroquel again...it wasn't working however he waited until this passed week before seeing th psych again...by this time he was in severe straits...
so Friday the doc took him off seroquel and STARTED Zyprexa at 10mg and added valporic acid initial dose at 250mg(I got it wrong I thought each tablet was 100mg)...that was supposed to HAMMER him and knock him out as he hadn't slept for days and was in severe anxiety(should have been hospitalized but refused)...
It DIDNOT knock him out so a phone call back to psych and he added (as a temp measure)..100 mg seroquel and 2 zoplicone...and that finally settled him enough to get some sleep.
the valp. acid is being built up by 250mg per night, so as of tonight he will be taking 1000mg(thus 4 tablets).
He saw psych again this a.m....he upped the zyprexa to 20 mg and told him he must d/c using the seroquel...son is using the zoplicone to calm self down as this is the only thing that right now that seems to calm him down...he was told only to use temp. until the other meds begin to work, than to taper down to 7.5mg.
he remains very anxious and suicidal
I have been the one handing out the meds to him at home and supervising as he is still to unstable.
I hope to God the doubling of zyprexa and additional val. acid works for him tonight.
he HAS to be back to work by thurs....thats why the psych is rushing the med increases...if he can't work by thurs he looses his job!
I keep saying tyler your life is much more important than any job..........but he has worked so hard to rebuild his life after addiction and bankrupty that he feels if he looses this new career and reputation he has lost everything and thus the suicide thoughts....I really do fear he will do if this job ends for him.
so I am just a very worried mother here trying to understand if anyone has been there and if this combination of meds has worked for them successfully.....does it stop those racing thoughts and anxiety????????????????
sure appreciate all your thoughts(only for opinion sake and not in anyway meant to replace his psych recommendations)
i wish somebody else intervenes here. i know it's a SOS call for help. The trouble is that it's many aspects, the job, thursday, the combo takes time to show effective or not. But i feel you are in control , not that i am encouraging you but because you hit the thing which looks very alarming right now at the moment i mean namely anxiety. he has it of course because of the fear to lose his job. True his life means more to you and to him but because the phases of his past life are reminding him not to tolerate mistakes this time.
however i wish to tell you even if your doses are high right now it's because of the above circumstances, but later you will taper off from some.
concerning BP with mixed states, everybody has been through i suppose in mixed states once and rapid cycler too sometimes. I was both until i intervened with seroquel. this med more than anything else i feel helped me through the bleak and dark moments of my illness especially if he is BP1 and the mania is your concern. the valporate is very effective for mixed states, while i don't know where you come from what is SK, is it in the USA? they use other alternatives to MS like lamictal and topamax (AC) so you may also discuss it with your pdoc. on the contrary places like canada, england, australia commonwealth in general they stick to the book they are more traditional with the classical MS e.g. lithium, valporate, tegretol / trileptal.
One thing very typical of BP that he/she thinks that a certain decision affects his life. Whereas this job is important to him, no doubt, no one can tell what if he loses it he may get a better chance somewhere else. Luck is not associated with a certain place, rather it's his anxiety which in charge here. So perhaps your role is to smooth things out, i know it's easy said than done, but there is nothing else you can do here except to follow your pdoc view and to wait.
hope for the best.
I wish really i can be of assistance more, but the drugs are not to be fiddled with, pdocs always know more. after all we are a bunch of amateurs who try to educate themselves, but to be an authority one has to climb the stairs from the very beginning i.e. to do anatomy, physiology,...,pharmacology and only at the end internal medicine and psychiatry so the whole picture is not clear to us. Besides, i had severe headaches from tegretol while a friend of the family is on it for 5 years and loves it like ice cream.
so wait until tomorrow and tomorrow is another day
one more info. If you DECIDE for benzo, i mean i don't advise you EXCEPT with the permission of the pdoc - and someone else here to correct me if i am wrong. Benzo is the best thing for anxiety. has no side effects to my knowledge except addiction (if you call this a side effect especially until thursday only) and non-interactive with your drugs. Take the advise of others, 0.5mg is good for sleep.
please don't follow my suggestion. I am only saying call your pdoc and enquyire whether i am right, I don't know about buspar, i know many pdocs write it as well as stablon, but really benzo will knock him out for sure .
Better to use the word "stabilize" than "knock him out". Its easy to get someone on a high dose of medications where they are sedated and can't function. That's not the purpose of medication. It has to be at a proper dose where he can function. That's within a psychiatrist's judgment whether to raise the dose until it works or put it at a high dose and then gradually lower it as he stabilizes. The ultimately goal is to make him functional and get back into life.
I suffered from extreme anxiety for many years. My pdoc prescribed me 3 mg Clonazepam. Yes, it is addicting. I have been on it for 2 years. My body is physically addicted to it, but I wasn't able to function with the anxiety. Clonazepam is one of the more addicting drugs because of the short time it stays in your system. I too have had addiction problems in the past. My pdoc still prescribed the meds. They are the best way to go short term. Once his medications kick in, he should be taken off it. Clonazepam also helps me sleep. I can't sleep without it actually. Right now i'm in the process of getting off the drug. It just takes time to ween it out of your system. Valium is a good benzo. It stays in the system longer, thus making it a less addictive drug (still addictive though). Your sons pdoc could give him anxiety meds short term and monitor it closely. It would be horrible if he lost his job. I bet once he gets back to work the anxiety will lessen. Good luck
well we are still holding....anxiety hasn't lifted, and even with a double dose of zyprexa he didn't fall asleep until 3 a.m...
SK is meaning the 'province' of Saskatchewan in Canada.
His pdoc will NOT presc. any anti- anxiety not even buspar...because of his prior addiction....Ur so right he needs this undercontrol, anxiety is right now his major problem.And I don't understand why he couldn't have something until other meds start working than taper off, the pdoc knows I keep the meds hidden (for now)..
he is all over the map with anxiety and thats why his pdoc used the term 'KNOCK HIM OUT'
b4 Friday (12th) he hadn't slept for days....But now what he does need is to 'STABILIZE' his pdoc said he needed the high dose because since he HAS to be to work thursday he needed to load him up faster than he normally would and yes of course he does have to function (which he does)...again this is a must, he works in the Oil Field here and is around dangerous gases....so function and memory are vital.
We talk all day everyday and yes I try to do the smoothing out of all his worries, some are realistic but some are also paranoia...and these worries won't stop the visious cycle in his mind, I'm sure you've all experience this as well, I only have a milder form of BP but I can sure relate. Well here we start day 5, he has another apt later today with the pdoc and I sure hope he can get him to presc....something for this anxiety.....In everyones experience how long does it take for meds like zyprexa and valporate to kick in?....shouldn't something have lessened the anxiety by now????????????????
I appreciate all the guidance here everyone..I do alot of reading however human experience is at times even more valuable.
i had really hoped to hear that your son had a nice sleep today, but apparently anxiety is still in its peak. poor him it's the job of course.
i am afraid it seems i gave you the impression that i know well about BP secondaries and related matters, only that i am a BP pt myself and am thinking loud with you that's all. i am only 26 years old and try to educate myself in my illness and knew that anxiety is a common factor to all psych illness not necessarily BP. In fact i suppose all of them start by manifesting anxiety. But i also know that the only solution to anxiety is benzo the quickest and effective way. it's not really addictive like Hash or morphin etc...but yes if you continue indefinetely. For instance for myself i have been on xanax since 2002 continuously without any interruption. The book says not more than a month until anxiety subsides. my pdoc controls my dose i was at first on 0.75 then reduce it until 0.5 then i use 0.25 at night plus half this tablet at noon i.e. 0.375mg. but in your case your pdoc has a point your son was already in the addiction mode and BP pts are also usually addictive not only to meds but to everything: alcohol, friendship, sex, etc...so he fears to go back to the viscious loop. They are more knowledgeable than us pts, they have seen a lot of them, we only acquire our knowledge from forums and websites. I just wonder what has valporate to do with anxiety or the zyprexa or seroquel !!. You know sometimes an antidepressant releaves anxiety like paxil/seroxat (PLEASE ask your pdoc first). I really had wished i could help but your son problem is not anything except his job. jst4shanell is right once he can attend thursday work his anxiety will lessen tremendously and may also disappear. You never can tell what will happen that day. So I pray God everything will be sorted out smoothly.
Let him ask his pdoc what is good for anxiety for a short term. i am sorry but really i am running out of ideas, i wish i could have been more helpful
I feel for you & your son. Anxiety is so destabilizing. He is on a lot of meds & as others have noted, nothing to really address the anxiety.
Zopiclone binds unselectively to the 6 GABA receptors including the alpha 3 subunit which has a major effect on anxiety. In this respect it is pharmacologically very similar to other benzos such as valium & xanax. This is why he is finding it helpful for the anxiety.
Unfortunately, throwing it in to the mix & discontinuing it has probably created rebound anxiety as his receptors withdraw from its effects.
Benzos are currently still the most effective ************** for anxiety but as others have said, they have significant side effects including addiction. The P doc is trying to save him from this. However, have you conveyed your concerns about his seriously suicidal feelings?
If he can be stabilised, there are non drug therapies that can work well for anxiety. 15 grams of inositol, in 2 divided daily doses has been studied to be effective for some. Inositol is a B group vitamin & large doses have not resulted in any significant side effects in the studies.
There are no counterindications with his meds identified so he could start taking inositol immediately.
When he is stronger, he would benefit from cognitive behaviour therapy which teaches your brain not to respond to the anxiety producing thoughts. It's hard work to learn at first but very empowering to do without a dependence on anti anxiety meds.
I thank u so much 4 all the valuable suggestions...I will do some searching to see if INOSITOL is avail here. I don't think cog. beh. therapy is avail for us in this small city but will look into that as well.
he was on a CRASH course of meds to get him stabilized fast as his pdoc knows there was NO option but to be ready to go back to work tomorrow.....so tonight he will taper down the zyprexa to 10mg, the val acid is held at 1000 mg. and 15mg zoplicone...
It takes him along time to fall asleep at night but he now can sleep for 6-7 hrs fairly restfully. and by today his anxiety level is significantly lower....
so tomorrow work and he feels he is more clear headed and less anxious and ready to go...he works 7days straight this shift @ min. 10 hr days on day 8 he leaves to go get his son and bring him up here for the summer(I get to be gramma again for 2 months...thats the main reason he is now living with me temporaily) so I pray he can hold it together for himself and his son.
I thank everyone of you for helping me thru this, just with knowing there are others in same or even worse conditions out there, also for all the information, its all valuable and considered even the constructive critisism.!!!
goodnight and prayers for all the torchured souls out there, may we all find our own peace
i read in a magazine that sage leaf extract capsules can help anxiety but ask your doc first. this is an herb and you can get it at any health store i believe, maybe online too. i'm bipolar with anxiety and i take cymbalta for depression, anxiety, and pain. i also take abilify for mania and xanax occasionally for panic attacks. the cymbalta is supposed to help with anxiety, i've only been on it a week plus a little so i couldn't tell you if it does but it's supposed to. buspar someone mentioned may work too. your son is on a lot of meds, he needs prescribed less but of the right meds. there are so many out there to choose from and so many combinations you just have to be patient and persistant. good luck velvetvenus
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