risperdal and controlled substances

[frndinneed]

My roommate has been going on a psychotic episode for 4 weeks now.  She was a functioning meth and marijuana user and didn't show any signs of psychosis until recently.  Around the new year, she quit using meth for about 2 weeks.  She then started using again, but not that much; maybe a couple times in a day or when she was tired.  She more regularly smoked marijuana (MJ) because she says it helps her handle her anxiety.  She has a history of traumatic incidents from childhood and didn't seem to have gotten proper therapy.  I believe she was diagnosed with PTSD.  

I read that someone can go through meth psychosis when quitting and re-starting.  She gets extremely angry, depressed, and paranoid.  The doctor started her on risperdal 1mg-day, 1mg-night.  It didn't seem to slow her down and she couldn't sleep because she was constantly worrying about different issues.  The doctor then increased it all the way up to 2mg-day, 3mg-night.  She has been on it for 3 weeks now and it still hasn't stopped her incoherency and her need to move things around.  She does have days where she is clear, but then it goes back to incoherency after about an hour.  I know she doesn't have regular sleep habits and she'll sleep only about 4-5 hours.

I noticed that she'll start dancing, stretching, and moving around after she smokes MJ.  I'm thinking that she maybe getting EPS or TD regarding her muscles.  The doctor just prescribed cojentin for her twitching.  We haven't tried it yet.  Smoking meth seems to calm her down.  I'd like her to quit, but being in this state of mind, she won't even consider it.  

My concern is whether the MJ is the cause of her not getting better and whether taking risperdal, cojentin, and smoking it is okay?  I read that MJ is not good if schizophrenic, and okay if bi-polar.  

[Crystlas]

Glad to help.  That is where I was regarding my being bipolar.  I had not come to terms with it yet and thought that yucky depression would just go away.  I also had my psychiatrist telling me the same thing and not properly medicating.  I switched and am now with a great doctor.  Sometimes rock bottom is what it takes!

[frndinneed]

Thanks Crystlas, I'm sorry that things got so desperate for you, but am glad that you are better.  As for my friend, she may have to hit that rock bottom before she opens her eyes.

[Crystlas]

I am glad I could give you sound advice.  I do hope it helps her when she does get out of the hospital.  If she is in a drug induced comatose state you can call an ambulance and they will force her into a treatment program.  When I got so depressed and tried to commit suicide my fiance called 911 on me and I was forced to go in an ambulance to the ER where they involuntarily commited me to a mental insitution.  I was so scared and upset that I could not go home.  However, it was the best experience for me and I really needed it.  I had a wonderful experience in a great facility and I got my medications straightened out and really came to terms with being bipolar.  Now I am on a road to recovery and life is going in a very positive direction.  So there are ways you can get her involunarily commited, but she has to be in a dire situation.  Hope this helps too.

[frndinneed]

I have been doing all the research, she is no condition at the moment to understand.  She does have her clear moments, and that is when I try to talk to her about treatment.  But, when she gets incoherent, she doesn't listen.  I told her that she can't live with me if she continues doing drugs, so she left.   She has been staying with some people that are enabling her.  And, she went completely off the risperdal for 3 days and refused to take cogentin.  Thus, now she is in the hospital.  

I have been going with her to the psychiatrist and have been working with the doc on her med treatment.  Even he told her that she has to get off the drugs or she is wasting all our time.

When she is released, I will talk to her about what you had advised.  And, explain what is happening and about bi-polar illness.  I wish they would force her into treatment!!  Thanks again for your support!

[Crystlas]

No problem.  This sounds like a scary situation.  She needs a treatment program.  Has she done any reading on being bipolar in order to understand what she is doing to herself?  Will she be willing to tell her therapist or psychiatrist?  I hope the best for your friend.

[frndinneed]

Thank you so much for your advice.  I have been trying to discuss with her treatment and told her that I would be there as much as I can, but in this state of mind, she is not thinking straight and is under the impression that she can still use and chase one drug with the other to stabilize her.  I will look into the addict forum.  Thanks again!

[Crystlas]

Any drugs or alcohol are very very bad for bipolar disorder.  I quit smoking pot the day I was diagnosed so that my medications would work correctly.  Marijuana is a depressant and will counteract any drugs that are used for depression, due to the fact of being a depressant. That is why I quit.  I also quit the light drinking I used to do.  I want my meds to make me as stable as possible.  Meth is very very bad for bipolar.  It shoots the uptake of seratonin sky high the first use which never reaches that level again, causing a more aggrivated depression at the come down off of the meth and it causes a meth induced mania during re-uptake of seratonin at the next use.  Your friend might have a drug indused bipolar disorder versus a biological one.  I was born bipolar and had symptoms all of my life until properly diagnosed and have never been that into drugs or alcohol.  It was mostly recreational for me and only pot with some light drinking.  Anyhow, her best solution would be to get into a treatment program and get off of all of the drugs in order to get a clean system and address the issue of how to be properly medicated for her bipolar illness.  Otherwise, she is doomed to ride the wonderful bipolar roller coster if she keeps aggrivating her illness with drugs.  Medications can not work properly with a drug user aggrivating their system and not letting meds to their job.  Aside from posting here, you might want to post in the addict forum to get some insight from individuals recovering from drug addiction with mental illness, which tends to go hand and hand.  They might be able to help you understand more about the drugs affect on the body and the impact of what it does to the brain functioning.  I hope this helps.  I have this knowledge that I shared with you because I am a crazy research buff along with being a social worker and came across a lot of this input when I was researching in order to better understand bipolar illness, as well as, a research project on illicit drugs I did in college.  Best of luck.