mood disorder with psychosis

[litsa]

My son is diagnosed with mood disorder and psychosis.  The doctor put him on 4 mg of risperdal, 1 and 1/2 mg twice a day of trileptal and benztropine for side effects 1 mg each day.  He recently went back and now has him on Dekapote increasing it each day from 500 mg until he gets to 2000 mg.  Oh my God!  How many meds can this poor child take?  He is a 22 yr old white male.  Years ago he was peer pressured into taking recreational drugs.  Previous to that he was a healthy child.  Did the recreational drugs cause all this?  He did have an episode last week where he left home in his pj's, drove around all day and was missing until he ran out of gas and he ran 8 miles home; he doesn't remember much about it.  He was hospitalized 3 years ago when they diagnosed him with bipolar because he had a similar episode.  Are these "delusional-psychotic" episodes flashbacks from the recreational drugs he took?  He is now seeing a doctor that likes to prescribe meds.  Is this safe?  He is a college student and is under a lot of stress.  I have been reading about bipolar disorder, exhausting myself out from library books to internet searches.  My son will not totally except this as he feels the episodes he experienced are real.  He feels the medicine will help him because of what he has been through, but he is against therapy because when his last few experiences with certain therapist have been ... you have an illness.  He needs to be handled with kid gloves on this issue.  But he needs psycho therapy as well as the right meds to get him back to himself again.  Please can you give me advice on this nightmare for my husband and I?  

[litsa]

I would like to thank the two individuals who responded back to me.You have no idea when I saw 2 answers back how excited I got to read them.  Any help I can get or opinions that can shed some light on this "horrifying" time in our lives helps.  Thank you for your opinions!  

[Roger Gould, M.D.]

This is a complicated picture and you need one trusted doctor to manage all of this so I agree with you that your son ought to be seeing a psychiatrist who does psychotherapy in conjunction with medication.  Perhaps you could explain to your son that there is a difference between a therapist and a psychiatrist, and all the  literature tells us that when using medications, you should also be working out the problems in your life, and that is the way to lower the dose and the number of medications.

[socgirl]

being a mental health clinician myself, i hope i can help answer some of your questions.  No one really knows exactly what causes mental illness.  It could be a combination of genetics, environmental factors, etc. Do you know what recreational drugs he was taking?  It's unlikely that itself caused his illness.  Depending on how old he was when he began experimenting with drugs, his drug use could have been a way to self-medicate.  With bi-polar, it's very possible he began experiencing symptoms in adolescence or even a bit younger.  As for the meds he's on...the only thing i would question would be the use of depakote and trilepal....they are both anti-seizure medications that are commonly used as mood stabilizers.  He needs the risperdal to deal with the psychosis.  The episode you described where he drove until he ran out of gas and ran 8 miles home, doesn't sound like a delusional episode...it sounds more like a manic episode, which is part of the illness.  I agree with you that he needs both therapy and meds.  Overmedicating is a common issue....i've been seeing it more and more in my practice.  it's something to look out for.  Also, for that age (22) resistance is not uncommon...well it's not uncommon at any age really.  for him to reach a state of recovery, he needs to be consistent with taking meds and going to therapy...eventually, symptoms should subside.  would he allow you or your husband to go to one of his appt. with him to you could ask his doc about medication questions, etc.?  If you have any other questions, feel free to post.