Could you help me be better informed?

[Elizabeth__0__0]

Posted by Elizabeth on July 27, 1999 at 18:49:39
Dear Doctor,  My 24yr old daughter was admitted and dx as having a severe depression with paranoia, auditory hallucinations and anxiety.  She has been doing quite well on Zoloft, lorazepam and zyprexa;however, since my husband has been notified of his job lay-off, my daughter has begun to hear the voices again!  She called the center and has an appointment to evaluate her episode.
She takes 5mg once a day at bedtime,Zoloft in the am and lorazapam during the day and receives counseling once a week with a wonderful doctor.  Myquestion is:  Will a patient override the medication if under stress (father's job lay-off) and need additional increase or try another?  She is such a caring young woman, I do think she feels she is a burden; eventhough, she is not to us.  She wants to go back towork but I do not think she is ready yet! Soon! The doctor says May 2000 or so...Is there a problem with this zyprexa?  She was on Trilifor but it caused very bad headaches and did not help with the voices all that well! What is it? Just trial and more trial? Please respond! Elizabeth

Posted by HFHS MD - RG on July 29, 1999 at 18:43:55
Dear Elizabeth,
    Mental illness is a very complex disease. It is stressful not only for the individual but also for the caregivers.
    The interplay of emotions is very complex whcih is why patient's emotional experience occupy the attention of all mental health professionals. It is possible your daughter's condition may deteriorate due to her reaction to her father's lay-off despite of being on medications.This is why patients commonly recieve medication and psychotherapy.
    Zoloft (sertraline) is an antidepressant belonging to the SSRI ( slective serotonin reuptake inhibitor) class. Following one of the hypothesis regarding depression, Zoloft increases the serotonin level in our brain to alleviate depression. It may have possible side effects such as diarrhea, nausea, and drowsiness, but these are usually temporary. It may take 2-4 weeks to begin to fully work, and as long as 6-8 weeks for maximum benefits.
    Ativan (lorazepam) is a benzodiazepine commonly used for anxiety. It is a sedative-hypnotic medication that is useful in the
treatment of a number of psychiatric disorders, such as anxiety disorders, and panic disorders, to name a few. Possible side effects may include sedation which can impair concentration,dizziness, and impaired fine motor skills.
    Zyprexa (olanzapine) is one of the newer types of medications belonging to the class of atypical antipsychotics. It treats hallucinations and delusions that impair daily functioning of the individual. Possible side effects are dry mouth, insomnia, and weight gain.
    Trilafon (perphenazine) is an older type of an antipsychotic. Its side effect profile are not tolerable for some patients such as hypotension, and extrapyramidal symptoms such as restlessness, tremors, muscle rigidity, and slowed movements.
    You did not indicate what type of work your daughter is doing but nevertheless, her doctor may want to stabilize her on medication prior to going back to her work for her safety as well as others.
    The information provided in this Forum is presented for general educational purposes only. Specific questions you have pertaining to your health should always be directed to your personl physician or you may call Henry Ford Behavioral Health at(248) 689-7476 for an evaluation.
I wish you the best,
HFHS MD - RG
*Keyword: Ativan, Zyprexa, Trilafon, Zoloft


Posted by Elizabeth on July 29, 1999 at 19:38:16
Doctor, thank you for your quick response! I apologize for all the additional questions throughout this forum as I am just trying to get answers within reason
as,my daughter was admitted in 3/24/99 and it is now, July 29, 1999.
Could this be a inherited disorder? I donot present with these symptoms but my neice, sister and mother have had such episodes. My mother had been able to live a fairly normal life until she was 68 in which the symptoms of such appeared more prevelant! My sister was always a bit differents growing up and was dx as having dystonia as an adult as well as manic depression with paranoia symptoms, and myneice was hospitalizeds three times for depression with the last being the most presenting, severe depression with paranoia, anxiety disorder. Whereas, I do not have any dx for mental illnes to date, could this be an inherited disorder?  The pyschs have not catagorized her condition as yet but only depression with paranoia, anxiety...Can you give me something to go on? E  

Posted by HFHS MD - RG on July 30, 1999 at 14:26:04
Dear Elizabeth,
Posted by HFHS MD - RG on July 30, 1999 at 14:33:27
Dear Elizabeth,
Different types of mental illness has various types of causes. Inheritance or what we call genetic loading is among the causes of mental illness. And for each type of mental illness, there are different chances one can "inherit" them.
Unfortunately, I would be unable to diagnose accurately without fully evaluating your daughter.
The information provided in this Forum is presented for general educational purposes only. Specific questions you have pertaining
to your health should always be directed to your personl physician or you may call Henry Ford Behavioral Health at
[phone] for an evaluation.
I wish you the best,
HFHS MD - RG
*Keyword: Ativan, Zyprexa, Trilafon, Zoloft