Neurontin, Lexapro, Seroquel and psychotic phase

[casey44]

A female relative, 81, was on lithium for two decades and had no psychiatric hospital. during that time. In 2003, she became toxic and was changed to Neurontin (300mg pm) and Exelon 1.5 mg am/pm. This occurred a month before death of husband of 50+ yrs. She did well for 6 months -was more mentally clear and focused than for sev. yrs. Lived independently. Psych. said he doubted that she had Alz, but didn't want to remove the Exelon bc she was doing so with w/the Ex./Neuron. combo.  In Dec, a neurologist prescribed Elavil for sleep. That was ok for about 3 weeks. Then, she became very anxious about a neighborhood crime and (uncharacteristically) doubled her Neurontin, Exelon and Elavil one night. This resulted in mania -- -- agitated and talking almost nonstop, recalling events of years past -- many involving instances of social anxiety. Family hired an evening sitter. Her psychiatrist immediately stopped the Elavil and added Xanax and Seroquel(25mg). The Xanax was used only for a week or so. She improved slowly and steadily. The sitter was discontinuted.

A few weeks later, she became deeply depressed; said she wanted to kill herself. She didn't have a suicide plan; seemed to be expressing a desire to die, as opposed to a true intention to end her life. She was hospitalized that evening. Lexapro was added to her Neurontin/Exelon. Seroquel increased from 25mg to 100mg. During hospitalization, she exhibited a little delusional behavior about other patients.

Within a week of her discharge, she was becoming increasingly paranoid and delusional. People trying to hurt her, entering her apartment in her absence, trying to poison, installing listening devices, etc.

Family members noted the behavior began with her hospitalization and asked if the meds could be part of the problem. Her psych. felt strongly that she was not taking her medications bc he had increased her antipsychotic med (Seroquel), but was showing signs of psychosis. Seroquel to 200 mg. Family began to monitor meds. Within less than 24 hours, the psychosis had increased. Within 36 hours, it was clear she needed to be hospitalized again. She was paranoid and delusional. This was 11 days ago. She continues to be hospitalized with this regimen: Seroquel 300-350 mg p.m.; Neurontin to 900 mg (600 mg am and 300 mg pm); Exelon 1.5 mg am/pm.  Lexapro 10 mg pm. And two or three days ago, Namenda 5 mg was added.

She finally appears to be improving, but still has some psychosis and isn't ready to go home. She also has wet her bed, which has never been a problem.

Her other meds are Accupril and clonidine for blood pressures; glucophage for blood sugar and Prevacid. Clonidine is new as of Dec03.

In Dec, patient was driving and alert. Now facing assist. living. We've read that neurontin can have immediate great results for bipolar, but often is ineffective w/in a year. Today's news about antidepress. is another concern. Considering geriatric psychiatric specialist. Your thoughts?

[Roger Gould, M.D.]

I like your last idea the best, a geriatric psychiatrist.  There are so many possible causes for what you describe that only a thorough exam and analysis will make a difference.  It is posssible that all of the medications are causing problems, and an experiment of removing them one by one down to minimum doses is in order. Its also possible that the opposite is true...she has an active underlying disorder that only medications can treat.

[deb723]

I am currently doing research for an upcoming book which deals with the side effects and withdrawals people have experienced from Effexor XR and other (like) anti-depressants. I am interested in receiving any information current or former users would like to share concerning their experiences with these drugs. Please email me @:
beach-***@****
and thanks!
deb

[OliveOyl]

My son had Seroquel added to Zyprexa and very shortly had to be hospitalized for paranoia and delusions.  You might want to research Seroquel in the combination of medications your relative is taking.

[naomipchef]

I am a 55 year old female who had two large parathyroid tumors removed 3/1/07.  I immediately was able to sleep that night after surgery, and the very next day started feeling like "myself"!  For years I was on every antidepressant - even investigational, sleep med, anxiety, seizure med, etc.  Nothing helped and I slowly became pretty much nonfunctional.  I had kidney stones, bone loss, GERD as well, all symptoms of hyperparathyroidism.  My blood tests were equivocal - just always elevated ionized calcium, which finally got me to surgery and a feeling of re-birth!  For four months after surgery I was truly well, just tired and needing adjustments to my thyroid meds - no antidepressants, sleep meds, etc., at all.  In June, my internist prescribed Neurontin for achy hips, which she felt came from a bum disk in my lumbar area.  With FIVE days of taking Neurontin, I swelled up huge in my legs and ankles, but worse, I was constantly crying, feeling my family was better off without me, passively suicidal but I did not attempt anything.  I had even seen my psychiatrist the day before starting Neurontin, basically we were tweaking my thyroid meds for the tiredness now.  Surely he would have noticed if I had "fallen off the bandwagon"!  I called my internist office on the 5th day and the nurse told me to stop the Neurontin immediately.  The swelling improved within a few days, but my wonderful mental equilibrium is GONE.  Crying, feelings of hopelessness, etc.  My psychiatrist started me on antidepressants a week after the Neurontin was stopped - we're starting a fourth one now, in a 3 month period.  I've heard of connections between Neuronting and suicidality - HOW were these people helped???  After having my parathyroid surgery and immediate improvement, I feel I can only attribute this to the 5 day Neuronting therapy.  WHERE can I get help?