Family and Caregiver Schizophrenia Discussion Forum

Are there sleep aids that are known to be unsafe for a psychotic person

My son is currently experiencing his first psychotic break. He is 24.
We have done all the right things, crisis line, BH hospital walk in (he left. when it was his turn for assessment), crisis team at home and going to the ER where he was given Zyprexa and then discharged once he calmed down and got sleepy.
He hadn’t slept in at least 4 nights before the Zyprexa and we are on our own again.
Still trying to figure out more ways to get him care. But I want him to be able to get on the best sleep cycle possible right now. I feel that the lack of sleep is making this worse, for him and for us, his parents and sister. Are there any sleep aids that are known to be okay or known to not be okay for a case like this?

Hello @kitmom, That is good they gave him Zyprexia. My son says that during his first episode (that we witnessed) and night in the hospital, they gave him Zyprexia and he had his best sleep in years according to him. After, they gave him Haldool and Abilify which gave him horrible tardive dyskinesia and acathesia. Avoid those, at least the combo. My son does pretty well with Melatonin. But, he really doesn’t need it if he is taking the Zyprexia. Zyprexia is the only AP he will take, because it doesn’t cause him TD. But, it causes a lot of weight gain. So, a strict Atkins/Keto diet was recommended for him. He gained ~80 lbs on it initially. He is now in a Behavioral Health center and he is taking Depakote with the Zyprexia. He says the Depakote helps control his impulses and helps him stay alert during the day and curb his appetite. Did they give your son a prescription for Zyprexia? It helps control the hallucinations and delusions. Melatonin will only make your son sleepy. If he doesn’t have a prescription for it, I recommend you get him to a psych doctor who can prescribe APs for him. And get him into counseling.
One thing I will say is you have come to the right place for support and advice. I did not find this forum for over a year into my son’s first break. Everyone here is so helpful and many have years of experience. All the Best!

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I don’t know the answer to whether there are certain sleep aids that are best to avoid with psychosis or which ones interact with the various antipsychotic medications. However, we have been working successfully on getting more regular sleep at our house. My unmedicated son had an episode about a month ago where he stayed up for three days smoking weed and drinking coffee. It took him about ten days to finally get back on track with the sleep and I have now prioritized that as something I do have a little control over. I make one pot of half decaf half regular coffee per day. At noon I dump what is left in the pot and there is no caffeinated beverages available in our house for the rest of the day. I didn’t say anything to him about this other than pointing out that caffeine can wreck havoc with sleep. He’s lost his ID and can no longer buy weed, which is a huge blessing. Sometimes he asks me for a joint and I will buy him one but nothing too strong. I turn all the lights off or to very dim at the same time every evening and make him a cup of chamomile tea which I leave on the counter before I go to bed. I turn the AC on high in his room in the evening and leave the rest of the house warmer. I go to bed at the same time every night and get up at the same time every day. In other words, I am doing all of these things to make a very predictable routine around sleep and it has been working. His sleep pattern is the best it has been in years. Prioritizing sleep is important for everyone.

Our son also found Zyprexa to be very sedating and calming. He took it for 5 years and was able to complete his college degree before the wheels came off necessitating a med change. Apparently even a happy occasion like a graduation can trigger a relapse.
Agree that sleep is paramount for our loved ones, and for us caregivers.

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Great tips, @Steadfast!

@PNWMom, Zyprexa has been a life changer for my son! No voices, no hallucinations, and it gives him a solid 10 + hours of sleep. He was also given that in the hospital last time he was admitted. His doctor told me sleep was everything and zyprexa has come thru for him so far. As far as the weight gain and diabetes issues, my son is really managing well. He’s very conscientious of what he eats now. And I thank his meds for his clarity.

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@mbheart, Thank you for sharing your son’s experience with Zyprexia. That is the only AP my son will take. Nice to hear your son has had a good experience with it and it’s decreased his delusions and hallucinations. Yes, my son also needs to be better about watching what he eats. That would help so much!!!

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@PNWMom , he also had horrible experiences with Haldol and Abilify. Terrible tardive dyskinesia, his legs shook constantly.
Best wishes to your son!

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@PNWMom They did not give him a prescription, just one sublingual dose of the Zyprexa by the triage doc for psychotic agitation. Once he got to the crisis center inside the ER (no mental health professional there and they didn’t call one, even though they said they would) he was getting knocked out from the med and they sent him home.
He is not on any medication because this is the first time anything like this is happening.
@Steadfast Thank you for all those tips. I know how important sleep is and have been trying to discourage energy drinks for him. It’s on only caffeine he is consuming, just one per day usually but often in the evening.
I think there were warning signs we missed earlier. His sleep would be great and normal, then out of whack with lots of getting up at night. He would still go to work ok and sleep during the day on his off days late. I feel so bad about not seeing this coming, but how could I? I do feel like I failed him by not being able to convince him to practice good sleep hygiene and see a therapist when I felt like he could benefit from one. On the other hand, he’s an adult and always, even as a teenager, said he was fine and could handle it.

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Hi Kitmom
Please don’t blame yourself. We do the best we can. There is really no way of knowing what will be a trigger. We just keep trying

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.@HeatherDiane Thanks. It’s so hard to not blame myself for not being able to prevent this

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To show how this impulse never seems to end, my mother still apologizes for having missed the signs or doing this or that wrong. I’ve been recovered for over 30 years, I’ve had years of therapy, I’ve told her there’s very little she could have done, I was actively trying to conceal my issues in my prodrome and on and on. And yet she continues. I periodically have to reassure her that it’s okay, it was a long time ago.

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Does he have a primary care doctor who can prescribe him the Zyprexa while you are trying to get him an appointment with a psychiatrist? The lowest dose is 2.5 mg, which knocks my son out. It is very sedating.

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@JoAnne_Meiers He is currently hospitalized. Sorry if I didn’t update this here. I have two threads going. He has been in a behavioral health facility since last Monday, so one week now. I was so relieved when he voluntarily went. I feel like it has saved him from a lot of potential trauma related to possible involuntary commitment. He is sleeping, no doubt with the help of medication, and participating in groups. He does sound better on the phone too.

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I’m so happy to hear he is doing better. That’s wonderful news. :blush: