Not sure if meds are working

Family
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I haven’t been on in a while, but have checked in periodically. My husband was doing “ok” if there is such a thing, no severely psychotic episodes recently but some break through paranoia and I’m sure hallucinations though he doesn’t admit to or talk to the voices outloud. He was continually arguing about taking his medication, Risperdal and he took it twice daily along with an antidepressant, then because he was sleeping tooooo much, doc decided (and I was willing to try) a diff antidepressant and he was changed to Paroxatine a few months ago. He still argued about medications and my brother is a psychiatrist and suggested the Consta formula (injected every 2 weeks) so I didn’t have to have the daily arguement about meds, hoping that things would semi calm down with me complaining I was controllig his life. Note that my husband is fully denying that he has sz, that I have made everything up including the psychotic coma he spent three days in the hosptial for, the double suicide attempt and anything else he has been told that happened. About 4 to 4 1/2 weeks ago (about a week and a half before we started the injections) he was showing signs of a possible break so I was thrilled that he agreed to the injections. Note this is the same medication he is already taking orally. Doc is a gp not a pdoc because he refuses to see a pdoc or even a therapist so no therapy is in play at this point. He has continued to go downhill. We are now to the fact that in 5 days he has smoked 2 cartons of cigarettes, he barely is eating (when forced and not normal quantities), cannot carry out a normal routine chore at home, showering he does but can’t guarantee he has clean underware or clothing on because “what I have on isn’t dirty.” He hung up on one of his daughter’s tonight on the phone and she called me in tears because that is NOT his normal behavior. He just asked me if it was bedtime, I’m up later than normal because he is showing all of the signs he did the night he tried to kill himself the last time. He is literally sitting here waiting for me to go to bed. He has been getting up at 2 a.m. to smoke. He does still go to work which is good, but I talked to his boss and she has noticed the change in personality, behaviors etc as well. I told him that we needed to see the doctor tomorrow and he said blatently NO. I’ll see her at the next appointment, which is next week. I have tried to reason with him, but he won’t go. I did ask if he was hearing voices or if they had calmed down (he has never really admitted that he does hear them, but you can tell and he doesn’t deny them either) and he said “yeah I guess.” I’m wondering if since he stopped taking the oral med in the Risperdal when he started the shot if that has caused the issue to get worse, or if it is possible that this would have happened no matter what as part of his cycle so to speak. I know no one can probably tell me, I’m just trying to find understanding once again of something that literally cannot be understood. I’ve been near tears today and in tears. I just know that you all can understand the frustration and maybe give some insight on the medications. I’m still fairly new to this arena, considering he has been diagnosed about 18 months and still isn’t his “old” self. I know that will never happen again. But to get some of him back would be nice, but that’s not happened either. Two years ago we had one of our 5 daughters get married, I see those pictures and remember the fun we had at her wedding and wish we could go backwards. We have a new grandson, a grandson who is 9 who was going to visit this summer, but it isn’t looking like it will happen if hubby isn’t doing better AND another wedding come October for another daughter. I worry, feel bad that her daddy won’t be the daddy who walked her older sister down the isle and possibly won’t be able to walk her down the isle at all…so much has changed,

Sorry…just rambling. Main question is has anyone had experience with risperidol consta? Was this started incorrectly? I read lots of info on it before he started it and never once saw that the oral was supposed to be kept going with it for a while, but then today came across something that said it was. :frowning: My brother couldn’t answer the question because he has never used /prescribed this specific medication. Thanks for listening to my rambles.

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The medical blurb says that depot injection delivers exactly the same anti psychotic drug as the pill form, over a long period. But in the real world, people’s experience seems to vary, with some saying the depot injection form of the drug metabolises differently to the pill form, and some people say the monthly injections can ‘wear’ off towards the end of the month. We experienced this with our daughter. Some people seem to be taking medication orally in this ‘end of the month’ period to keep things calm.

Of course, your husband’s illness may just be changing down a gear for a while and that he’ll come back up. If it was me and my daughter was going downhill, I’d ask the gp if he/she can prescribe something in addition to the anti psychotic, perhaps an anti anxiety calming drug like Lorazapam or Diazapam, to keep the lid on things, just to see if the illness is having a bit of a blip. There’s no black or white with this illness, just a muddy grey day on a roller coaster.

When you look back at the life you had before sz got hold of your husband, do it with a sense of ‘we had some great times and we’ll have more great times in the future’. Things have changed for you, that’s for sure, and the great times you’ll have from now on will be different, you have to change the goal posts that define your sense of what are great times. Because your lives have changed, try not to compare what comes in the future, with what has been in the past, especially when it comes to your daughters weddings for example. I have 2 daughters too, one with sz, and the younger one with no mental health issues. The younger one has achieved a boyfriend, car, good job, buying a house, and I’m sure there’ll be wedding bells soon and in time the pitter patter of little feet. The older sister, with sz, is very different, her achievements are no less rewarding to me, but are quite different, and I never compare. She’s achieved so much, is able to use buses and trains on her own, lives independently for several days at a time, cooks home made soups, is great with computers, the list goes on.

Stay positive, stay strong, take the initiative and you’ll find a way through. All the very best to you.

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They tried Invega Sustenna with my son. Invega is supposed to be the new form of Risperdal with less side effects.

Our experience was that the shots just didn’t work for my son.

He went into the hospital, they started the shots plus gave him oral Invega - he did well.
He came out of the hospital, and the outpatient doctors would take the pills away.
Eventually, they would increase the dosage of the shot, but it still just didn’t seem to be as effective for him as when he was taking the pills too.

The doctor explained the Invega shot to me like this. She said it takes about 2 weeks to be available in his system, then you get the next shot at the 28 day mark so there’s some overlap, and every month it gets better.

We were at the 6 month point, he got the maximum injection for the 2nd time, and stopped sleeping 5 days in. In another week, he was back in the hospital. I talked to them & they’ve discontinued the shot to try something else.

While he was in the hospital the last time, they also added Trileptal, a mood stabilizer, and that helped him a lot. It took away a lot of the angry spells, made his moods more even and somehow made him more agreeable to taking his meds. Maybe that would help?

If it was me, based on what I’ve went through with my son, I’d see if you can give him some oral Risperdal until the shot kicks in really good & maybe ask about a mood stabilizer too.

In my experience, the anxiety calming drugs like shop1uk mentioned are great in a hospital setting, but they can cause a lot of problems at home if your husband has any kind of substance abuse problems. And, they can be the beginning of a substance abuse problem - they were for us anyway. I’m sure other people don’t have the same problem, but they’re a nightmare for us.

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Thanks for the input! I try very hard not to compare before and now, it is hard! He was VERY active, creative and a go getter…no longer. I will talk to the doc about the oral and the mood stabilizers as well. Thanks again for the help, funny how he kept it hidden according to the pdoc that he saw in the hospital since he was 18-19,now he is 57. This is one strange illness!!!

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Hi mom25grls,

When the Risperdal Consta shot is started, it needs to be overlapped with the oral medication for a week or two. The nurse told me it takes about a week to be effective, so maybe it will still kick in?

I hope your family has a good outcome.

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Thanks so much to everyone! The doctor put him back on oral Risperdal and then increased in injectable to 50 mg IM every two week starting today, with a p.r.n. order on the oral, so if he starts showing signs toward the of the two week dose, she said to give him the oral 2mg twice daily. Unfortunately the pharmacies don’t keep Consta on hand and we spent all day yesterday searching for it. FINALLY found a pharmacy that had it today. Hopefully by the end of the weekend things will calm down. He is still off…after his injection he wanted to know if he could go home…I said no you still have to finish the day of work. He didn’t argue, was just acting a bit confused but was able to finish the day. He kept asking me the last couple of nights if it was bedtime yet, however then he really didn’t sleep, and I had to force him to eat. Tonight he was hungry, but is still off due to the fact the only time he likes chicken of any kind is when he is psychotic, that is what he asked for for supper…I am still in awe of this aspect because he worked on a chicken farm and despises chicken any other time. LOL Anyway thanks everyone for you help and support!

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I’ve found I have to pre-order a lot of psych meds, especially if they’re expensive.

It’s irritating for me to coordinate that, so it’s no wonder some people come straight out the hospital & go off their meds immediately.

Once I figured it out, I would get them to order the Invega Sustenna a week ahead of time. I think I even had a hard time finding the oral Invega - they said everyone was clearing it out and waiting on the generics to come in.

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I just read that it takes three weeks for the injection to work. Sounds like they’re taking his symptoms seriously and trying to get him better by giving him both the injection and the oral meds.

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Abilify injection is ramped up in the same way, with additional oral Abilify which is gradually reduced whilst monitoring that the injection is taking effect.

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I had to change pharmacies any way so the one that had it on hand is where I went. I can do the ordering online for it to be filled so hopefully that will make it easier. The doctor put in a 6 month order for it, we see her about every 2 to 3. He is still off :frowning: I know he is getting worse overall. His boss contacted me asking if he was okay (what does that word mean anymore? ) He was getting snippy with her and his big boss and hiding from them. She wanted to know what to do. What do you tell someone when handling your own husband, knowing that it could mean his job? I talked to him, whether he is appreciating what I said or not I have no clue, but I literally sat him down and said that he could NOT treat people outside of our house with being snippy and rude, that he could not hide from his boss while working. He said “ok”. I don’t know any more…I so feel I have a 57 year old 5 year old if that makes any sense.

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That’s a pretty nice boss to call you and ask about his behavior instead of firing him. Still, it made me giggle a little to imagine a grown man hiding from his boss (sorry; I know it’s not really funny). Does he work in an office?

My husband got so he could not work in any office setting. No one ever gave me the courtesy of a phone call, probably because most jobs didn’t last that long. Although when he had his first psychotic break, he had been working at the company for a few years.

I still am saddened by the heartbreak of him getting a new job, and then losing it due to his paranoia. He was in his late 20s early 30s, just really getting started professionally. He’s in his 50s now, and we are divorced. He is on disability (thanks to me, seeing how he probably wouldn’t be able to full time), but works pretty regularly part time.

Anyway, I just want to say, I get it. Work is so important to one’s self esteem, especially for men.so it’s great that your husband works. But maybe he could take a leave of absence until his symptoms are better controlled? They seem like understanding bosses.

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My husband is a maintanence man in a motel. Been there for 30 + years. His boss is awesome. Has again contacted me to let me know he was “hiding” again and getting snippy with her. I know the hiding sounds like a little kid, and you know sometimes that is what I feel like I have, a 5 yr old in a 57 yr olds body. I am glad they will let me know. because I sometimes feel that I watch so closely that I might actually be seeing something I’m really not, if that makes any sense??? I’m sure you all understand that one, when others definitely cannot.

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I totally understand that - we are trying to figure out if my son is actually taking his meds or not. Since we have seen signs that could go either way, we are waiting to see if he refills them…