@caregiver1 That does look like a fast decrease. However, my son had his olanzepine dosage cut by 25% 2 weeks after hospital discharge. He was on the highest dosage though, 20 mg. He had never been on any medications before and was in the hospital for 9 days with very visible weight gain at discharge. I don’t know how much because he never used to weigh himself. His FEP program requested all records, so hopefully there is a starting weight in there. He is pretty tall and was always quite slim and started working out a few years ago. So he was still trim but strong. He had to buy all new pants today 
. He is craving carbs like crazy but I know it is not just calorie intake but metabolic changes too. I’ve looked into Omega 3 supplementation and found some indication that that might help with the metabolic issues. I dread the day when he realizes the weight gain is a direct result of the medication and might start refusing to take it.
@kitmom, I’m glad that you and your son are focusing on FEP, because I believe that’s treated differently than after many psychotic reoccurrences. There are programs where I live for FEP, but when my son had his first episode of psychosis in 2018, I didn’t know anything about FEP and his psychiatrist never brought it up.
My son takes 1,000 mg of metformin 2x a day to help with the olanzapine metabolic effects, but he’s still gaining weight.
No. I mean two or three different dosages PER medication. That is, dosages adjusted up or down (mostly down) per my symptoms and situation. Sometimes over, sometimes under “recommended therapeutic dose” depending on the drug, my response and the situation.
I think laymen sometimes get caught up in notions that there exists some sort of formulaic dosages and diagnoses. In my experience, these are used more as rules of thumb. Treatment and sanity are averages and require expertise and experimentation with methods and some luck to prove successful.
OK. My son is on 15 mg of olanzapine and 500 mg of quetiapine, which seems too much for me. But it’s doing a miracle cure type of job, so I suppose the results are what count.
The olanzapine was decreased from 20 mg 6 weeks ago because of high triglycerides and the quetiapine was being titrated down from 600 mg, but the titration was stopped because of some incipient, but not bothersome, voices.
I’m pretty sure the titration down will resume soon because the latest is that the voices have totally gone away. Amazingly (to me) my son is not 100% okay with this, as he got used to some of the friendlier voices.
I’ll reiterate what I’ve said in the past: recovery is not the absence of symptoms, but rather developing coping mechanisms to make them more manageable.
I had similar periods in my recovery: one where I gave up talking back to my “voices”, another where either I let them go, or they left me. They weren’t all bad, and as with everything it’s a question of perspective. As strange at it may seem, they were good company and knew me better in some ways as well or better than myself, because they were a part of me—even if perhaps an unconscious part.
They might tag along wherever I went, and while they took effort to ignore and sometimes monopolized my attention, it was much easier acquiring and keeping them than finding new friends after becoming ill. There’s a loneliness after they are gone, because unlike voices, you have to work to find and maintain friends.
That helps to explain what’s going on. I hope he can recover and adapt to the comings and goings of his voices also.