Too high a level of medication?

My son is in a psychiatric ward of a hospital and is on the following meds:

20 mg of olanzapine
600 mg of quetiapine ER
900 mg of lithium ER.

The olanzapine + quetiapine combination is a bit more than I’ve ever seen him dosed with.

He had gone off his meds and I’ve heard they don’t work as well when they are restarted, so maybe that’s why the high dosage.

This Antipsychotic Dose Calculator puts it at 900 mg of quetiapine, which is 100 mg higher than the maximum dose.

I want to tell you how sorry I am that your son is in the hospital. I feel your pain. I know that right now you don’t think anyone can feel your pain. I dint know much about those meds. The only one I am familiar with is the one that starts with Q. My son was on generic version called Seroquel. The dosage was not that high. It was started at 200 and up to 400. As the doctor increased doseage he got worse. So now he is on no medication.
Now he does not hear voices. He is just in very bad shape. He doesn’t talk and stares a lot. I have a scheduled consult with Amen Clinics but I am also trying to get him into another doctor ASAP because he is worse than I have ever seen him. I started him on B12 and am adding Folate and omega 5 fish oil.
This is do scary and I, which I’m sure you do too, feel like I’m at the mercy of the doctors at this point. I’m hoping the natural meds work but will do whatever it takes to get my son well again.
I would research the meds m, the doseage the doctors have him on and the side effects.
Then be sure to be included in the discussions with doctors.
I’m so so sorry you are going through this.
Everyday I just hang on and pray that this will all get better and my son will be healed by medication or a miracle. I will accept either! My heart goes out to you! Kathy

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I generally suggest if you question medication doseages talk to the doctors or pharmacists directly and don’t rely on calculators or comparing notes with other patients or caregivers. I’ve had such discussions in my own behalf and on my father’s and brother’s. They should be able to explain their reasoning and discuss risks or why certain guidelines are relaxed in practice rather than theory. Drug companies are often conservative because they are highly liability adverse and off-label doseages and usages are common as a result. I’ve found this especially true in dementia and elder practice. The bottom line is you aren’t knowledgeable or qualified enough to make these choices, otherwise psych meds would be over the counter.

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@Maggotbrane, we are going to schedule an appointment with my son’s private psychiatrist and I will bring it up. Thanks for the suggestion. I’d like to ask the shrink who is treating him in the hospital but he does not return our calls. My wife and I have HIPAA access and speak to the social worker and nurses who have helpfully told us what is in my son’s notes, but have never spoken to the psychiatrist. I talked to the shrink at intake when he called to take a history. That was the only time I’ve spoken with him.