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Unsure how to handle daughter's delusions?


#1

My 26 year old college educated daughter had her 1st psychotic episode in Dec 2015. She refuses Abilify which has helped in the past because she also suffers with an eating disorder). After Abilify cleared her delusions she was put on 200 mg of Seroquil and it was great for 5 months. Then out of the blue she told us ( in a panic) that the voices/connections we coming back … took 1 week to see her Psychiatrist and by then she was back into a full psychotic episode … initially she could reason that the voices/connections she feels were not ok… but that is no longer the situation. She has had her Seroquil now increased to 800mg with no sign of the voices going away. The Dr added Rexulti after 3 days ( and delusions getting worse) she changed it to Vraylar ( again no sign of improvement.) after 4 days. We are seeing Dr again tomorrow I will push my daughter to try Abilify again ( really only thing that has cleared voices in the past … this is our 3rd episode ). I am wondering if Seroquil is still needed since it appears that it had stopped working? Her delusion is a person she met briefly ( literally knew him for 4 days) lives across the country and my daughter’s only contact with him is through " mental telepathy " it’s not “voices " it’s a connection … that we don’t understand because she was the chosen one to have these special powers” she is a flight risk because her only goal
Is to fly to where this person lives even though she hasn’t seen or talked to him in 2 years and even then didn’t know him ( met him right before she had her 1st episode.)
In our state it is impossible to have any control over her mental health which is frustrating! Diagnosis had been Bipolar with psychotic delusions. Any suggestions on medications or how to handle this on a daily basis would be much appreciated.


#2

My daughter with sz has similar delusion, communicates by mental telepathy with a previous boyfriend and is also contacted by God on a daily basis to tell her she’s Satan and is going to die. She wasn’t like this before her relapse, she’s on Abilify and Quetiapine but the medications have only ever made the voices a little quieter, they’ve never removed them completely. Her illness tends to go up and down so I’m hoping her delusional voices will weaken as she recovers and her mind grows stronger.

The mental health experts tell her to use distraction techniques to cope with her delusions and voices, so you could try that e.g. writing, music, tv, art, reading, cooking, playing a game, play the keyboard, do some exercise etc. If none of these work then we’ll go for a walk or take her out in the car, or go out for a coffee somewhere reasonably quiet, or visit a small shopping mall or go to a park and just sit in the car people watching.

I’m no expert on bipolar (with psychotic delusions, and an eating dosorder) so couldn’t say if your daughter’s treatment plan is sensible. For sz, a medication like Abilify is continued because it helps to keep the delusions away, but maybe the Abilify was stopped for your daughter for other reasons.

We’re told that anti psychotics take a while to get into or be flushed out of the body, and can take days or even weeks to become really effective. If this applies to Seroquil, Rexulti and Vraylar then changing things every few days doesn’t sound like the best plan.


#3

abilify …was stopped only because my daughter refuses to take it… she insists that it will cause weight gain … even though all of them have the same side effects … she will not budge… and she is thin even on the medications. It was a great medication for her the voices completely were gone and she was able to look back … some of which she remembered much of the things she didn’t … but could understand the voices were weird and bizarre that it happened to her. When we try distractions she seems to get more " odd" like her mind then plays music with her delusion. The changing of the medications have me confused as well … this is pretty new to our family to deal with… ugg it’s frustrating as you know:( thanks


#4

In my own case, it became irrelevant what my son wanted or didn’t want…he needed medication he was refusing to take, he was psychotic, delusional, and very thought disordered to a point of limited functioning. We pursued temporary guardianship first, followed by a county attorney initiated involuntary hospitalization with mandatory medication order. He truly was a danger to himself…and was so terribly ill he couldn’t care for himself.

Something that I found very interesting is there are clinical trials for Minocycline, a version of doxycycline, that they like to administer to reduce the inflammatory response in the brain during psychotic episodes. What motivated us to push, and push hard, was the sooner he was medicated, the sooner we could possibly mitigate any further remodeling of the brain. That gave us great urgency to let it go on no further, or to do everything we could to get him some help…even if it was against his will.

My prior posts were in late January and early February surrounding his hospitalization and the process of getting him there.

Wishing your family and your daughter the very best outcome.


#5

@jmarie1067 - can you post a link to the Minocycline clinical trials for the inflammatory response?

I’ve heard anecdotal evidence & seen some research studies, but they were more geared towards possible infections than an inflammatory response. I’d love to see something not related to infection - mostly because inflammation is an easier argument than infection.

I kind of feel like a Minocycline trial couldn’t hurt anything if it didn’t work - or couldn’t hurt much.


#6

Here is something I just found, @slw .

I might have others in a file from my son’s hospitalization. He refused it, and they cannot involuntarily make someone take a clinical trial.

It is fascinating!


#7

My son just came home from the hospital.

I was visiting when a brand new nurse practitioner who was studying to be a psychiatric nurse came to check him.
She asked me if there was anything else I had questions about.
I asked if there was anything physical they should check while he was in the hospital. Of course, she said no, not really. I was asking about a sleep study & they didn’t think it was applicable.

However, our family doctor is willing to check him for anything physical that we can think of, so maybe she can check for any abnormal inflammation, then we can talk to the pdoc to see if we can try it. I know they have to be very careful even with OTC drugs with Clozapine, but it’s still good to know.

As I just mentioned on another thread, I feel like there’s something missing with what’s going on with my son.
He responded to meds so well in the past, had great insight, had long periods where he was stable - and now he just finished his 5th trip to the hospital in 10 months.


#8

Thank you - I’ll be reading it tonight!


#9

You literally have to take it a day at a time and use the hospitalizations as a breather. I know that sounds horrible for a mother to say but I am being honest. When you have someone driven to do something, the only thing you can do is try to distract. Does she live with you? Having a separate place close by works unless they are in full psychosis, then they need to be hospitalized usually. Zyprexa worked for my son but he refuses all medicine.


#10

She was in her 2nd year Graduate school 4.0 in a PSYD program ( ironic…!) and only 6 credits short of her Masters in Psych living in California we live in the Midwest. After her 1st eposoide we brought her home until she was well enough to return to school and live across the country alone … however it was short lived about 6 months … and now she is living with us. The problem is she refusies being in a hospital! She was hospitalized over Memorial Day weekend … and sadly I know exactly what you mean by a breather … it’s practically impossible to have on a hold ( she has been on a hold before 2 seperate times ) but then will take no medication and we/dr hasn’t been able to ever win a mandatory ruling stating she must take meds… so then she is released because there is no point in her being in a hospital because they can’t make her take meds and usually is worse after a hospital stay due to being off the meds ( which I Do make her take) … . She is extremely educated in Psychology and was ironically was doing Psych intakes at a state run facility in Southern CA so she knows the rules/rights better than most as well as medications because she had completed her Pharmaceutical classes. That makes this so much more bizarre and probably harder for her to deal with because she does have that additional knowledge. I have tried the 3rd party petition and made it no where… since its " not illegal to be mentally ill"
Even ifwhen the police are involved we might get her assessed and then released after 6 hours ( seriously has happened… she knows what not to say to not be held )
She was seen today and her medications have been increased so I’m praying for a miracle. Zyprexa I believe she was on until Seroquil ( I think they are in the same class or something …


#11

Hi, my daughter is on Abilify and Lithium for psychoaffective disorder. She did well at uni before her psychotic episode mid last year. I sense she had quite a lot of stress in uni, and I added to her stress level at that time that probably brought about the psychosis. My daughter is recovering at home and while her mood is stable, her logical thinking sometimes needs to be guided. I found that helping her to disengage from stressful situation helps. And also, once she calms down, it was much easier to help her see the situation more clearly. Recent one being acne outbreak…

Chong.


#12

Prayers for your daughter! Stress is definitely involved with my daughters episodes as well.