Acute psychotic syndrome. Please help

Hello Everyone
I would really need some advice or suggestion from your experience.
My husband has been diagnosed with acute psychotic syndrome, breakdown happened on 1st March. I am not quite sure what exactly happened because I wasn't with him for last 3 month ( I had moved abroad for job search and he had recently joined new office so we couldn't travel together). During these 3 month he often complained me about his colleagues that they are treating him bad, not giving him work to do judging each of his decisions etc. He started to use alot of alcohol, like drinking every day just to be able to sleep, smoking 2 packages of cigarettes daily etc.
After all this my husband believes that there are corporates after him(he believes that one of his previous office he was working for doesn't even exist but it is some kind of fake organization made just to humiliate him/or made to spy in other country and he has discovered it) , government is after him, our house is bugged, all his family including me are against him and trying to harm him etc.
In the begining he has taking Zyprexa 20 mg and Remeron 30 mg (he actually also was cheating with medicines - spitting them out and not taking them properly as it is poison and we are trying to kill hi) We changed psychiatrist and new one prescribed Serenace 15 mg a day that we give 3 times daily with Kempro, and clonozopine for sleeping.
My worry is that medicines doesn't seem to work properly, yes he is calmer, he doesn't have so many delusions (like by seeing news on TV he would say that corporates/government or whoever is giving him some warning) or smth like that, but still he has these delusions. He just doesn't talk about them so much, I think he tries to hide them as he has attitude I am perfect, I am fine. Doctor by seeing and talking with him is ready to reduce dose of medicines and only after we confirm that there still are delusions he leaves previous dose.
Even now he is saying me that I should leave this country and go back to search for job because corporate are after him or something like that.
In the same time he is very depressed and worried about future, his job, carreer, me, my health. He is smoking approximately 1-2 packages daily
we have also taken him to psychotherapist for now there has been only one session.
Reason why I am writing to you is just to confirm if it is normal that he until now has these delusions and for how long it will continue? He is using Serenace for more than 2 weeks now.
I sometimes think that medicines are not working properly (even though doctor says it is part of recovery process) Do I want result too fast?
How recovery process happens? He is until now convinced that we all are just after him and trying to harm him by taking him to doctors, giving him medicines etc.
I dont know what to do to help him, can someone suggest something? Please...

I am no doctor. He should be seeing a psychiatrist and a clinical psychologist. He should act on their advice.

Cut his alcohol out or down significantly. Drinking can cause malabsorption and thus vitamin deficiency which in turn causes psychosis. Thiamine (B1) deficiency in alcoholics is a well-known cause of psychosis, but other B vitamin deficiencies cause psychosis. So try him on a good B-group supplement, subject to his doctor agreeing it is fine to try it.

Food intolerance can cause psychiatric symptoms. Are there any foods at all that he reacts badly to? If so, get a referral from his doctor to an allergy/food intolerance clinic in a major city. Under medical supervision, he could try the elimination diet practiced by the Royal Prince Alfred Hospital in Sydney. If he does, reduce his meat and fish to a very small amount, but under the supervision of a dietician and his doctor. Some psychosis is caused by hyperammonemia (high ammonia) and eating less meat and fish and protein may help with this. Testing his ammonia levels may not be conclusive as to whether hyperammonemia is a cause, but could be tried.

Get him fit and healthy with exercise under the supervision of his doctor and a trainer.

If you want to know if there is likely to be a physical cause over and above the tests his doctor should have done, get his serum amino acids tested. If there are abnormalities, they may be a result of his underlying disorder. Finding out the cause of these abnormalities may inform treatment. But this is getting beyond where most treating doctors and researchers are at. Sadly, medicine is still looking for over-arching diagnositic tests, and for one-size fits all treatments for such disorders that are often applied on the basis of clinical presentation alone. My personal view is that personalised medicine based on understanding the individual's abnormal test results would be a much better way to go. So if you find abnormalities and do not have the skill set to try and find out what the cause could be yourself, then you are stuck with merely knowing there are abnormalities that are currently not understood. If you do subsequently think you have found the cause, make sure his doctor agrees with any treatments you are considering based on your research.

Good luck. Lots of people do recover. But it is better to be proactive.

ornithine wrote:I am no doctor. He should be seeing a psychiatrist and a clinical psychologist. He should act on their advice.

Cut his alcohol out or down significantly. Drinking can cause malabsorption and thus vitamin deficiency which in turn causes psychosis. Thiamine (B1) deficiency in alcoholics is a well-known cause of psychosis, but other B vitamin deficiencies cause psychosis. So try him on a good B-group supplement, subject to his doctor agreeing it is fine to try it.

Food intolerance can cause psychiatric symptoms. Are there any foods at all that he reacts badly to? If so, get a referral from his doctor to an allergy/food intolerance clinic in a major city. Under medical supervision, he could try the elimination diet practiced by the Royal Prince Alfred Hospital in Sydney. If he does, reduce his meat and fish to a very small amount, but under the supervision of a dietician and his doctor. Some psychosis is caused by hyperammonemia (high ammonia) and eating less meat and fish and protein may help with this. Testing his ammonia levels may not be conclusive as to whether hyperammonemia is a cause, but could be tried.

Get him fit and healthy with exercise under the supervision of his doctor and a trainer.

If you want to know if there is likely to be a physical cause over and above the tests his doctor should have done, get his serum amino acids tested. If there are abnormalities, they may be a result of his underlying disorder. Finding out the cause of these abnormalities may inform treatment. But this is getting beyond where most treating doctors and researchers are at. Sadly, medicine is still looking for over-arching diagnositic tests, and for one-size fits all treatments for such disorders that are often applied on the basis of clinical presentation alone. My personal view is that personalised medicine based on understanding the individual's abnormal test results would be a much better way to go. So if you find abnormalities and do not have the skill set to try and find out what the cause could be yourself, then you are stuck with merely knowing there are abnormalities that are currently not understood. If you do subsequently think you have found the cause, make sure his doctor agrees with any treatments you are considering based on your research.

Good luck. Lots of people do recover. But it is better to be proactive.

Thanks for the info. Very helpful.