prognosis

Hi again. I have posted previously under "confused and misguided" My friend has been transferred to a tertiary hospital as she has not improved in 3 weeks and is refusing to take her meds as prescribed. I believe she is taking some but not all of what she should be taking. She refused the risperidone and is now getting zypexia. The doc would prefer her to take the risperidone but comprimised with the zyprexia. When she was diagnosed 18 months ago, it seemed to only take a few weeks of medication and she was able to come out of the psychosis. This time she just does not seem to have much reality going for her at all and it has been almost 4 weeks. I am very scared for her. Can anyone help me understand what is going on here. What will be the prognosis? Is it a bad sign that the delusions are lasting so much longer and not allowing her to take her meds? I think this will be a life long journey for her. Will it be a turbulent roller coaster? Please if anyone can answer my questions, I would be very grateful.
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They (healthcare professionals) tell me that everytime someone gets psycotic it takes longer and more drugs to come back to where they can function, and the delusions have receeded.

The first time he was in the hospital for 2 weeks on risperidone, the 2nd time 10 months later (after being off meds 12 weeks, with drs permission) he was in the hospital 41/2 weeks. This was being complient with the medication the whole time, during both admissions.

Thank you for your interesting insight. I do recall a social worker stating that every time a psychotic episode takes place, it becomes more ingrained in the patients head. It is best to avoid psychotic episodes. Did the Doc take him off just to see if he would relapse? Will he now be on the meds indefinately?

He didn't like the psychiatrist so he stopped seeing him. He did go to his family doctor who would prescribe the medication. He ended up developing type 2 diabetes, probably from the antipsychotic meds. The family doctor seemed happy to find an illness he could treat and told him to stop taking the antipsychotic drug. This time he has agreed not to prescribe any psychiatric drugs and my husband has a new psychiatrist.

A medication nurse told me that if they can get a patient to stay on antipsychotic meds for two years (a hard thing to do) then they will sometimes try to wean them off after that time and they might be OK without the drugs. I think it is different with every person.

The meds.

Well...that is an intersting thing. While my DD/PPD ex was on them he did better. He had/has taken Risperdal, Zyprexa, Cogentin, Zoloft, Ambien, Effexor, others that I can no longer remember.

He stayed on Risperdal for one full year and was the best during that time. It was a mixture of Effexor and Risperdal...I think.

Once he was weaned off of Risperdal and had a massive psychotic episode as a result ( took one month after being off a larger dose to go back into a delusional state) they then put him on Zyprexa. Had to get him on a really high dose to calm him down.

Nonetheless...the statement about once they have another major psychotic episode it is harder and harder to return them to reality is the truth. The new episode, and any old ones, come right back and are stronger and more ingrained in their brains than ever.

After that last one he refused to to take his meds (the Zyprexa) and that was the final episode that led to our divorce. Mind you, that was...ummmm... 6 or so years ago now and he's not been on any meds since. His family reports that he's as delusional and paranoid as ever.

So...my experince was that keeping them on the meds IS the best chance for them and for us. Off them or going on and off them is NOT a good experience.

I wish the USA had programs like Canada as well. The injections would have been ideal as even when he did take his meds, I had to practically stand over him to be sure he was doing it or he'd spit them out or try to flush them down the toilet. <<<sigh>>>

Tori

Thank you for answering my question Tori. It is really a sad truth about these episodes becoming more and more ingrained. My friend has been in hospital for 6 weeks now and compliant with meds for about 3 weeks. She still is extremely delusional and paranoid. I just cannot believe this. 18 months ago all it took was a few weeks of meds and she was laughing about her behavior. This time she is really deeply into the delusions.

The prognosis is never very good with this disorder. I am interested to see that it is indeed classifeid as a psychotic disorder. It IS. No matter what anyone says.

The meds are really the best chance for them and for us.
Many say the meds do no good, many say they refuse to stay compliant with the meds...that is REALLY the problem non-compliance.

My ex was never the same after the first really bad episode. But the meds made him somewhat the person I once knew. Off them, Lord only knows who or what he was or would do. Scary stuff.

The more episodes they have the worse it becomes and it takes more and more to bring them back...so to speak. But they are never really brought all the way back. It becomes a choice as to whether we are willing to stay with and live with or deal with them as they are...once this terrible illnes takes hold of them.

But as many have said and I have said in this forum...we need to break free. It is hard, no mistake about that, but in the end it is the best thing we can do for ourselves, family and any children that may be involved.