[kitty004567]

So my T said the incident from Saturday night (see full post here http://forums.psychcentral.com/showthread.php?t=173540) was indeed a psychotic episode. She said they sometimes happen with people with bipolar disorder. She was going to talk to my pdoc about it.

The thing is she said if it happens again to either call her or my pdoc immediately. She said she would recommend immediate hospitalization and my pdoc probably would too. That's kinda where we left it, we ran out of time. I'm uncomfortable with this. What's going to happen if I call them? Are they going to send an ambulance? Are they going to send someone from a mental health facility (if there are people here who do that)? Or am I going to end up with swat at my house again and basically get arrested and taken to the hospital again. I want to know how this is going to be handled. What is she going to do?

Besides which the episode only lasted 30-45 min. I've been fine ever since. By the time they got me to a hospital it could very well be over and I could be back to my stable bipolar self...and I'm going to be med-change resistant because I would much rather learn to deal with occasional psychotic episodes than possibly mess up the stability I've got going on with my bipolar disorder by goofing with meds. And, this is the first time this has happened who's to say it will happen again. On the other hand, should I have a bag packed for the hospital incase it does? IDK... very upset. Any ideas?

[Trippin2.0]

A similar thing happened to me, I freaked out and called my pdoc. He arranged for an emergency appt and advised me to go to a clinic. I obliged, my meds got tweaked (not anything drastic, jis added an anti-psychotic, well IMO that;s not drastic) and the only time I've experienced something similar was when I was "clever" and skipped my meds for 2 days...

just wanted to let you know you're not alone, and also, I don't think the ride to the hospital will be a circus(ambulance and what not) or futile. It could be the answer to your prayers. It sure was mine, and I only stayed for 2days...

Also, this was not the first time this happened to me, granted the occasions were few and far between, but it definitely got worse for me. thus me freaking out the last time...
Not sure if this helps any...

[blueoctober]

I've had psychotic episodes and have had them since I was a child. Mostly visual hallucinations, but I've also had auditory ones. As far as hospitalization I've been hospitalized once and this was when I received my diagnosis at 31 years. I agree that it's probably a good idea to let your pdoc know, in saying that I've never called my pdoc regarding them and just let her know at my next appointment. It's one of her standard questions, but she has never suggested I go to the hospital immediately. I would suggest letting a friend, significant other, and/or family member know.....I never do that either. I'm not the best example of what a person should do.

[Tsunamisurfer]

Wow, Kitty! A lot more commonly experienced than I realised!
My psychiatrist also prescribed antipsychotics (which I hated because they knocked me flying) to help me deal with such experiences. He told me to keep them handy and use them as and when necessary, rather than take them continuously. My main treatment was mood stabilisation.

Like Beth, my approach was to let my pdoc know at every 6 weekly review what had happened (unless critical). The experiences weren't even given a label - just treated with fast acting antipsychotics when they occurred.

As far as men in white coats and whoopee rides to hospital go, I'd rather be completely nuts in the privacy of my own bedroom, thanks. Especially if it is going to be short and we can treat it at home. Hospitals freak me out!

Oh - context: I'm practically unemployed, and my approach may not be the best for people in an office job who may start flipping out in front of the boss or in a high level sales meeting.

[Trippin2.0]

Oh - context: I'm practically unemployed, and my approach may not be the best for people in an office job and may start flipping out in front of the boss or in a high level sales meeting.

LMAO, that happened to MEEEE! highly embarrassing, but at least I can laugh it off now. heehee

[yagalada]

Ideally, I would talk to the pdoc asap to maybe tweak your meds to try prevent this from happening again. I don't know what you're on, but for me, SSRI's really add to my psychotic features.

As for going to the hospital, the only times I was taken in an ambulance have been when I was section 12'd or unconscious. I don't remember either. When I've gone in under psych advice, I took myself in, had a loved one drive me and just presented at the er -- no big dramatics involved. The crisis team at the hospital then assessed me and then the mountains of paperwork completed and I get walked up to the unit.

[kitty004567]

Thank you all I decided instead of sitting here worrying to call my T and ask what would happen when/if it happens again and I call her. Basically she would just want a friend or family member to sit with me until I come out of it and if that wasn't possible to take me to the hospital.

I'm taking: gabapenten, xanax, and seroquil (an anti-psychotic) to manage my bipolar symptoms. According to my T, she and my pdoc talked yesterday and decided that it may be the fact that because I ran out of 25mg seroquil pills that I take in the morning, my pdoc gave me 50mg xr tablets to cut in half. Saturday morning was the first day I took one and I accidentally took the second half that evening. My T's exact explanation was apparently antipsychotics can sometime cause psychosis and that change in medicine (even though it was small) was what caused the psychosis. I don't believe her. I think she's blaming the easiest explanation.

I do feel better about the hospitalization thing. I have been hospitalized before and it was my choice then and it sounds like it would be again. I've made a list of things to pack should I need to and I'm going to leave it at that I think. My friend who was with me wants me to call my pdoc and hear straight from him that the med difference caused the psychosis. I don't actually care unless he knows for sure. I've got a disaster preparedness plan in effect, I don't think there's much else I can do in the mean time. Thank you all for your reassurance.

[Tsunamisurfer]

Woooooooooohoooooooooo!
Xanax and Seroquel are the two that knock me like a baseball bat. The alternative to a whole bottle of scotch. (Neurontin (gabapentin) didn't seem to do anything for me)

That point about the antipsychotics causing psychotic symptoms is an interesting one.

My experiences have been while off Seroquel. But I had recently come off 3 weeks Prozac monotherapy, and was out of my tree with mixed state symptoms at that stage. I'd be inclined to point fingers at the SSRI causing such distress, at least in my case.

Originally Posted by kitty004567

I'm taking: gabapenten, xanax, and seroquil (an anti-psychotic) to manage my bipolar symptoms. .... My T's exact explanation was apparently antipsychotics can sometime cause psychosis and that change in medicine (even though it was small) was what caused the psychosis. I don't believe her. I think she's blaming the easiest explanation.
.....

I'm glad you have a plan in place and feel better about the whole situation. You're not supposed to cut the Seroquel XR in half though - it says it on the patient fact sheet -
http://www.seroquelxr.com/pdf/medication-guide.pdf?ux=m

I think your doctor is trying to cover her butt if she told you do do that.

[kitty004567]

Originally Posted by jadedmoonbeam

You're not supposed to cut the Seroquel XR in half though - it says it on the patient fact sheet -
http://www.seroquelxr.com/pdf/medication-guide.pdf?ux=m

I think your doctor is trying to cover her butt if she told you do do that.

Yeah I know... I read the fact sheet too. My understanding was you're not supposed to cut it in half because it would effect the XR part. *sigh* who knows. Fortunately, it's been a week and it hasn't happened again.

You can cut the seroquel xr in half. It just makes it act like regular seroquel instead of being extended release.

[MissMay1977]

You are doing the best thing you can do by being prepared for a possible hospitalization. When I was hospitalized, I was taken by cop car ( not handcuffed) in the back seat quietly to the ER. Good luck!