[JMIR]

Hi, I have a friend that takes just tegretol. He is completely functional, married, works etc. but he gets sick and gets sick is having to be hospitalized as he gets racing thoughts, somewhat paranoid and just deteriorates. It takes a few weeks to get him back on track, but it is just heartbreaking!! Anyone have any experiences with people they may know who has to be hospitalized that is on Tegretol? Thanks!

[Rhiannonsmoon]

I answered this post in the new intro section

[Michah]

Hi Jmir,

I have been hospitalised in the past and also been on Tegretol. What would you specifically like to know, dear one?

Michah

[Rhiannonsmoon]

Originally Posted by Rhiannonsmoon

I answered this post in the new intro section

Another post I don't remember making...

I wonder if the dose is adequate or if you could also ask for another medication in tandem to stop breakthrough problems which may be the issue here for you...

Rhiannon

[JMIR]

Hi there, Tegretol as off label has worked for his condition. He is also on some other medications for his manic conditions, racing thoughts, some paranoid behavior. I am searching for a pathway of care or something different than what has been the way over the last 20 years. He gets sick, has to be hospitalized, medications and then he comes back.

Mental health is that ghost that makes us wait to see if/when it will happen again.

So, as he is older now, does our metabolism, blood work change that requires change. He does not have epilepsy, but Tegretol works for now. Have you ever had a neorological work up, MRI of the brain etc..

Is there another specialty that can help gets closer to better control?

Thanks, JMIR

Originally Posted by Michah

Hi Jmir,

I have been hospitalised in the past and also been on Tegretol. What would you specifically like to know, dear one?

Michah

[Michah]

Originally Posted by JMIR

Hi there, Tegretol as off label has worked for his condition. He is also on some other medications for his manic conditions, racing thoughts, some paranoid behavior. I am searching for a pathway of care or something different than what has been the way over the last 20 years. He gets sick, has to be hospitalized, medications and then he comes back.

Mental health is that ghost that makes us wait to see if/when it will happen again.

So, as he is older now, does our metabolism, blood work change that requires change. He does not have epilepsy, but Tegretol works for now. Have you ever had a neorological work up, MRI of the brain etc..

Is there another specialty that can help gets closer to better control?

Thanks, JMIR

Hi Jmir,

Apologies for my delay in replying. I am assuming your friend is dealing with Bipolar Disorder. On that premise, lithium is a very good mood stabiliser. I have heard good things about a combination of Lithium and Lamotrigine(also a mood stabiliser but better for the depression in a down phase). If your friend experiences psychotic mania, carbamazapine(tegretol) alone would be in question for these episodes. Your friend may benefit from a mild anti-psychotic/mood stabiliser(seroquel) but I am not sure of their intractability. This will help in the manic phases as well as provide a sedative effect. I have been on lithium and Olanzapine(Zyprexa) combination in the past, but it was found that I do not have bipolar. However, a friend of mine has bipolar type I and it works well for her. Olanzapine has a very negative side-effect which is weight gain.

And yes, as we get older our metabolism changes as does our ability to excrete waste through cellular respiration. Any of these psychotropics need to be monitored closely as they can can effect the thyroid, kidneys and liver. With lithium, your friend would need regular blood tests(lithium only works if its blood level is at a certain point) and liver function tests.

Sodium valproate(Epilim) is also an anti-seizure medication used for mood disorders. Your friends options are quite varied and it sounds to me like he really needs to have his meds reviewed. Does he have a psychiatrist? Some talk therapy would also not go astray. As we get older, we sometimes find that our needs and priorities change. It is good to able to talk to a therapist about these changes.

Just a note, depending on the age of your friend, hormone changes can also effect metabolism. Even men can experience significant changes in this area. He needs to get a full physical and hormone panel done, just to make sure that he is healthy physically. It could also explain any extremes in mood changes he may be experiencing with little or no obvious pattern to them, if that is the case.

Take good care and good luck.

Michah

[JMIR]

Hi, his symptins are more mania, can't sleep, pacing and paranoia. He is on Tegretol, Resperdole ? , Seroquel and one other. It is going on day 8 of his hospitalization and he has gotten worse. Not sure what changes to meds the physician is making, he tells us that if my friend does not provide approval to speak with a family member then he can't, as in his wife or father. How freaking illogical is that? He admitted himself to the hospital and this physician is saying it is the law, blah, blah and if he wants to get out, then he cannot stop him. There is no one to take care of him! This is horrible! Any ideas on the many points I just made?

Thanks, JMIR

Originally Posted by Michah

Hi Jmir,

I have been hospitalised in the past and also been on Tegretol. What would you specifically like to know, dear one?

Michah

[JMIR]

Thanks for the note, did not think about the hormone panel, he is in his 40's now, works out consistently and works in the sun all day, that may have changed it and the old ways of medication do not work anymore.

Originally Posted by Michah

Hi Jmir,

Apologies for my delay in replying. I am assuming your friend is dealing with Bipolar Disorder. On that premise, lithium is a very good mood stabiliser. I have heard good things about a combination of Lithium and Lamotrigine(also a mood stabiliser but better for the depression in a down phase). If your friend experiences psychotic mania, carbamazapine(tegretol) alone would be in question for these episodes. Your friend may benefit from a mild anti-psychotic/mood stabiliser(seroquel) but I am not sure of their intractability. This will help in the manic phases as well as provide a sedative effect. I have been on lithium and Olanzapine(Zyprexa) combination in the past, but it was found that I do not have bipolar. However, a friend of mine has bipolar type I and it works well for her. Olanzapine has a very negative side-effect which is weight gain.

And yes, as we get older our metabolism changes as does our ability to excrete waste through cellular respiration. Any of these psychotropics need to be monitored closely as they can can effect the thyroid, kidneys and liver. With lithium, your friend would need regular blood tests(lithium only works if its blood level is at a certain point) and liver function tests.

Sodium valproate(Epilim) is also an anti-seizure medication used for mood disorders. Your friends options are quite varied and it sounds to me like he really needs to have his meds reviewed. Does he have a psychiatrist? Some talk therapy would also not go astray. As we get older, we sometimes find that our needs and priorities change. It is good to able to talk to a therapist about these changes.

Just a note, depending on the age of your friend, hormone changes can also effect metabolism. Even men can experience significant changes in this area. He needs to get a full physical and hormone panel done, just to make sure that he is healthy physically. It could also explain any extremes in mood changes he may be experiencing with little or no obvious pattern to them, if that is the case.

Take good care and good luck.

Michah

[Michah]

Originally Posted by JMIR

Hi, his symptins are more mania, can't sleep, pacing and paranoia. He is on Tegretol, Resperdole ? , Seroquel and one other. It is going on day 8 of his hospitalization and he has gotten worse. Not sure what changes to meds the physician is making, he tells us that if my friend does not provide approval to speak with a family member then he can't, as in his wife or father. How freaking illogical is that? He admitted himself to the hospital and this physician is saying it is the law, blah, blah and if he wants to get out, then he cannot stop him. There is no one to take care of him! This is horrible! Any ideas on the many points I just made?

Thanks, JMIR

Is your friend not in a fit state to discuss meds and that is why they need to speak to a family member? You are right. That does sound completely illogical and I sense your worry and frustration. I am assuming you are in the US. I am not well-versed on American Mental Health Legislation as I reside in Australia, but you can contact a local advocacy group. Most advocacy groups whether they be general mental health advocacy or primarily for people with Bipolar, they usually have a good understanding of the law. The hospital can only keep him in involuntarily if he is a danger to himself or others. If he is feeling worse, then they should keep him in for support and observation.

An advocacy group will also be able to speak on behalf of your friend or on behalf of you, depending on their stature with the law.

Keep going Jmir. I know you are worried, but some practical methods for resolving this problem and getting the right help for your friend will help you feel proactive.

Let me know how you go and take care,

Michah

Originally Posted by JMIR

Hi, his symptins are more mania, can't sleep, pacing and paranoia. He is on Tegretol, Resperdole ? , Seroquel and one other. It is going on day 8 of his hospitalization and he has gotten worse. Not sure what changes to meds the physician is making, he tells us that if my friend does not provide approval to speak with a family member then he can't, as in his wife or father. How freaking illogical is that? He admitted himself to the hospital and this physician is saying it is the law, blah, blah and if he wants to get out, then he cannot stop him. There is no one to take care of him! This is horrible! Any ideas on the many points I just made?

Thanks, JMIR

Those are the US privacy laws. Patients have to give specific permission for a family member to speak to the doctors. He also has the right to be discharged at any point unless he is deemed by the court to be a danger to himself or others.