[sandkitcat]

Hey y'all.

I'm not on any anti-psych's as of yet, because I've had such issues with them.
Me and my pdoc are working on getting me on a good one, though.

But I had a quick question- are there any medications out there that you can take for acute psychotic episodes that are fast acting? As in, if I am having an episodes, I take one of those medications to hopefully bring it to a halt? Not as a long-term medication, but one that you take when you are specifically not having a good time with psychosis.

The only thing I do right now when I'm experiencing these episodes is take some klonopin and hope for the best...but are there any medications that actually truly help with a psychotic episode??

[*Laurie*]

Seroquel is the first one that comes to my mind. It can be taken prn (as needed), but generally you'd take it prn if you're already on a steady dose. In other words, you might take a bit extra at a time when you need more than usual.

To my knowledge, AP's are not like, say, Advil.You have to maintain a blood level for at least some months in order to prevent a prolonged psychotic episode, or to prevent a relapse.

But maybe someone else here knows of an AP that can be taken prn.

[peacelizard]

Disclaimer: I don't have any personal experience with psychotic disorders; I struggle with major depression and social anxiety. But for the past 8+ years, I've worked on an acute, locked inpatient unit for people with Bipolar I and other psychotic disorders and thought my experiences with hundreds, if not thousands, of people dealing with psychosis (and all the med trials they've been through) might be helpful.

So, that being said, in general, I think what Laurie said is right: that AP's are not known for being effective (or as effective) on a PRN basis and really need to be taken consistently to get the most out of them. That being said though, where I work, they're definitely used on a PRN basis, but they're usually PRN's of already standing medications, e.g. a patient might be on 20mg of Zyprexa at night, but then also has written 5mg Zyprexa PRN to use twice a day. Then, if the patient took the PRN consistently for a few days, the PDOC might consider upping the dosage to whatever it was plus the PRN dose. Whether the individual PRN doses actually affect psychosis — a lot of times it's hard to say because the experience is so subjective.

For whatever it's worth, I know Risperdal, Zyprexa and Seroquel are the most commonly prescribed AP PRN's. I wouldn't put as much faith in the Seroquel though, as, at least in my experience with rare exceptions, it's not a very good AP in general.

[tecomsin]

For acute treatment, i would try the zyprexa that dissolves under the tongue. I think zyprexa is more effective as an antipsychotic than seroquel. They give zyprexa injections to calm people down in psych wards. It can be very sedating if you are not used to it. Once a psychotic episode starts it doesn't go away with just one dose unlike something as simple as a taking a tylenol for a headache. As *Laurie* and peacelizard wrote, you will need to take it for awhile to tamp down psychosis.

I personally take an antipsychotic 2mg of Rexulti but if I were to start to get psychotic symptoms I would add zyprexa prn because i know it works for me.

[sandkitcat]

Thank you for the advice, y'all. I've taken all of these drugs (except Rexulti), but they were all the XR versions I believe??

So maybe tacking this on to whatever AP they give me next time (Vraylar is gonna be our next try, praying for results and no terrible side effects!) I was just really hoping for some kind of one PRN that works well since I have bad episodes that the AP's long term effects can't always fix.

But thank you all, I will definitely look into the short-acting versions of these drugs!

[bpforever1]

In the hospital, I was injected with haldol. It knocked me off my feet.

[sandkitcat]

Originally Posted by bpforever1

In the hospital, I was injected with haldol. It knocked me off my feet.

Was actually wondering about that! I know they inject with haldol often at hospitals, so I'm curious to know if there is any milder at home equivalent.

[RainyDay107]

Geodon, Seroquel, Abilify...they all work(ed) quickly for me. Geodon is my preference.

[BipolarSpinster]

Originally Posted by sandkitcat

Was actually wondering about that! I know they inject with haldol often at hospitals, so I'm curious to know if there is any milder at home equivalent.

Vraylar worked very well and very quick for me.

[TicTacGo]

A drug that I know of is the Zyprexa Velotab, which dissolves under your tongue.something like that would work quickly.

The notable short acting injection form would be Zyprexa IntraMuscular.

[Guiness187055]

Thorazine works well too.

[peacelizard]

Originally Posted by sandkitcat

Was actually wondering about that! I know they inject with haldol often at hospitals, so I'm curious to know if there is any milder at home equivalent.

Not really. A big part of why they inject Haldol/Ativan/Benadryl (pretty standard drug cocktail — "chemical" — 5-2-50 — in most ER's and psych wards) intramuscularly is because it's faster acting than by mouth and the feeling of sedation is a lot more pronounced.

I wouldn't be surprised if the Haldol did something in terms of mania/psychosis, but on a pretty small scale. As much as I hate to say it, I think it's largely the sedation to kinda knock the person out or at least slow them down some. Also why it's frequently paired with physical restraint (staff having to hold the person down) and/or mechanical (traditional 4 point restraint — “leathers" [although sometimes they're velcro] facing up on a specifically designed restraint bed or sitting up in a restraint chair)