[LuckyCupofTea]

Hi All-
My husband was hospitalized in April. As usual, he had secretly stopped taking his medication and then couldn't handle himself anymore (he hears voices, has paranoia, confused thoughts, rage episodes). He stopped going to work and then disappeared for 24 hours (ended up being that he drove about 2 hours away and slept in the woods with a bottle of vodka). We had sold our house faster than expected without a new one lined up and had to move into a 1 bedroom apartment. This was a major stresser for him.

After being released from the hospital, we took it easy and he agreed to only work part time and see his therapist every 2 weeks, pdoc once a month. He is on abilify maintena (which doesn't do enough), thorazine, depakote, and some anti tremor meds.

Last week his cousin/uncle (owners of the small company he is working for) were on vacation so he worked full time (if he could work full time without having a break down, he would in a heart beat). 3 days ago he threw up out of no where and I thought-medication withdrawal! Well, of course he said "no, no...I'm taking my meds. I'm sure it was something I ate". He's a master manipulator.

Yesterday he was zoning out. Looking around. Extra quiet. I sensed he was off of his meds or at least had skipped doses. I was right. He admitted to "skipping a few doses" but he closes up and says "I don't know" when I ask him anything. He didn't remember what he did yesterday--and I googled his location history. He drove for 5 hours.

He has a new therapist because his other one who was wonderful changed jobs. His new one doesn't have any other schizoaffective clients. She doesn't know how to read him. He doesn't just open up. You have to ask him the right questions. His last therapist almost always knew something was up with him.

I wish I knew what to do at this point. He admitted to me that he "had a theory" that he could lower his dose of meds and then just stop taking them altogether and be fine. He has said to me a few times now that he is unsure about this therapist. I'm not BLAMING the therapist but I also wanted to give her a year because it takes ages to form trust and get to know one another. On the other hand, I don't know how to go about looking for other therapists since they are typically connected to the P-doc.

Okay, that was all over the place but those are my thoughts.

[Bbop]

Your husband is sooooo lucky to have a wife like you! A support system is very important for people like your husband and I. My husband stays by my side despite my struggles with SZA. Without him, I don't know where I'd be. I am happy your on this site, it's good to have your point of view.

Sounds like your dealing with quite a lot at the moment. You'll be in my thoughts and prayers!

[still_crazy]

hi. dropping the psych drugs is a common problem in people with schizoaffective and other "severe mental illnesses."

My 1st thought--since I deal with this stuff, also-- was that maybe he's on a bit too much and the adverse effects are making him more inclined to drop the psych drugs. I'm not trying to blame anybody, but when I had problems with my prescribed stuff, I dropped it as soon as I could.

These days...I'm on fewer drugs, and the ones I'm prescribed have been (thank goodness) carefully selected. I take Trileptal instead of Depakote (minimal blood work, fewer adverse effects), oral Abilify instead of anything else (its not a wonder drug, but I can tolerate it reasonably well), low dose lamictal (mostly for low mood, plus it helps even my mood out, overall). I'm also prescribed a low dose of gabapentin (neurontin) for as-needed use. I very rarely take it...usually, I'll pop a couple to lull me to sleep, when I get too agitated.

I just thought I'd bring this up because it sounds like he's on some heavy medication that's resulting in additional drugs for adverse effects. That happens a good bit, of course, but...over time, that can really cause "issues" that might make one more inclined to drop the oral psych drugs altogether.

One thing that worked for me, when I was in a worse state than I am now, was low-dose, as-needed risperidone. Again, its not a wonder drug or anything, but it effectively boosted my Abilify w/o causing too many problems. I've never taken Thorazine, but I've heard that risperidone is easier to tolerate and also doesn't cause as much sedation, dysphoria, cognitive impairment, etc.

I also take tons of supplements. Its called Orthomolecular. I have far less anxiety and agitation now, I tolerate my tranquilizer much better, and I have 0 signs of tardive dyskinesia. That's a big, big deal for me, because I actually had TD at one poiont, from "atypical" tranquilizers. Turns out...according to some "alternative" mental health people, Orthomolecular can reduce the risk of TD considerably and can sometimes bring about remission/recovery from TD. Also, OM seems--for me, and for a lot of other people, also--to over time help one get "more mileage" out of the psych drugs.

I'm now down to 20mgs/Abilify (down from 30) and I've dropped my antidepressant (high dose Wellbutrin). I no longer require the as-needed risperidone, and I very, very rarely take the gabapentin. 0 EPS, 0 TD, my mood is a lot better. Oh, and my allergies are much better, too...but that's a separate issue, lol.

I hope your situation improves.

[Victoria'smom]

I have difficulty being med compliant. Currently I'm on lamictal and zyprexa desolvables. I'm fine taking those we just decreased my zyprexa I'm worried the psychosis will come back. It sounds like he may need weekly therapy to stay on track with meds. I need a reminder that yes you do need these meds to function from someone other then my husband, he's learned not to tell me to take my meds. It's best for our relationship that he doesn't say much.

My husband is BP also. So I know both sides of this situation. It's hard to see someone you love slowly slipping away, when the answer is right there. I would up his therapy if you can.

[LuckyCupofTea]

Originally Posted by Miguel'smom

I have difficulty being med compliant. Currently I'm on lamictal and zyprexa desolvables. I'm fine taking those we just decreased my zyprexa I'm worried the psychosis will come back. It sounds like he may need weekly therapy to stay on track with meds. I need a reminder that yes you do need these meds to function from someone other then my husband, he's learned not to tell me to take my meds. It's best for our relationship that he doesn't say much.

My husband is BP also. So I know both sides of this situation. It's hard to see someone you love slowly slipping away, when the answer is right there. I would up his therapy if you can.

Thank you for that. My husband is now in the hospital.
The voice in his head was constantly telling him to cut his wrists or mutilate his body. He elected to go to the hospital without my persuasion because he didn't trust himself. He hasn't "cut" for probably 11 years, but you never know. He actually said to me on the way to the hospital that maybe cutting is a solution to the voices. So he was not in a good state of mind obviously.
These hospitalizations have been fairly frequent over the past year and a half. He will take his meds consistently for a while and then when he feels better, I think something clicks and he thinks he no longer needs them,
no matter how many times someone tries to explain it. The hospital does think that we need to up his level of care at this point. Every 2 weeks is not cutting it. He might also change therapists again. He needs consistency but he doesn't seem to like the one he is seeing (as of January). It's hard to compete with his last therapist who left. He has given this lady about 6 months. He wanted to give her a year before decided. He was not doing well when he saw her the other day but she didn't recognize that. It's not her fault. My husband is a great actor. On the other hand, I think he was testing her in a way because his last therapist knew when something was up.
She asked the right questions. Sigh.

A side note too-I'm guessing this job isn't going to work out for him. He has been trying to learn the electrical business with his uncle and cousins. My husband is hard-working and then overdoes it. Last hospitalization we all came to the conclusion that he needed to be part time. He pushes himself and rides on this high of overworking and then things go south. Here are some good and bad things about his current situation:

Good:

It's family so they "know" his situation. His mother communicates with them and they understand that he HAS to go to doctor's appointments more frequently than other people

This is the first job that has "known" about his diagnosis. I say known loosely because they don't know the full extent of it.

There is SOME flexibility here because it is family.

Bad:
It's family. They are super hard on him. In labor professions (which my husband is used to), people can be pretty rough with the hierarchy. The new guy gets a lot of crap from everyone. They have been a bit TOO hard on him though.

His memory. He's having trouble with that aspect.

They don't ACTUALLY understand. They keep thinking that he will just "get better" and be able to work full time, especially because he does so well the majority of the time.



The work thing is just another layer of this complicated onion. We have a disability case going but probably no court date until fall 2018. We have an attorney. Even IF he wins, he will still work somehow because he needs it for his well being. Even if it is 2 days a week.

[Victoria'smom]

Your husband may not be able to keep a job and stability. Volunteering may be best for him.