[LuckyCupofTea]

My husband (with schizoaffective) is currently working with his uncle who is an electrician. He is slowly learning the very basics of the job (it's a long process). He is only working part time as--he has lots of doctors appointments and needs limited stress...we have learned that the hard way with many lost jobs over the years and hospitalizations.

Anyway--he is currently on
Abilify Maintena (the injection)
Thorazine
Depakote
Cogentin
Inderal

He was taking abilify orally too but not he is switching to zyprexa. He was on zyprexa before and it cause weight gain so he went off but it was the most effective of the many things he has tried and has decided to try again on a low dose. His doctor said he would prescribe topamax with it if the appetite gets out of control......

So what's my point...well--his memory was already quite shakey but it has drastically gotten worse. I know that Cogentin has the side effect of memory problems, but it was prescribed to help with the shaking and blurred vision problems. I don't know if it actually helps with the blurred vision.
My husband's mom called me today with concern about the side effects of the medication. My husband's uncle does not know his diagnosis, just that he has doctor's appts regularly and takes medication. I think he expressed concern that the meds could effect job performance.

I just don't know what to do in this situation. OBVIOUSLY he cannot go off of his meds. BAD idea. He doesn't need a reason to further question them either since he certainly doesn't want to have to take medication every day. I already have to have the responsibility of scheduling appointments, making sure he goes, keeping track of the calendar, and keeping track of the medication cocktail. Suddenly with his mother's interference, it makes me feel sort of attacked--as if I haven't checked into every side effect of the meds already.

Note-he has only been regularly on meds for about 4 years. He has had a diagnosis since he was 14 or 15. He is 31. He has had many many jobs, hospitalizations, etc. The meds/therapy thing to me are still a new development and I wouldn't want anything to hinder that. On the other hand, work is VERY important to him.

[still_crazy]

Some doctors prescribe metformin with zyprexa, to prevent and/or reduce weight gain and metabolic problems. metformin is an older, generic diabetes medication. I think its fairly safe, but there's some bloodwork involved in ongoing treatment.

Just based on personal experience, I'd say try to get down to 1 antipsychotic, at least for daily use. I couldn't stand depakote myself, which is why I'm on the trileptal and low dose Lamictal. Both are generic and cheap(ish), and there's very little blood work. there's also not as many drug-drug interactions as with depakote, or so says my current doctor.

Sometimes, instead of adding another antipsychotic or raising the dose of antipsychotic, a different kind of psych drug can help. Some people take gabapentin or hydroxyzine as needed for anxiety. Other people take antidepressants to help with lingering problems. Benzodiazepines, such as Klononpin, Ativan, Valium, etc. are sometimes used with antipsychotics, also.

Zyprexa comes pre-mixed with Prozac in a pill, Symbyax. Both drugs are generic now, so I imagine if your husband's doctor thinks that's an appropriate treatment, he'll prescribe the 2 separately. Anyway, I just mention that because there's actually a lot of research on zyprexa+prozac for bipolar depression and some other problems, and it helps a lot of people. The downside there is that Prozac stays in your system a long time, so if he has problems with it, the adverse effects could linger.

I'm glad you're there for him. I hope he and the psychiatrist can get this all straightened out.

[LuckyCupofTea]

Benzos were a horrible idea with my husband. He has a history of addiction. He was prescribed benzos last september and was in the hospital within a month. I wasn't pleased.

I do find it strange that he is on the abilify injection, thorazine, and zyprexa. He hasn't started the zyprexa. That's happening tonight (he has taken it in the past).
We shall see how he responds. I TRY not to "play doctor" but it's good to keep things in check sometimes so to speak, since my husband typically does not express to the doctor his feelings about certain meds. I think in his mind-the doctor just knows what he's doing. I'm not saying that he doesn't but, everyone responds to things different.

I have been writing down my thoughts and questions for my husband to take the doctor with him. My husband doesn't have a problem with it and I think prefers it that way. The less talking he has to do, the better I guess.

Thanks for the thoughts. I already called his doctor a few days ago just to confirm when he is to take the new script and that it is indeed supposed to replace the abilify oral medication. I don't want to call the doctor just a few days later to start questioning his decisions. Hmm. He has only been on the thorazine since October. I have no idea what it is doing. It might be helping. Hard to say!

Ugh. More research needs to happen on all of this.

[still_crazy]

hi. I'm definitely not one to "play doctor," but mixing antipsychotics can cause problems (more EPS, more tardive dyskinesia, etc.), plus it drives up costs. I've personally found that supplements (I do orthomolecular) with the antipsychotic helps a lot. I tolerate the drugs well now, no need for pills for side effects. Just a thought.

[Victoria'smom]

Do you trust his DR? Can you go with him to the appointment and discuss your concerns?