Just to recap, my mother was living in another state and her doctor was prescribing her a ridiculous amount of medications for years, with no intervention, no therapy, nothing. My sister and I made the decision, that she cannot continue with these medications unmanaged and she is now residing closer to me and I have taken on management of her health care.
Prior to this, she was taking 8 mg of Xanax + 2500 mg of Hydrocode in addition to 225 mg of Effexor, daily.
With the help of doctors here and ongoing medical intervention, we have helped her discontinue the Hydrocode and the Xanax altogether and have gotten her a Social Worker and Psychiatrist. But, that's not enough at this juncture...
When she discontinued the Hydrocode, her overall response was pretty good and there were no significant withdrawl systems physically (at least none that I could see). However, the Xanax is a different story altogether...
Her withdrawl both physically and psychologically, has been a nightmare for her. It resulted in several trips to the ER, and I now have her in an Acute Psychiatric Unit where she's been for two weeks.
When I initially suggested detox (because I knew the doctors weren't going to continue prescribing the medications she had been abusing and I wanted her to wean off of them as well), she refused it, and as a result ended in the ER when her new doctors refused to continue prescribing her the amount of Xanax she was used to taking (they went from 8mg/day, to 2 mg/day).
The first week in the Acute Psychiatric Unit, they prescribed her 50 mg/daily of Trazodone, which seemed to help her sleep and be less anxious/panicky. Though, she almost appeared to be in a "manic" state, as her overall mood seemed to be highly elevated and not usual for her.
The following week (this week), they discontinued the Trazodone, and are now giving her Buspar and Clonidine. She has since returned to a state of high panic/anxiety and she is not sleeping at all. The program she is currently in, consists of three levels before discharge, she is at level II.
Today when I called her, she informed me that she has signed discharge papers. because she is going "nuts" and can't stand being there any longer.
By law, I cannot legally keep her there. But, I told her that if she discharges herself, I will not be there for her and she will be on her own (obviously, it's impossible for me to just let her waste away, but I had to draw that boundary with her very firmly so she is aware of the repercussions).
I don't know what to do at this point and/or how to help her, if she discharges herself. She cannot drive, she has no car, so there is only me to rely upon at this point (or her Sister, which I will need to have a talk with).
I told her that she NEEDS to stay the course, complete the three levels and then she can return home at which point, she will begin partial hospitalization.
One of the main issues right now, is helping her sleep, as I know that is wearing her down. I've been speaking with her therapists, and they said the Buspar and Clonidine will eventually help her with that, but when? I know these two medications in particular aren't controlled substances so I feel relatively at ease with her on them but I need to see how her blood levels are and know how they will affect her.
Okay, well there are so very many things wrong here, lets just jump in I guess.
First you list your mom's meds previous to you so jumping in and saving her from herself as Xanax 8mg/day, Effexor 225mg/day and Hydrocode 2500mg/day, now I'm going to assume that you mean Hydrocodone, which is Vicodin...and then I'm going to say you have to be mistaken. The strongest Vicodin prescribed is a 10/500...she would have to have been taking 250 pills a day of Vicodin to get 2500mg of Hydrocodone a day and not that, that wouldn't have been enough to kill her, she would have been taking 125,500 mgs of tylenol a day, your mom would have been dead. A lethal dose of tylenol with some variance for body size is around 40 pills, and it's a slow painful process.
Now, big problem #2, apparantly your mom was taking a large amount of some pain killer, but if it was anywhere near the massive amounts your intimating, your statement of "When she discontinued the Hydrocode, her overall response was pretty good and there were no significant withdrawal systems physically (at least none that I could see)" in no way happened. You don't just stop ridiculously large amounts of Narcotics and have no physical symptoms and no, the Xanax wouldn't make up for the narcotic withdrawal.
Okay another really major big problem...you forced your mom to detox, quit her meds, which she was prescribed by some Dr. for some conditions, sounds like Depression, which it sounds like she actually is. You moved her from her home, out of state, took away her free will, treated her like a child, stuck her in an inpatient program and now seem amiss that she's not onboard with it all....I think I got it covered. Addicts don't get better because someone makes them get better...it doesn't work that way. They have to want to, it's a lot of hard, painful - physically and emotionally painful, sometimes agonizing work. She has no friends, no support system, nothing....a daughter or two who's irritated and angry at her most of the time, and yes, whether you show it or not, she can and will see it. She knows that you do not want to do this, your not doing it out of a great act of care...your doing it in your own words because you, "made the decision, that she cannot continue with these medications unmanaged and she is now residing closer to me and I have taken on management of her health care".
Xanax is a very difficult and cruel drug to detox from. It wraps itself around your mind and is pretty good at making you think you actually really will go crazy without it. The way to detox from Xanax is a Slow, controlled, taper. You don't just stop it, or drastically reduce the amount then plop the person on to other drugs after a week or so, that doesn't work and it's very, very cruel! Any caring, compassionate, well educated Psychiatrist who knows what he's doing and considers his Patients' well being above and beyond that of his patients family members knows that. By rushing things because you want your mom fixed, and you want this over....you can do so much more harm and draw this process out so much longer with little chance for success.
Someone has to be your mom's advocate here, the Dr.'s at the inpatient place don't get paid to and they probably don't care enough, she's not well enough. Is she still taking Effexor? Because Buspar and Effexor have a major drug interaction, and a very serious risk of Serotonin Syndrome when concomitant use. Sleep will be an ongoing issue, until she completely detoxes from the Xanax and Narcotics and probably even after that. She'll need to retrain her brain to learn normal sleep rhythyms and routines. She can use herbal supplements to help with this such as Melatonin, which is the natural substance your brain produces to regulate sleep and/or Valerian Root, they can be gotten at any local pharmacy or superstore. A healthy diet will help her while she detoxes, fruits, veggies, protein, milk, water....lay off the junk food, caffiene, carbonated drinks, sugar, etc. Her stomach is probably going to be in a mess for a while, encourage her to eat several small meals throughout the day as opposed to 3 big ones....or nibble on fruit or grain cereal, raw veggies throughout the day...try to keep food in the tummy...yogurt is great also. KEEP HYDRATED, that's a biggey.
Depression can be crippling, try to get her involved in something. Excercise is good, walks outside in the fresh air. 20 min of sun a day increases the Vit. D level which fights the Depression naturally. Think back to your childhood, what did she like to do, puzzles, word games, coloring? Anything like that, just to have something to do...don't push her or constantly tell her to do it, just make it available. Don't treat her like a child; she's got to get her self-respect, self-esteem, body image, feel-good, etc. all of that back.
This is going to be a long road, it takes time to get back when you've lost yourself this far....it's a slow road and you can't be rushed. She has to want to do it, and she has to do it, you can't force her and you can't just do it for her. You mentioned your sister, get her to help out....to give you a break, so your mom isn't constantly seeing irritation and anger in you.
If she's going to be in the hospital, then the hospital should be more diligent in making sure she's getting what she needs to get healthy, which includes sleeping at night. Inpatient at the hospital treatment place is actually not always the best place to get healthy, clean sure, healthy notsomuch. Clonodine is a high blood pressure medication, and it does tend to make most people sleepy. Buspar is an anti-anxiety med, but in a different class than the Xanax, less harsh side effects, less potential for abuse, and unfortunately for most folks it's less effective on the anxiety. Effexor is a good ole SSNRI anti-depressant. Hopefully the Pdoc (psychiatrist) you got your mom is the real-deal and she's able to talk to him/her and get some benefit. Once again, pdocs can't be forced on people, you usually pick them yourselves and you need to click with each other....the depression, anxiety, pain...all the things your mom was being treated for are real conditions...if she had them, they still have to be taken care of, they won't just go away.
I'm sure your a busy person, have a job, a life, perhaps a family, etc. and this isn't easy to deal with...but you took it on when you chose to take over her life without her input. Now for both of your sakes, please try to make the best of it. Big Rule of Thumb with Addicts...Action is better served than Reaction....don't rise to her bait, be firm but try to let her know that she's still your mom and you love and care about her....what you may not have stopped to consider is she's scared half to death right now.
Feel free to ask if you have any specific questions, or yell or whatever...I don't take offense nor scare off easily.
Keeping you guys in my prayers, take care.
Last edited by katlin09; 05-18-2012 at 06:56 AM.
Reason: sp. correction
The Following 3 Users Say Thank You to katlin09 For This Useful Post: gardengate (05-18-2012), Phoenix (05-17-2012), Tysmom1 (05-25-2012)
Yes, Hydrocodone. The name listed on her original prescription, says "HYDROcodone/Acetaminophen (VICODIN). She was prescribed 5 mg/500 mg and told to take 2 tablets every 4 hours "as needed". So, I presume broken down, that means 5 mg of Hydrocodone and 500 mg of Acetaminophen??
Based on what my mother has told me, she was taking 7-8 pills/daily (sometimes up to 10-12 on other occasions, depending on her "stress level", she said...).
Actually, the medical doctors who treated her, informed me that Xanax can cushion the side effects associated with coming off of an Opiate (it apparently also reduces the risk of seizures which can result from Opiate withdrawl). Keep in mind, she did not come off of BOTH at the same time. So, when she came off of the HYDROcodone, she was still taking 8mg of Xanax per day.
My mother was not "forced" to go to detox, she voluntarily agreed, when her doctor reduced her Xanax strength/quantity. Would she have voluntarily chosen to go, without medical intervention, probably not. My mother has suffered from severe depression her entire life, and she has NEVER gotten help for it. Instead, she wasted away on a couch in front of the TV, doped up on prescription meds. She was unhappy, cried all the time, and hated her environment. She had no friends, no support system and an alcoholic brother living with her who was emotionally and verbally abusive with her.
So, I prefer not to "debate" whether or not this is/was the best thing for her, as far as I'm concerned (given her previous environment and circumstances) I believe that it is. So does my sister and many other family members who she is NOW surrounded with and are supporting her. I appreciate your viewpoint nonetheless, and I understand.
I am fully aware of how hard it is for individuals to get off of Xanax and how hard it is on the person (though, I've never personally experienced it myself, so of course I don't know the thoughts/feelings associated with it). Please know, that the medication wasn't just "stopped", it was reduced because the doctors out here, were not willing to prescribe her such high dosages. There was a time factor involved with all of this, because I had to go through the medical process of getting her evaluated, getting her social workers in place, getting a Psychiatrist in place, all the while without medical insurance and very little income. When she resided in a different state, I helped her apply for Medicare, but given I did not reside in the same state, I could not take her to all the appointments that they required her to go to, and she was eventually denied. My means to help her further were LIMITED given the circumstances.
I initially tried the supplements you mentioned (Melatonin and Valerian Root and a few others I've researched), when the doctors here reduced her Xanax, prior to her going to detox. But, unfortunately it did not help. That's not to say it won't down the road, but not at that juncture. She has been in the hospital for two weeks, yesterday when I saw her, I asked the attending nurse to speak with the medical physician to see if she can begin taking them and/or if they think it will help (I also informed her social worker there to speak with them as well). So, I am waiting for their approval and also having them look into a sleeping aid of some sort, to help her sleep, as that has been a big issue for her as of late.
She is still taking Effexor, but they are giving it to her at a lower dosage (75 mg/daily in the morning). The Trazodone, is at 50 mg/daily, and they give that to her at night (they began this last week). I need to find out the Buspar dosage and the Clonidine which she just started this week.
Unfortunately, I cannot give her certain foods/drinks, as that is restricted to what the hospital is giving her. She is drinking a lot of water though so that's good, they are giving her yogurt and egg whites and grains along with the 3 meals per day.
As it stands, she is back at Level I under the Acute Psychiatric Program (she made it to Level II, but because she rescinded and opted to leave the program yesterday, they've placed her back at Level I). There are three levels that the program suggests the patients complete, and once they reach Level III and deem it is medically safe, is when they recommend the patient can go home and begin an Outpatient Program. So, I'm hoping to stay the course with her and help her along, get her proper medical care, and work on getting her home. The main thing right now, is finding a healthy solution for her to sleep, so she can be within the right frame of mind to complete the program and get better.
Aside from the over-the-counter remedies for a sleep aid, is there anything you can suggest that can be used for a sleep aid that is not a controlled substance or habit forming and that is safe? I am in ongoing communication with the Social Worker who is overseeing her and she is in communication with the hospital's medical doctor/psychiatrist so I am trying to work with them on finding a solution, so the more knowledge I have, the better.
Thank you so much for taking the time to reply, and all of the valuable information you provided. It's very helpful and I really appreciate all of your thoughts and advice.
First my condolences on you and your family's situation. Kat made some very good points, and I would agree with much of what she said. Opioid withdrawal can be very distressing, but is almost never fatal. Xanax, however, especially at those doses when discontinued without a slow, very gradual taper, can cause what is known as benzodiazepine withdrawal syndrome, which can be very dangerous and has resulted in death. The underlying conditions, depending on severity, could make treatment of both substance abuse and the other conditions quite difficult. I have been on Norco 10/325 (which is hydrocodone 10mg and acetaminophen 325mg - same drugs as Vicodin just a different dose and ratio) and Klonopin (same class as Xanax) for chronic pain and anxiety on and off over the years, and balancing the management of my pain and anxiety with the temptation to take "just one more, this one time" to get that extra little boost in pain/anxiety relief has been quite tricky to say the least. Clonidine is sometimes used in acute withdrawal as it has been shown to attenuate the discomfort (I learned this after voluntarily stopping my opioids once to see if I could manage and when the withdrawal got bad enough that I called my PCP, he told me to take the Clonidine which was prescribed previously for high BP but I hadn't taken in a few months).
As far as OTC stuff, Kat has pretty much covered it all (to my knowledge), and unfortunately the options are limited. Low dose Z-drugs (Ambien, Sonata, Lunesta - all designer sleep aids) might be quite helpful - they are prescription but help a lot with sleep and anxiety as they affect the same part of the brain as Xanax but are unrelated. Often, benzodiazepines are actually given when someone is detoxing from opioids like hydrocodone (Vicodin) specifically to reduce withdrawal discomfort, which makes the situation tragic with regard to the dual detox. It might have been much smoother had they completed the opioid detox first while leaving the Xanax alone, then beginning the slow gradual taper off the Xanax; but thats water over dam now. Have you considered discussing the use of a longer acting benzodiazepine like clonazepam (Klonopin) to ease the situation? That would likely address the sleep, withdrawal from Xanax, opioids, and other residual effects. I know this worked for my uncle when he went through inpatient detox, who was on a regimen of Clonidine, Buspar, Klonopin, and Ambien.
I hope things improve, and best of luck
Last edited by Recombinant; 05-18-2012 at 01:13 PM.
Reason: Typo correction
IMHO your help is better than no help at all
I wish you and your mom the best
Thanks. My help is due in part because of the love my mother instilled in me and gave me as a child (granted, she was not always available in the mental/emotional capacity that I needed her to be growing up, but she did the best SHE could and she sacrificed a lot for her children).
I struggle with not only what she's going through, but from a moral standpoint (IE. kind of what katlin09 touched on...), was this the right thing to do? Was this the best thing for her? There are a lot of "what's". I'm trying to contain it as best I can because I CANNOT LET IT INTERFERE with my ability to stay the course with her. I have this mental image that keeps popping in my head, of her sitting in a wheel chair when she came off the Xanax, and it's an image that is going to be burned in my mind forever. I feel guilty, everyone says that I shouldn't, but that is something that has to take a back seat for now and I will have to resolve on my own. Thank you again for the warm wishes, even though I don't know any of you personally I am going to pass along the warm wishes to my mother when she is feeling better.
The following 2 users give hugs of support to: Jen2012 bolter (05-19-2012), Tysmom1 (05-25-2012)
First, kudos to you for interceding in Mom's health and for continuing to take an active role in searching for help for her. Welcome, and I hope you can find some help and hope here.
As someone who has come off Xanax ( after a total withdrawal from opiates), I do believe that the drop in Xanax from 8 mgs to 2 mgs may well be part of the culprit here. I was at only three .5 mg tabs of Xanax ( 1and1/2per day)when I began tapering. I tapered off over a course of 6-8 months and it was brutal at times. The restless legs and lack of sleep were the very worse, while anxiety came in a very close second.
I was your Mom for a few years. Drowning in depression and trying to drown the depression with pills. Vicious cycle. The opiates and benzos in themselves can drive us into depression. Coming off them there is inevitable depression that is a part of the process. The depression becomes layered and is unbelievably tough.
One of the greatest helps in finding sleep at night (although truthfully, it did not work every night) was to stay on a strict routine. Up at the same time, various activities at the same time (walks, showere or baths, eating, etc) were all at the same time. Retraing the brain's rhythms, you know?
Melatonin did help a great deal, but I think perhaps, at this point, Mom is pretty deep in withdrawal yet and that is why it is not helping. A really great help also was massage. It provided at least a bit of relief from the muscles knotted up from the anxiety and tension.
Just wanted to share with you my own expwerience which might help you understand Mom's predicament. I wish you, mom and all those involved well. I am sure it is as trying a time for you as it is for mom.
Okay, well that Hydro info makes alot more sense. And honestly, she wasn't on very much, if she was only taking 7 - 8 pills most days, she wasn't even taking her full prescribed daily allowance, which would be 12 a day. At 40mgs of Vicodin a day, yes her withdrawals would not have been that bad with the Xanax providing cover.
Unfortunately with her inpatient there is not much you can control. You can ask the PA's, nurses and Dr.'s but they're probably not going to give your mom any kind of herbals or supplements to help with sleep, diet, etc. Right now she's being treated as a psychiatric patient moreso than a detox patient. The combo of Psychiatric meds she is on now is potent stuff...Trazadone, Buspar, Effexor, Clonodine...Trazadone will put "normies" literally under the bed at small doses, it knocks your socks off....it's not unusual to for it not to phase depressed folks....Depressed folks tend to not sleep. If your mom continues as such, the hospital will eventually move to stronger sedative sleep meds such as hypnotics like Sonata, Ambien, etc....unfortunately they are addictive. But, once you put her there, you lost control, they're not going to let you tell them how to treat her....they'll do what they need to, to get her normal body functions back under control. Places like that, generally just don't have the time, resources or staff to spend time on the therapies and non-med therapeutical interventions for sleep reset. It will be easier when she's home...alot of what she does during the day will help with her sleep, just being active, changing diet, things of that nature....things you can't control right now.
As far as what meds they put her on, your not going to have a whole lot of control their either at this stage, just be aware and keep an eye out for too many "psych" meds...they've already got her on quite a few, 2 anti-depressants, 1 anti-anxiety and the High Blood Pressure med. Just because they're not using the meds per label, they still work on what they're designed to do, so don't just let the Dr.'s tell you "oh, it's fine" and keep stacking on the psych drugs, it's not the best answer.
Seroquel can be very helpful for sleep issues, and it is often given for psychiatric conditions including Depression with anxiety. Seroquel is an Anti-psychotic. As with any of these meds it can become habit forming and the potential for abuse is there, although with Seroquel you don't have that "euphoric, feel good" sensation, so the abuse angle is not so much. That may be something you talk to her Dr.'s about replacing the Trazodone with, if it doesn't start working. Any psych meds, sleep meds, narcotics...all the things they use in a hospital setting to regulate sleep are going to have habit forming and potential abuse side effects, that's something that your not going to be able to get around for the time being. Right now getting your mom to feel better each day is more important that worrying that every med she takes is going to be a longterm problem.
Thanks for giving more information about how your mom came to be here. I'm very glad for you that she wanted to get help, and I'm very glad that you were able to get her out of an abusive and unhealthy situation.
I hope you'll continue to keep us posted on how she's doing.
Trazadone will put "normies" literally under the bed at small doses, it knocks your socks off
I can vigorously agree to that. I was put on Trazadone 100mg HS (at bedtime) when having issues with insomnia and comorbid depression. The first night I took it, I literally thought I was dying; I mean I was laying on my back, and I was so 'stoned' (not high, but literally felt like a stone) that I felt like I couldn't move without extreme effete, and I wondered if I was still breathing. I never took 100mg again, and even avoided 50mg whenever possible. The Seroquel (quetiapine, I think?) is also not a bad idea; Having taken it off label myself for other reasons, I much prefer it to Trazodone and it is multimodal in positive effects, meaning it will help multiple symptoms.
While the Xanax dose is higher than anyone I've ever known (I have *known of* high doses, just not with anyone I know) to have at what was probably 2mg (the largest dose unit made) 4 times daily, again Kat is right on the hydro. When on Norco, I have had spans where dosing was up to 8-10 a day which is 80-100mg hydrocodone (mind you the scheduled dose was usually about 6 a day, with the ability to double up for breakthrough pain/bad days). What I was taking is a significantly high dose, though 40mg would be moderate IMO.
I really would not be surprised if the worst symptoms are due to benzodiazepine withdrawal syndrome (BWS), which can induce psychosis like states and as I mentioned in extreme serious cases cause fatal reactions. As such, I agree with reachout and think the massive Xanax dose drop is to blame for a lot. I have taken Xanax, Valium, Klonopin, Ativan, Restoril, and Halcion in succession (though not that order), and at one point while on Klonopin an ER physician told me I needed to be cut off. I remember when relaying this advice to my psychiatrist she firmly disagreed explaining that not only would abrupt cessation or overly rapid tapering potentially cause BWS, but having been on benzo's long term it wasn't prudent to force me (or anyone) off them (though there are many negative effects of long term use). Diazepam is actually specifically used to treat benzodiazepine withdrawal and if there isn't improvement, in your shoes I would ask the attending clinicians about the possibility of BWS due to the sharp Xanax dose drops. Whether you mention diazepam (aka Valium, which along with Xanax are the two most prescribed and abused sedatives in the US as of last year) due to the fact it also can cause dependence is a personal call, but with such long duration at least it would ease the suffering while it was tapered.
Of course all of this is conjecture from various personal experiences, but I'm "typing out loud," so to speak, anything that comes to mind which might help. Kat really knows what she's talking about and her knowledge is hard to top, some of the best advice I've gotten myself was from her. Remember to hang tough and we're always here. I'm pulling for both of you.
"'I'm not feeling very well, I need a doctor immediately!' 'Ring the nearest golf course'"
- Groucho Marx
Good morning. I wanted to quickly say THANK YOU for all of the wonderful information and warm sentiments. I will be seeing my mother again this weekend and have several things to tend to, but I'm definitely going to review all of the suggestions in more detail. I will update on how she is doing a bit later and respond back. Thanks again and warm hugs to everyone.
I wanted to provide an update and hopefully a bit more guidance. I've seen my mother a few times over the past couple of days, and she's gone from extremely agitated to more relaxed and subdued.
She has recently gotten into a habit of asking for all different things to bring when I come and she's very descriptive with it. So naturally I bring them, but then she doesn't seem to take much interest in the things I've brought.
She'll then call me again shortly a few hours after I leave, and ask for new things, and to take other things back. This pretty much occurs on a daily basis now, and I don't know but I find it odd for some reason. It's not your typical, "hey can you bring me this" I can't quite put my finger on it...
Anyway, I have been told, that they are now giving her: Thorazine and Seconal. I'm not sure what dosage, and if they've ceased the other medications, I will be at the Hospital again tomorrow and they've typed up a new list of all the medications she's on so I will know more then.
At this juncture, they are suggesting she continue to remain there, and once she reaches Level III, be put in a program called a "C2 Program" which I am not sure what that entails but will find out more over the next few days.
I've looked up the Thorazine and Seconal and I'm a bit confused why she is now being given these types of medications. My mother was never properly diagnosed on an ongoing basis with her Depression, and from what I've read, the Thorazine is used to treat Bipolar, Schizophrenia, Psychosis.
And, I'm not sure why they are giving her the Seconal, given it's a Barbiturate, though I know one of the biggest issues for my mom was she was having such a hard time sleeping, so maybe they are just giving this to her short term.
I just hate this!! I hate that she is on all of these different types of medications and I hate that I feel like my mother is gone, not physically, but mentally. It's like she went from one mental state heavily under controlled substances, to another mental state, and I don't get to have my real mother. I'm trying to stay strong and positive but I just feel for her and feel so helpless to bring her back. I just want her to be happy and have a normal life for ONCE
Sorry your having such a hard time with all this...I know it's not easy. Having been on both sides, both in the Psyc ward as a patient, and having a family member as a patient, I know that both are mentally and physically exhausting.
Seconal is a barbituate and generally used for severe insomnia, when the other types of sleep meds such as hypnotics and anti-depressants don't work. It's mostly only used in an in-patient setting, and not real popular these days, probably why it's not familiar to you. With what you've said about your mom's sleep troubles, she's be given it to control her insomnia would be the best assumption.
Thorazine is a very hardcore drug, it's actually the first Anti-Psychotic ever discovered. It's used often as a "chemical restraint" in hospital's. I would assume they're giving her a pretty low dose if she's visiting with you, calling you, up and being coherent, because this med will pretty much knock you for a loop at any significant dose. Has your mom been displaying any signs of significant mood disorder, such as going from a very depressed state to a manic/hypervigillant/very agitated state, or hallucinating or hearing voices or expressing delusional thoughts of grandiose thoughts, i.e. unrealistic scenarios that she thinks are real and happening, but realistically could not happen? These would be reasons to be placed on Thorazine. Also if she's being completely uncooperative, physically agitated/abusive of staff or other patients, etc. But it's not a standard med that used for run of the mill Depression and Anxiety.
The Thorazine would also explain the way she's behaving with the requests of specific items, then changing her mind, etc. The reason they stopped all of her other meds is because with the Thorazine they pretty much have to, all of them have interactions with it....like I said, it's a pretty hardcore drug, it has lots of side effect and tons of drug interactions, over a 1000...for a drug to have some interactions with other drugs is normal but that many, well I'm sure you get the picture. It's not used very much anymore because there are too many newer, safer options.
I would definitely have some discussion with your mom's docs about why they've taken this route and don't let them blow you off...make them answer your questions about the efficacy of the current medication changes.
Hang in there, hopefully your mom will show some improvement soon and things will look up for you. Is your sister helping you with all of this at all?
Thank you SO much Kat. You're right, it's mentally/physically exhausting, I feel wiped out by it at times but I can only imagine what my Mom is going through and that is what keeps me going. I'm sorry you had to go through this as well, hugs to you.
This is very helpful information. As a result of the new medications, she has been able to sleep and she does seem more relaxed/at ease, wheres before she was very "twitchy" and her demeanor reminded me of what you sometimes see of TV with people addicted to crack. From what I gather, she has been participating more in the various activities they have there, she's going to AA meetings (even though she's never been a drinker, it's still an addiction nonetheless so it's good she's going). And, she's doing a bunch of other things, so all very positive.
To answer your question "displaying any signs of significant mood disorder, such as going from a very depressed state to a manic/hypervigillant/very agitated state", well that's hard for me to say.
My mother has been in a depressed state for as long as I can remember, the only time I can recall her not in a depressed state, was when I was a child. But here's the thing, when I was 7 years old, I attempted suicide and the doctors told my mother that her daughter (ME) is severely depressed (I didn't know/understand all of this until I was an adult, though I do recall the attempted suicide). I left home when I was 16 and moved to another state after suffering from my own depression and struggles, parents divorcing, all that good stuff. I never struggled with a controlled chemical substance addiction but have battled depression/anxiety through ongoing therapy and a very mild/low dosage antidepressant. I've put forth the work to combat it so I know what's involved and how to manage it. Of course, I still have my moments, but the occurence/length/intensity is very minimal at this juncture.
So, perhaps that was a reflection of my mothers depressed state all along? Not sure. My mother lost her parents within 2 years of each other, before she reached the age of 20. Her father died, and shortly thereafter her mother was diagnosed with Ovarian Cancer and she spent her teen years caring after a very sick mother. She then went into a marriage with a man (my father) who during their marriage was very emotionally abusive. He's not that way anymore, thank god.
So, you can see where it all stems from. I don't recall moments of "mania" on her end, but, I've never been around someone with Mania so I am not sure what it "looks like". The closest I thought I witnessed, was right after she came off of the Xanax and they had her on Trazodone. This was during the first week she was in the hospital, and her mood was VERY elevated, she was in an extremely happy/positive mood and just very unusual for her (given her ongoing "depressed" state and she has always been an extremely negative person overall).
Her social worker asked me the same question. It's just hard to determine given all the different medications she's been on, and is on now. I'm hoping with time, it will become more clear and she'll have a proper diagnosis.
My mother has never been outwardly violent towards other people. She has however, admitted to cutting herself in the past, when she would get into arguments with her brother (who she was living with for several years). She said she did it to release her anger and so that she wouldn't express it towards other people.
I don't think she's admitted to hearing voices or expressing delusional thoughts of grandiose, but since she's been in the hospital, she has worried that she is going to die and that her senses are all off (whereas, she feels very unbalanced, noises effect her and/or hears noises as louder than they are, her taste buds are off, etc.). Again, that could all be because of the different medications, and readjusting to the medications she was addicted to prior (Xanax and Hydrocodone).
I will definitely continue to communicate with her doctors regarding her medications and ongoing prognosis. All I can do is continue praying and looking for the light at the end of the tunnel with my Mom, I just want her to feel some sense of enjoyment, which I know I cannot force or give to her alone, but I still hope for it for her.
My sister lives in another state, and so does my two brothers. So, the help is limited. But my sister and I are very close and we keep in constant contact and she helps as much as she can and she's been a huge source of support. My brothers, not so much, and they've only called my Mom once while she's been in the hospital which I am a bit perturbed by but I don't want to be angry with them over that.
Thanks again for all your help, you have been very supportive and I greatly greatly appreciate it.
Last edited by Jen2012; 05-25-2012 at 06:05 AM.
The following user gives a hug of support to Jen2012: bolter (05-26-2012)
Yes, your family has definitely had it's share of troubles. If your mom had ever been manic, you probably would have remembered it, true mania is not something people really forget, it doesn't mirror other emotions such as extreme happiness....my 22 yr old son can probably tell you every time I've been manic through his life....I can go 5 - 6 days and not sleep at all, paint the house at 3a.m on a whim, unfortunately that included the room he was sleeping in at times...work for days (not hours) at a time non-stop, spend thousands of dollars in a days time on crap....true mania just doesn't look like anything else...it's pretty noticeable.
And the cutting, well been there done that too...cutting is a solitary condition, you don't share it with anyone, you don't force it on anyone...it's not an outward act of rage or anger. So she wouldn't have used that against anyone. Odds are she was just very depressed and used it as on out for her own pain, fear, sadness and desperation.
Hang in there, it will get easier slowly but surely. I'm glad your mom is doing better and participating more for both you guys' sake. Hope you get some rest and time to relax a little this weekend.
Yes. There's much more on my mother's side of the family I could tell you about, which would explain even more, but I'll leave that to her therapists.
Based on your description of "mania", I can safely so, no. My mother has never displayed that type of behavior. The cutting, from what she tells me, began a few years ago. She told me one day while we were speaking by phone (about 6-7 months ago), while she was still living in California.
Through this ongoing destruction, my sister and I reached the conclusion that intervention is needed and that's why we chose to step in and assist my mother. I believe it should have been done sooner, but, I can't go back in time at this point. When she came here three months ago, I discovered she had cut herself after an argument ensued between her and I over her spending habits (she was blowing through her retirement money and not budgeting, which was what I foresaw, as the starting point of putting me in a financial hole whereas I had to cover expenses to compensate the excessive spending). What resulted a few days after that argument, she became disoriented and ended up tripping and falling onto the floor, and was taken to the ER. I went with her to the ER, and when she changed into her robe, I saw all cuts marks on her arm and they were fairly fresh. She stopped for a while, but then when the Xanax was tapered down to the lower dosage, she began doing it to her hands and they were all scabbed up.
That is why when you first commented on the intervention, I was firm with my response/decision in that regard. Of course, I still struggle with whether or not what she is going through now, is better than where she was THEN, but, that's not something I'll be able to resolve any time soon.
Thank you again for the warm wishes and for sharing your story, you seem to be at a really good place so kudos to you! Yes, I will be getting some nice needed R&R this weekend.