Posted by silva bonvicini on August 16, 2000, at 1:59:13
To the age of 16 years, my daughter came recovered to the psychiatric hospital
with the diagnosis of acute psychosis,I Think consequently to one strongly
depression (often cried, remainedin her bed, she did not eat anything,
and she didn't feel the necessity to go in bathroom for all the day.
Then she was like- blocked, she heared a crying child , and to the end she
did not sleep for an entire night, being much anxious, earing the
television speaker ignited in the other room who said:"Maria (she) is died
(or must die...)" having fear to die and seeing her body bleeding.
After a month she was discharged, continuation in regimen of day-hospital
and finally visited sometimes (always near the psychiatric hospital of Pisa)
with therapy and talks, with good recovery of the tone of humor,
(before she was introvert, timid and this because of the continuous arguments
in family and consequent separation from my husband, a violent type that
neglected also the sons, preferring the company of friends and poker's
table, without any work or taking care of its family).It was cured with Tegretol, Talofen, orap and Disipal, slowly diminishing
the doses, and in the arc of approximately three years was suspended
(the Tegretol in low doses was continued for approximately a year)
All this without having any relapse, having good relationships with the
other people and having exceeded its shyness, so that she was married in
1996, at 22 years, and changed city.
Lately it was a lot preoccupied why they had become indebted themselves for
the house, and therefore she has been working for an year.
Then they had a car crash, followed from breach of the glass crash
(in different times). Further she was preoccupied for its twin sister,
who also suffers from depression. Moreover she did not have good
relationships with her husband's mother, for which task that all these
stresses (also arguments with the husband) have caused one relapse on
June 24th.
She heared a voice saying she had to die, she did not sleep, and so on
,exactly, all like the first time, with the difference that in the previous
days it was not gotten depressed and didn't remain in her bed , but she was
nervous, she had no concentration ability and was agitated and nervous,it gave
annoyance to her to be in house of husband's parents where she did not feel
her privacy (were hosts from a month). All this on saturday night,in which she
didn't sleep for all the night. and the day of Sunday was the same one,
with lucid intervals.
But the situation in the night got worse and was necessary the emergency,so
that te doctor made an injection so that slept all the night.
The cure of the specialist was following:
Haldol (Halperidol)100 1/2 matt. 1/2 evening;
Mutabon (perfenazine + Amitriptiline) 1 matt 1 evening;
Surmontil(trimipramine) 1/2 the evening if insomnia;
Tranquirit (diazepam) 15 drops matt. - lunch and evening
.It Seemed that it was resumed well, and after a week quite had resumed
to work (what that had left me perplexed). But I had some doubts regarding
the cure, as Tegretol had not prescribed: I know it is a mood regolator and
in her case had given optimal result.
July 15th, (saturday): She began to feel anxious, finally returned in
confusion and Sunday she recommenced to hear voices etc.
Specialist absent on Sundays and finally in the evening he added as
follows:
Tranquirit 15 gtt. three times a day;
Mutabon 1 tbl lunch and evening
Haldol 1 tbl morning and evening
Surmontil in order to sleep.
"Sleep effect " was caught up, but the situation got worse. My daughter was
not else in psychosis, but she was in strongly depression and confusional
state.Change of doctor.
Speaking with the doctor of Pisa, cure therefore was changed:
Tegretol (carbamazepine) 200 1 cp. matt. 2 evening
Sereupin (Paroxetine) 20 1/2 matt 1/2 evening
Haldol(haloperidol) 20 drops. 10morn. 10 lunch 10 evening
En drops(a Benzodiazepine like diazepam) 12 12 12 .Primary said that the confusional state had to the humor jolts and needed
continuous surveillance, and no jobs , peace and so on.Some days later I discovered, after some questions, they had not gone to
Pisa, but that his mother was itself in this matter, changing specialist.
I was angriest, but for peace( and for my daughter) I kept myself enduring
within every thing, informing on the "new" cure.
Sereupin(Paroxetine) 20 1 matt.
Seroquel(quetiapine) 1/2 matt 1/2 evening
Noritren(Nortryptiline) 25 1 matt 1 evening
Tegretol 200 1 matt 1
En drops 15 at evening(benzodiazepine)
.
With this fact more I didn't not felt me calm, and the time after, that is
August 2nd: I observed better my daughter, and I had the
impression that her cheerful mood had something of " forced ". I had the
doubt that the combination of those drugs gave " an induced " joy, but I did
not have any element for being sure of this.
I feared that these drugs were not adapted, owing to the secondary effects of
Quetiapine . I seemed Haloperidol was adapted, as the second relapse wasn't
so serious like the first, and increasing Haldol the delirium was
cessed.
Further, in the instructions I have read that the association paroxetine with
nortriptiline provokes a strong antidepressant effect. Moreover in case of
mania Noritren must be suspended.
August 4th, friday:
Her husband said on telephone that she had not slept and that it feared
nervous. Sure I didn't wait for, and in the afternoon went to my daugher.
She was in confusion, monosillabic answers, on her face was an expression
sometimes interrogative, sometimes perplexd ,like speaking with someone
invisible without emitting words .Towards the 7 p.m. began also to make
gestures, she cames without reason in other rooms, observing and then exit
ing. Once she tried also to get off home, feeling the usual " voices ".
However to the evening the specialist said to increase :
1 Seroquel and to 1 Tegretol, adding with the up said drugs.This didn't her calm. Only with 40 drops of En she felt asleep.
Her husband confessed to me that from the psichiatry they have demanded
" something " to aweaken herselve" up, as they say (he and his mother)
that " she was like a doll".
Today 8 Mondays August my daughter do not have psychosis but it sleeps a lot,
even if when wide awake she is seemed stable like humor.
These are my askings:
1 - It's possible my daughter suffers from bipolar desorders?
(I have read that Tegretol is used in these cases) I know that the
mania crises determine also a well-being and euphoria sense, and this
does not seems to me in my daughter's case. She has been also
irritable and stressed, previously crisis.Further her hallucinatory
fantasies are not euforic, but they concern on death, or bugs that
exit from her ears. The hallucinations generate anguish (After the
crises she remembers all perfectly,thinking that is a dream, even if
she did not reveal them easily.2) - My impression is that the association of two antidepressants provocates
a speed to mood provoking one psychotic crisis (maniac). It may be
possible?
3) - Quetiapine is " an atypical " antipsychotic: what does it means? In
which it's different from the Haloperidolo (Haldol)? Can Quetiapine
have therefore insufficient effect on my daughter, so to provocate the third
relapse in psychosis?4) - The " crises " have been manifested to the distance of approximately
fifteen days , (always in the weekend) .May it have a meaning for her
disease?5) - Are the two successive relapses caused by a not adapted therapy or
by an aggravation?6) - Can be useful psicoterapy of support of psicoanalisis?
I attend with anxiety an answer, thanking of the opportunity gived to the people
to contact someone who can give indications.Silva Bonvicini
poster:silva bonvicini
thread:43039
URL: http://www.dr-bob.org/babble/20000811/msgs/43039.html