Bipolar Support Group

Is it possible to be immune to meds? My daughter is currently on 750 mg depakote, 150mg seroquel, 15mg abilify and 50mg imipramine. She has been on these meds for about 4 weeks and still feels as though she's on "alert", paranoid(has thoughts people can read her thoughts) and still believes in some of her delusions she formed during psychosis.

She states the meds do "nothing" for her, except make her tired. Is this possible?

Well, I am at least hoping the meds prevent another "episode". She had two within 7 weeks of each other.

What are your thoughts on meds being ineffective?

Thanks,

Deb

It is possible for people to become med-resistent, but 4 weeks isn't long enough to know whether or not a med it working since it takes 6-8 weeks for meds to be absorbed in the bloodstream. If she continues to show paranoid behavior, her Seroquel may need to be increased or she may need to be switched to a different antipsychotic like Geodon or Risperdal. By the way, I used to be considered med-resistant myself in the early 90s when my meds wouldn't help my voices, delusions or severe depression. I think though that the reason meds didn't help my voices is because I wasn't on an antipsychotic. (I was taking Lithium and Prozac at the time) I'd give it another 2 weeks or so and if you still do not see any improvement, definitely give her pdoc a call. Her meds may need to be adjusted or changed.

Post edited by: neondreams, at: 06/18/2009 03:44 PM

I also wanted to add that 750mg of Depakote is a low dose. That may need to be raised to 1000mg or more. I'm not her pdoc though, so this is something you would need to discuss with them. Nothing lower than 1500mg of Depakote works for me, but we're all different. I know someone who takes 500mg of Depakote and is doing fine. It varies from person to person and what works well for one person may not work well for another.

One final comment please. It took me awhile not to believe the delusions I had during my first manic/psychotic episode in 2006. From what I've read, it can take a year for someone to fully recover from a manic/psychotic episode. This was certainly the case for me. I didn't start to relax and stop being on guard until 15 months following the onset of my manic/psychotic episode. That being said, it's also possible that she may recover much, much faster. I've had plenty of manic/psychotic episodes since 2006 (although not as severe as the one I had 3 years ago) and it took me hours or a few days to get my bearings and recover.

It is possible to be med resistant although it would probably be too soon to tell with your daughter. If you have misgivings about what's going on I would call her pdoc right away. If nothing else he/she can put your mind at rest. It takes a while for the meds to start working and even then it is normal to have to adjust dosages or even try other medications. Good luck.

I know the doc at the outpatient program she was in was taking blood tests to watch her white blood cell and platelets. So far they were in the norm range and I think they do this because of the effects depakote can have. We don't see her reg pdoc until July 6th. However, I am trying to get her into an outpatient program over at one of the universities( they specifically handle bipolar, schizo, and psychosis) and I'm still waiting to hear back on when our appointment will be.

Neondreams,

When you had your second and third psychotic episodes were there any warning signals or triggers? I'm keeping a close eye on my daughter as she still lives with us but am concerned about when and where the next episode will happen.

Also, she keeps having the thought that cameras are watching her. I've tried to reassure her that there are no cameras but it doesn't seem to relieve her distress. Any suggestions about how I can help her? I am keeping a calm on the outside but inside I am so scared!!

Having this board and the members to go to has been such a help to me, other than the doctors I don't know where else to turn to.

Thanks everyone so much!

Deb

Deb said: "Neondreams, When you had your second and third psychotic episodes were there any warning signals or triggers?"

Before I answer your question, I wanted to say that when I was admitted IP 3 years ago for my first manic/psychotic episode, I had a very low white blood cell count which was due to the Depakote I took. The only reason this happened is because this was the first time I had ever taken this med. I've been on Depakote ever since and my white blood cell count is fine as is my liver function.

To answer your question, that is difficult for me to answer because I've been hearing voices since 1991. At that time, I had no warning signals as to when my voices would occur. They came out of nowhere and I heard them 24/7 nonstop.

Now that my moods are stabilized, I do have some warning signs that I can watch out for.

They include:

1. sleep deprivation

2. not eating regularly

3. stress

4. illness

5. mania

6. depression

I'm not too concerned about my voices if they are at a moderate level because I've been hearing them at this volume level since 1991.

However, when they become loud and angry or they shout at me and tell me to harm myself, that's when I know I need immediate help.

One thing I cannot emphasize enough is NOT to tell your daughter that her voices aren't real. I've had people tell me this and although they mean well, it makes me extremely irritated because they most definitely ARE real and unless you are the one hearing them, you have no idea how powerful they really are. Hearing voices is a frightening experience and isn't something a person imagines in their head. It's very real and can have serious psychological implications upon the person who experiences them.

I don't know if this answers your question, but since I've been hearing voices 24/7 since 1991, it's difficult for me to explain what my warning signals are.

I have a list of warning signs for psychosis and mania on my fridge.

They include:

1. Rapid speech

2. Flight of ideas (sentences do not make sense)

3. Mania (i.e. extreme happiness, restlessness, extreme irritability, etc.)

4. Delusions

5. Paranoia

6. Auditory hallucinations

7. Rapid cycling (i.e. mood changes from "normal" mood to severely depressed to manic or any combination thereof several times/hour or minute)

Deb,

Regarding your daughter's paranoia about cameras watching her...Is she currently seeing a tdoc? She can learn mindfulness and CBT techniques to control her paranoia. Note that this will not completely eliminate them, but they will help reduce them to the point where she feels more comfortable and can deal with her feelings as they occur.

The only other suggestion I have is to wait another 2 weeks to see how her meds are working. If you don't notice any change, I would contact her pdoc and let them know that she is still symptomatic and may need to be put on a different antipsychotic to address her paranoia.

I take Risperdal for my voices, delusions and paranoia. I've been on this med for over 2 months. I still feel paranoid, but it is nowhere near as severe as it was before this med was added to the Klonopin I take to help my rapid cycling, acute mania and anxiety.

Neondreams,

We're on our way to the tdoc now, and I will have my daughter tell the tdoc about her thoughts (cameras). When my daughter tells me about her being watched, I have always said, "that is so distressing to have to feel that way". Then I gently mention, let's do a reality check, do you see any cameras etc. She says she doesn't but is still distressed by the thoughts. I told her acknowledge the thought, do a reality check, and then do something else(like put clothes away, go for a bike ride) to try to get her mind off of it. Hope I didn't do the wrong thing!!

Deb

I forgot to ask you, how much kolonopin do you take?

Deb