Medication query for relapse episode - Action on Postpar...

Action on Postpartum Psychosis

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Medication query for relapse episode

sarahm2015
sarahm2015

Hello everyone - I’m struggling and suspect a relapse of postpartum psychosis or in perhaps another episode of psychosis if it is considered that after 19mths since my 2nd episode of PP. I’ve started on lorazepam and sleeping tablets for the next few days while I wait to see a consultant.

They have already mentioned restarting olanzapine but it wasn’t very effective initially, took a while to get the dosage right so seemed like I was super ill and not sleeping for longer than maybe necessary. Then the appetitive increase was so intense! I gained a lot of weight which I’ve been working really hard to get off (I know that shouldn’t really matter right now and I just need to get well but it does affect my hapiness) and on the plus side I slept really well on it, still wake with the kids if need be etc and recovered on them pretty quickly. So I’m not ruling it out as such.

I’m really just wondering if any of you have been prescribed any other antipsychotics that didn’t increase appetite so much and how u found them? Aripiprazole perhaps? Or anything else? A family member takes that following a manic episode and is doing really well on them, taking them longer term over A Levels and back to his usual self whilst on them.

Any advice on meds would be much appreciated so I can a research a little before I meet the doc.

Thanks xx

19 Replies
oldestnewest

Hello,Sarah my wife takes now aripripazol for a while and although there is no hunger but tense on the back and shoulder and bit of anxiety.She is on 20mg.

We really want now to reduce it after a few month.

Sometimes she feel her her moving a little when really is not and her legs couldn't rest.

But overall much better than olanzapine.

She had for the side effect mirtazapine if I am right.

Hope it helps to get a picture.

I wish you quick recovery

sarahm2015
sarahm2015 in reply to Vikrika

Ok thanks Vikrika that is good to know, does it help her sleep well? Thanks

Vikrika
Vikrika in reply to sarahm2015

Not perfect her sleep,but I think she just finished antidepressants,so it could have affect on her as well.Still she is having a dearly good sleep,we both wake up to our baby,vary who is sleeping deeper.

Her condition I would say fairly good,she returned to work this week,she get really tired but I think is normal,lockdown made us weaker with stay in house and do less.

She is getting fed up to take medication as she never had frogs in her life not even cigarette,so she want to get back her life now.

Hope it helped a bit

Aripiprazole aka alilify is much better than olanzapine as a maintenance drug , my husband is on the injection , however I would just like to point out that your ppp was most likely a result of low progesterone , after giving birth progesterone drops dramatically, this is a scientific fact, progesterone is a very calming hormone it moderates estrogen which is excititory , in the absence of progesterone estrogen can become dominant and cause ppp and autoimmune disorders If the cause of the problem is hormonal then surely hormones should be considered as the cure

The menopause is when hormones are changing and it is treated with hormones ppp is hormonal yet is treated with antipsychotic drugs

Just checked and my coil releases progesterone so this relapse might not be hormone related despite the period coincidence?

Do you have estrogen gel as well as progesterone coil ?

Don’t think so - just a standard Mirena coil?

They usually give estrogen as well, progesterone drops at that time of month that you mention

Actually, I think lilly of the valley may have a point. I wonder if you are using the pill or hormonal contraception? If you are, then your hormones should be well-regulated.

In all these mood disorders it's worth keeping a mood chart, and you may (or may not) find that extreme mood swings are linked to your cycle. If they are, then you may not need other drugs. If you do need them, however, they are a God-send. I've had quetiapine instead of olanzapine in the past, but it just made me so sleepy I couldn't function.

If olanzapine didn't suit you in the past, they are usually ready to listen to you and your experiences.

sarahm2015
sarahm2015 in reply to Well-read

Ok thank - that is really interesting. This relapse has occurred at my time of the month so I do feel amongst the huge pressure and stress I am under that the hormones play a part.

So maybe you want to ask the doctor about going on the pill. (Of course if they do a blood test for hormones, the results will vary depending on the time of the month.) If the dr says that hormones can't cause mood swings that extreme - yes, they can - I'm here to tell you!

Ellie_at_APP
Ellie_at_APPAdministrator

Dear Sarahm2015

Hi, I'm Ellie, I'm the National Peer Support Coordinator here at APP, and had postpartum psychosis myself after the birth of my son in 2011.

I'm really sorry you are struggling with a possible relapse after having postpartum psychosis. I know that decisions around medication can be difficult too, balancing the side effects etc. It sounds like you have sought some support, it's so great you've reached out.

Have you been struggling with sleep? I know this can have a massive impact on mood and mental health, it's good you're taking something to help you sleep.

I would suggest you speak with your psychiatrist about medication, and the concerns you have about side effects etc. I'm not sure if you are in the UK? If so you could ask to be referred to Cardiff University Psychiatry Service who offer a second opinion. They are specialists in Bipolar and PP, and can see you remotely, and can work with your mental health team / GP around medication / treatment etc. You need to be referred by your GP or mental health team. It's free to access, and you could emphasise that rather being a 'second opinion' it's a 'specialist' opinion.

There's information on our website: app-network.org/what-is-pp/...

And also on the Bipolar Disorder Research Network site: bdrn.org/cups/

I think a lot of us struggle with moods around our cycles / hormones etc, and that's definitely something to explore? However, I've heard some people saying the pill really helps with that, but then other people say the pill makes them feel much worse, depressed etc. It is all so individual and just finding the right things for you, which I imagine might take a bit of time.

I wanted to respond to LilyoftheValley's reply about hormones being the cause of PP. We need more research to understand the causes of postpartum psychosis, and we suspect that hormones do play a part, but they are definitely not the sole cause for postpartum psychosis.

From the research that has been done, and also from hearing many people's stories (yours included I'm sure), often a mixture of things can cause it - the hormonal changes, lack of sleep, birth trauma, etc, and this is different for each person (you will see on this forum a recent post asking if people feel birth trauma caused their psychosis, so that's a good example). We often describe it as being a 'perfect storm' for someone, with a few factors all contributing.

There's more information about the possible causes of PP, from what is known, on our website under FAQ: app-network.org/what-is-pp/...

I really hope this is helpful, and hope that you will feel better soon and get the right support. Do know we are here for you, and you can write on here anytime

Take care,

Ellie

Thanks Elle

Yes the lack of sleep (trouble falling asleep) is usually my first indicator so I sought help for that after 2 bad nights but in the last couple of days it’s gotten worse so I’ve seen a consultant and started new meds. The no-huge-appatitie variety 👍🏼

EmiMum
EmiMumVolunteer in reply to sarahm2015

Hi sarahm2015,

Just wanted to applaud your self awareness and how you sought out help so quickly. I hope the new medication works well for you. Write here whenever you feel like, we are all here to listen. Take care

sarahm2015
sarahm2015 in reply to EmiMum

Thanks so much, it’s early days but I’m really focusing on my self care and coping mechanisms to get well quickly for my family (without putting too much pressure on myself of course!)

Pikorua
PikoruaVolunteer in reply to Ellie_at_APP

Well done, Ellie :-)

Pikorua
PikoruaVolunteer

Hello Sarahm2015,

pleased to meet you on this forum. Thank you for sharing your experience with us. I believe I can strongly resonate with the given support by Ellie.

We all have very different templates and dispositions. In addition our surroundings, external and internal stressors can cause immense triggers and may slow down the healing process.

After PPP (2010) I suffered with PTS, because of ill-treatment in a mixed gender psychiatric unit, I suffered with a lot of side effects from some very traditional meds. I was under a network of health professionals and close supervision once released from hospital. A care plan was continuously updated and my partner was my main carer.

Yes, I took Lorazepam as well, but was gradually weaned off together with Risperidone by a wonderful Psychiatrist.

Nevertheless, I lost two family members in a short period of time and did not sleep much for many years (Insomnia, anxiety and fear, concentration problems, mind racing etc.) until I found APP, received forum support and one-to-one...I eventually was referred to Professor Ian Jones and received the diagnosis of BP1. A second opinion was vital for improving life quality, for my partner, my son and I.

Take good care and hope you will be able to get good guidance via health professionals.

Stay safe,

x

Hi Sarahm2015My daughter swopped from olanzapine to arapriprizole 4 months after her second relapse because she didnt like the weight gain. She has lost a stone in weight and has been on it for two years now. It is working well for her. She has sleeping tablets as and when needed as well.

sarahm2015
sarahm2015 in reply to Bulb

Fab Bulb, thanks for answering my questions - great to hear she is doing well and has lost so much weight - well done her! X

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