Antipsychotic dosage is it working?

hi there

My wife started on 5mg Olanzapine, upped to 10mg once a day now 20mg 2x 10mg per day

My wife is still having delusions about physical health especially uterus & she thanks she must have a hysterectomy

I know It takes time but upped meds and no hat to racing thoughts, huge unrealistic ideas, hostility to me and conviction that she has serious illnesses - surely thered'd be SOME effect by now?!

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  • Hi ozy

    I am so very sorry to hear that your wife is suffering from delusions, and especially worrying about her physical health.

    In a strange way, delusions can sometimes show that the person knows there's "something wrong" but can't seem to attribute it yet to the real cause (I wrote 'psychosis' in inverted commas in my notes for quite a few weeks in hospital). It's almost like the brain is desperately trying to figure things out but getting crossed wires. I know it is so hard to be patient right now, and it must be devastating for you to see the Olanzapine not really fully taking effect yet. Hang in there.

    Be assured that the medical staff will be doing their absolute best to monitor how your wife is responding to treatment. Keep asking them questions when you can, are you able to speak to them on the phone regularly? Have you been invited to attend the ward round meetings - this is where plans for any next courses of action will be made. There are alternatives to Olanzapine... but medications do take quite a few weeks to build up a full effect.

    From my own experience, the strong convictions, argumentativeness and racing thoughts did take a good 2 weeks to even begin to calm down. And then it was a very gradual process of re-gaining understanding, healing my brain through sleep and rest, and having short visits from my baby and husband to relearn skills and slowly build confidence in being a new mum.

  • Its been three weeks and I can't do the ward rounds - I have a 3 year old to look after and I am 2 hours away by car - visits are gonna be irregular

    My wife is not a new mum - this is the third instance; first with me; first child died in cot death; second is 15 and psychosis resulted in divorce and loss of custody

  • Apols for 'new mum' terminology - I guess I meant confidence in being a mum of a new baby again & was applying it to myself & my experience. It sounds like you have all had an extremely rough ride. But things will eventually get better for your wife through treatment in the MBU.

  • Hi Ozy,

    sorry to read about you and your wife struggling at the moment. unfortunately knowing from personal experience, it can take a few weeks for the beneficial effects to take hold and with each change in dosage can cause mild 'hiccups' in progress. Hang in there and if you still feel worried you could ask for an alternative medication or a second one, to work hand in hand. x

  • Dear Ozy - I hope things settle down soon. I have to echo the other answers and say the Olanzapine did take a couple of weeks to kick in for me and I still had various delusions and manic symptoms for a little while. But it does get better - hang in there. My husband found my psychosis very hard as we used to argue and argue. I was very irrational and got very angry with him when he didn't understand what I was trying to explain. I now know that what I was trying to explain didn't make any sense which was why he couldn't understand it. But at the time is felt like I was so right - intensely so.

    Good luck with everything.

  • Thanks so much for your replies bpdmum and hackneygirl - this describes exactly what the early weeks of Olanzapine were like for me too.

    Hope this helps ozy - hang in there and things will get better. x

  • Definely hang in there ozy. Things do get better if you just keep slogging through.

    My own experience is a little different from the ladies who have answered already. I self-admitted to emergency in Australia when manic and became psychotic while in the emergency ward. I am one of the lucky ones who responds extremely quickly to Olanzapine. The staff injected a very high dose immediately which stopped the psychosis in its tracks within hours. My husband looked into my eyes and said "You're back" and I wondered where I had been. Some reflection made it all too apparent.

    However, after then, I still was given a few months of Olanzapine (10mg then 5mg) as a precaution to ensure the mania was completely gone. It really can reassert otherwise. I sank into anxiety and depression about 6 weeks after my daughter was born. Cymbalta brought me back out of that depression a few months later. I think it took me about a year to recover all up from the episode and its effects on my confidence and self-belief though.

    I completely agree that it is important to monitor progress, ask questions, follow your instincts to get the information you need, expect hiccups and realise that the irrationality is the illness, or echoes of it, talking.

  • She has been upped to 20mg....

  • Hi there

    I am sorry to hear about your wifes situation.

    I too was prescribed olanzapine a few years ago and they did not have any effect on me.

    In 2006 Iwas prescribed a mood stabiiser, depakote, and also an antipsychotic, zuclopenthixol.

    This combination of medication has kept me stable for the last 7 years.

    I think it would be a good idea to talk to your wifes psychiatrist, and discus possible alternative treatments.

    I hope this is helpful for you

    Best Wishe Poulson

  • I thought PPP was limited? 7 years???

  • Hi Ozy

    I guess the key is here that we all have our personal story of PP. And each recovery journey is different. Please try not to worry yet about the length of recovery. I know that's easier said than done!

    For some women, staying on medication to maintain wellness makes good sense. For others, after recovery medication is gradually reduced over 12-24 months and things are fine.

  • Hi Ozy.

    Yes, PPP is limited.

    I had my first episode back in 1989.

    I was very ill for months, and after the traama of PPP I suffered a long depression.

    I had the second episode in 1996 after my son was born.

    I was never treated for PPP and sued the health authority for misdiagnosis.

    I went to prison in 2000 and then in 2006 pureley due to .misdiagnosis.

    I was diagnosed wth Bipolar in 2006 and treated for that condition successfully.

    I now suffer from chronic P.T.S.D due to trauma.

    I am sorry if you misunderstood my first message.

    If you want any more information from me please ask.

    Best Wishes Poulson

  • I am so sorry you had to go through all that; I truly hope things are better for you now

  • Hi Ozy.

    Yes, things are better for me now.

    I am remarried to a wonderful ma, and I am now studying for a degree in psychology. I am in my second year and I am enjoying it very much.

    Pass the mesage on to your wife that she will get better, and that there is a life after PPP.

    I wish you all the best luck in the world for the future.

    Best Wishes Poulson

  • Hi Ozy,

    Unfortunately, try as she might, there is no quick fix for your wife if she has PP. She can't go round it, only through it. There is nothing more she would like than to be home with you and her young family but she is not in control right now. I can imagine how, as a caring husband, watching your wife so lost is very upsetting for you. However, rest assured with time and treatment her delusions will fade as will hostility towards you.

    I don't know what stage your wife is at with her delusions but they are so real and frightening to her. So, if she is telling you what she believes and you doubt it, she will be hostile. She doesn't mean to argue, she is fighting for her sanity, which in time (in my case six months each time) will return. Sorry I can't help regarding medication as my PP journies were so long ago. Be strong, there is hope and we are all here for you.

  • Hi Ozy. I too had Olanzapine when ill with pp- and can say that it worked for me, but it does take some time. In my case I'd been put on something else before that was doing no good and had to work out of my system and the olanzapine also to take effect. My husband was really frustrated too. It's such a desperate time and we can only sympathise and advise hanging in there. All in all it was probably a bit less than a month til I came out of the worst delusions, mania, psychosis bits. It could well be that your wife won't remember it well (I don't and I know my husband, whilst intensely frustrated is also relieved by this). As others have said, get feedback from those treating your wife and hopefully the advice and info on here is helping in some way too.

  • In my case the PPP was limited to a few months with depression for up to a year later. In my case, the traumas of pregnancy caused me to develop bi-polar disorder at the ripe old age of 37, the PPP was the first mania in the cycle. The good news is it is well controlled by Epilim and I have a productive, happy work and home life. And my experiences, while awful, taught me a lot about what is valuable and what isn't. Keep hanging in there. It can get better but it feels awful before it does.

  • Hi Ozy, my wife had olanzapine and again it worked for her but it does take time; we had a couple of times when we thought we'd cracked it, only to find the dillusions etc. still there. It was an incredibly frustrating and upsetting time, plus I felt like I was walking on egg shells, I could say something innocent for it be taken a completely different way! but as with so many comments above, the recovery journey can be different for all, but it does get better.

  • Hi Ozy, sorry to hear you are all suffering desperately and she is not yet responding. Your wife has been through so much. A cot death has got to one of the hardest thing to endure, and it's no wonder with that trauma in the past and her subsequent propensity to psychosis, she is taking time to respond. Because you are so far from her hospital, she must also be missing you and her son, but it can't be helped. Sadly these things take time, just try to be compassionate where possible, but I can imagine (but not truly understand- having been the ill one, not the partner) that it must be frustrating/scary/highly stressful for you. She is still the same person underneath, it's just her brain is currently not wired correctly, so she won't be rational. She will recover, try to believe that.

  • All - great news - my wife was discharged last week - still a way to go & she'll be on anti psychotics for 3 - 5 years and there's community care but she and my baby daughter are home

    There is light and hope for you all - get treatment as early as you can and make sure pre natal there are mechanisms in place

    And remember, the illness isn't your partner - they are there and you will find them again x

    Thank you for your advice and support xxx

  • Hey Ozy

    I was just popping in to the thread to see how things were going. Really great news!

    I am really moved by the way you are already able to say that your wife was there all the time, and you found her again. Amazing and just brilliant!

    Just to say we are here whenever you need us for this next stage at home. When your wife is ready she is very welcome to come on and chat to us about side-effects of medication, getting back into 'mum-world' and the process of recovery.

    You and your wife might find these links helpful.

    A survival guide for dads (written in Australia but lots very relevant)

    app-network.org/wp-content/...

    APP recovery guide for mums and families

    app-network.org/wp-content/...

    Wishing you the very best, and enjoy your family time back together

    Naomi x

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