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She-Wolf
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Discussion Starter · #1 ·
from those with knowledge/experience? (this is long - i bolded the main points)

his Dx is bipolar type II and ADHD. the BP was mainly triggered after taking Zoloft 8-10 years ago which put him in a manic episode and since then he has been on a variety of meds with his mood being sometimes stable sometimes severe again.
most of the time though, it's been very debilitating and of with his life drastically changing ever since the first episode.

ANYWAY, my main point is that in the past 2-3 years his health has significantly worsened by the effects from his meds. and it's very bad now.


his current cocktail of meds:

-quetiapine/seroquel (atypical antipsychotic), dose 200-500mg (unsure of exact amount).
it's been effective in getting him to sleep at night and for treating the mania (off it he is very paranoid/manic in general), BUT the sedating effects keep him in bed for sometimes up to 16 hours (also related to the depression), causing him to be late for his jobs which is partly why he loses them so often.

-lithium, current dose 900mg. i believe this is the main drug that has ****ed with his health the most. he's been on it for years (possible all 8 yrs), and has been as high as 1.5grams at times. he's developed hypothyroidism now (and effects on his kidney maybe?). he has gained 150-200lbs, he has TERRIBLE tremors - so he can't write without the ink going all over the place and it is very sore on his hands when he tries to steady it, anything he just attempts to do is difficult because of the shaking, he can't hold cups or plates or else it spills everywhere, etc etc so i end up having to help him with these if he needs it; then there's constant dry mouth/hydration; and probably other symptoms.

-valproic acid/epival (don't know exact dose), for the mood stabilizing effects. i'm unsure in how effective it is, and i think he is too, since he's always on more than one med at a time and has never been on it alone.

-propranolol, a beta-blocker (don't know exact dose). this is to reduce the effects/symptoms from the hypothyroidism and lithium. he says it has helped in his tremors, back pain and fatigue but when i saw him last they were still bad enough to have a negative effect on his functioning.

-ritalin, 30-60mg (?). its effective in helping him focus (not enough to keep jobs, mind you) and in getting him out of bed. he also abuses it, i should mention - he snorts it at times and will (regularly) take more when he has to stay out late or is going to drink alcohol (he has admitted this on a few occasions).

i THINK that is all he is on at the moment.

other drugs he will do off and on: he still smokes cigarettes but currently still wears the patch as it helps him cut down (um, if he's still smoking then its clearly not working); whenever he has access to weed, he is fully addicted to it and has admitted (when he's back home here visiting and i live with him i see him smoke all the time, sometimes my bro and i will smoke with him but he just does ridiculous amounts all throughout the day and is high/burnt out for pretty much everything); inhalants such as amyl nitrate and nitrious oxide (the 2nd he has openly told me about - that was a while ago so i don't know how much he does it); salvia (rarely, and i don't believe it has many negative effects); and there might be others i'm unaware of.
the weed and cigarettes he does the most and have the worst effect on his health.

the symptoms i see as being the most harmful: approx. 150-200lbs of weight gain; very bad hand tremors (can't write, hold cups/plates, etc); very, very poor memory and cognitive functioning - both short and long term, forgets important things such as my brother quitting smoking (whenever he finds out he says "wow! thats great! i had no idea!", how does he forgot something that important?), my plans for next year despite telling him many times, the day of the week, anything he did in the past day, week, month, any responsibilities (often has not showed up when we've made plans despite reminding him the day of or before), he can't stay organized, any thing like having to get done several things in a day takes hours longer than it should; fatigue and muscle pain; very high colestorol and blood-pressure from the weight gain (the doc has said it's so bad he will die within 10 years); likely others i'm forgetting.

as far as his mood is concerned, he is not manic nor severely depressed, but in a way his personality has completely changed:
he has constant apathy; paranoia over others controlling; very very subdued (previously would be very outgoing, in a good mood, would make jokes, laugh, etc); often very defensive to everyone.
he's completely out of it - hasn't paid child support in months; hasn't held down a job, and i know he can't now so i encourage him to go on disability but he refuses... basically he's a different person.

he's also in denial very much of this - he has been hospitalized recenlty to adjust the meds, and the memory is a major problem but he thinks it isn't and won't tell it to the doctors (he will go back soon tho). he still smokes weed, and he knows he shouldn't so he hides it from the docs/nurses. he thinks everyone is controlling him, the few people he listens to are me (i'm still his "little girl" to him, i guess), my aunt, and his girlfriend. he always needs someone to look after him, since he can't do anything (but won't see it that way).

it's become almost a joke when i see him in person, since he's so unaware of everything. i sometimes have to look after him over stupid ****... reminding him to be on time if we are going anywhere, holding things for him if he's shaking too much, counting out change for the bus (also because he might be too stoned *rolls eyes*).

he's pretty much just not co-operative in fixing it, though he regularly says he is and says he will change habits. he still eats very very poorly and when i remind him he says "well i only eat mcdonald's when on vacation, once i go back home i'll eat better..". when a family member says they are concerned (e.g. my uncle), he says they are just trying to control him and use it to get back at him. he will admit he has certain problems then deny them later, or with someone else.
people that have known him all his life, like my grandparents, my aunt, my mum (though they divorced years ago), say that he is a completely different person now with a different personality, and it's even hard to recognize him. when i compare him prior to the illness i see it too.

he's just really, really messed up. it's always hard to say whether he is worse on meds or off. when he's ON them he can't do **** and can't keep his life together and it's shortening his life. but when he's OFF the meds there's the fear of him killing himself, which is not irrational and quite possible (he has been close to doing many times, and he will occasionally tell me when he is having bad thoughts of suicidal ideation - not to mention how impulsive he is).

yeah, i just don't know what to do about him. the current next step is getting him to the hospital again to adjust his meds. i'm still encouraging him to address his memory problems, so i'll continue doing so, and i want him to get on disability. he lives in another province with his girlfriend so i'm not around him a lot, but i'm thinking of trying to talk to her personally and see what she thinks about all this.
 
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