General When Their Medication Could Be Causing Problems

[amethist]

My husband has been struggling with his medication for a while now, and we have no help as yet to regulate or change them, if that is what is needed. His GP does not really understand much about PTSD, and the Psychologist who he was seeing at the day center discharched him from her care when they discharged him for the day center, that's if you could call it care she gave him. so to be on honest we have been on our own medication wise for quite a long time now.

He started falling asleep within an hour of taking them last year, so we reduced his morning dose by 0.5mg, which helped and he settled back into a reasonable routine again. We reduce the same one again a few months back as it started happening again. Again he settled down again and was doing OK. he then was waking up in the morning fuzzy headed and this stayed with him all day, so we decided to reduce the same on in the evening, that sorted the fuzziness out with in a few days.

For the last 2 weeks the need to sleep within an hour of taking them, started again. So after some discussion he decided to cut the last of this medication out all together yesterday morning.

The one he has been reducing is an anti depressant called Fluoxetine, but does cause drowsiness, which is why he was reducing this one as it is the easiest being in 0.5mg tablets.

Unfortunately yesterday he went from being drowsy to being so hyper, changing so much, that even my youngest daughter said something was not right when she was talking to him.

He then went from hyper to being assertive to the point of crossing boundaries of how he spoke to me. This was not him at all, not even before PTSD set in did he ever speak to me like this. he demanded his bank card so he could go to the pub, telling me he could make his own decisions and if he wanted some money he could have it.

I had to agree yes he could have money if he wanted it, also trying to explain why it was not a good idea to go for a pint, when his mood was probably caused by his body reacting to not taking that medication in the morning. Plus many other reasons, but without saying how much it would effect me. he still takes the other one which is Paroxetine.

He was so insistent that he would be fine, I gave in and gave him the bank card, writing the number down for him. Trouble was he got me so stressed out by all this I wrote the number down wrong, and the card was not excepted. he came back telling me how I had messed up, which I explained was his fault for being so bull headed about it all.

I ended up going with my own card and getting money out giving him it and going off to take my granddaughter out.

He decided to go to his mums last night before I got back, for the stupid idea that I was not coming home last night. I have never stayed out over night no matter how tough life has become with PTSD.

He came back this morning and took his medication, including the one he knocked off yesterday, and within an hour he was again falling asleep.

He has been in quite a bad way all day, partly because of the medication, but mainly due to the reaction of how he behaved yesterday. he has slept most of the day, getting up for food and drink, but looking very drawn, even disassociating at one point, with me having to bring him back top his safe place.

He is fed up of feeling tired and listless, he want to get his life back, but how can he when his medication seems to be causing more issues that what is fixing now.

So Monday morning I am on the phone to make an appointment with the pharmacist we were told about, who would be able to help and guide him with medication problems and even may be able to suggest an alternative. He has had reviews with his GP, but is just told to keep going with them. So after 3 1/2 years on these meds, maybe time now for some one else to take over with them.

I do hope this can be done, as we are getting no help from anywhere else right now.

As for his reaction to what happened yesterday and how he spoke to me. His dad sorted that out and told him what an idiot he was being. I did get an apology of sorts, maybe when he is back on a level, we will be able to talk about the full reasons of how we both reacted to this.

For now I am back in full carer mode, as he cannot think straight, and does not really know which way is up.

Amethist

 

[Sazza]

Amethist things sound really difficult for you and your husband right now. Its sadly true that sometimes medication can cause us more problems than we originally had, however with all the medications out there now there should be something more suited, you should not have to settle with the fluoxetine when it is causing so much issues.

I just wanted to say i hope you manage to get things sorted with the medication, it certainly sounds like it isn't agreeing with him. Please take care of yourself the best you can at this difficult time.

Sending strength and wishes that things get sorted as soon as possible for you both.

Sazza

 

[amethist]

Thanks Sazza

I do the best I can for myself in this crazy PTSD life.

This morning more came out of why he went into hyper mode on Friday. It seems that as he was feeling so alert after weeks of feeling drugged and sluggish, he decided that he could have a coffee on Friday morning, before I got up, then another one while I was in the shower. This does explain the hyper mode issue.

Then because he crashed a few hours later, he got himself fired up and this is where the obnoxious, demanding and over the top bull headedness husband came from.

He knows he is not supposed to drink coffee at the moment, but being in the stubborn, rebellious mood he was in, did not give a damn.

This morning he has taken his medication as it was before all this blew up on Friday, saying he would rather fall asleep an hour after taking it, than end up like he was on Friday. Wondering if I would let him back in the house, or if he had a wife to come back to at all.

So back to him sleeping more than he should until we can get this sorted. But at least we do know it can be sorted soon.

 

[cherryblossom]

Hi Amethist. Sorry to hear about the issues hubby and you are having, and hopefully the pharmacist will be able to help..

You do need to find someone to review his medications.

If you have not already been given an explanation, I would firstly question why he is on 2 SSRI's (paroxetine, and fluoxetine). SSRI's are similar, and have the same mechanism of action, so why take 2? If an SSRI is not having beneficial results, Doctors usually increase the dosage, switch to a different SSRI, or add a drug from a different class. Drugs can interact with each other in unpredictable ways, which is why I would question the benefit of taking 2 SSRI's. At low doses, I don't think taking 2 SSRI's is a danger, but why take 2 different medications of the same class, when maybe one would be sufficient?

Drowsiness is not a side effect of all SSRI's for everyone. Has he ever tried an SSRI that doesn't cause him drowsiness? Is he on any other meds not mentioned above, that could be interacting with the SSRI's to cause drowsiness?

3 and a half years is quite a long time, and although this combination has been beneficial, it is causing more problems now, and needs reviewing, as you have said. There are also newer, different classes of medications now available which might be more suitable.

And, the power of caffeine should not be ignored!!

 

[amethist]

Thank you so much CB, your the first person who has actually agreed with us about his medication. I did say a long time back, that I did not think these were right for him, but was told out right, "They are the best ones for him".

We have basically been left to get on with everything, apart from visits by his CMH support, it was him who told us about the Pharmacist. This guy is based at a purpose built unit at one of the main hospitals, and is the man who knows.

The main psychologist for our area, was rude and ignorant, and I have not met anyone yet who has said anything different. No one likes her, not even those who work along side her.

Hubby got up earlier, had a sandwich, watched about 20 mins of the Silverston F1 race, then had to go back. I could see he could not keep his eyes open, he cannot go on like this. He cannot function at all, this is no way for anyone to live.

We know for certain is is the medication now, as he did get up this morning bright and breezy. But again within an hour of taking medication, he was falling asleep again.

Being ill is fine, struggling with agoraphobia, we can cope with, anxiety attack's we can manage. But this is ridiculous now, what kind of a life can anyone have taking meds that are supposed to help.

Not going to be fobbed of anymore. Tomorrow we start getting some answers and some help.

 

[Ladyhope Somerset]

Hi Amethist,
I've not heard of a pharmasist being able to issue a new prescription but if your hubby gets support from CMH, if that's Community Mental Health, he must be able to get a review of meds. If not you should be able to speak to someone at the PALS, Patient Liaison Service, at the hospital.

My hubby has been oversedated in the past and it wasn't good. Hubby's transition to new meds regime wasn't without problems, feeling hot and cold, some PTSD symptoms getting worse eg hallucinations. Some people have their meds tweeked up when an anniversary is coming up and then back down when through that extra difficult time. Some of the new drugs are easier to introduce as well.

Your hubby no way has to accept feeling like poo! Getting meds reviewed sounds like a must :tup:. Maybe the pharmasist is the first step for advice.

Good luck x

 

[amethist]

Thanks LHS

He did have a yearly review back in January, and then there was no issue like there is now. Of the 2 GP's who we trust to talk sense, 1 is on holiday for 3 weeks and 1 retired 2 weeks ago. The other's in the practice, 1 told him to go for a walk at the side of the canal, when he was almost suicidal a few years ago, and another told him to stop relying on me so much, just before he had his PTSD diagnosed. The CMH center he did go to, discharged him after 31/2 weeks into the 6 weeks he was told he would be going. The main Psych Dr was supposed to see him a few weeks after that, but discharged him from her care too. His GP once told him that the Psych Dr was the one who would change his medication if needed, but how will she if she wont see him, as he is no longer under her care.

So he is stuck in limbo. with no one taking responsibility for his medication. so we will now take it into our own hands and sort it ourselves tomorrow.

His support from the CMH is off work until the 18 July, he was the one who told us about the Pharmacist, and that he does help patients out with medication, and this was the best way to get expert advice if anything did go pear shaped.

The pharmacist is one who will advise about medication, so we can then go back to see if one of the GP's will issue a prescription on his recommendation. It seems he will sit and help you with any medication issues you have as he is the main pharmacist for the Mental health unit at one of our biggest teaching hospitals. Once we do get in touch with this guy, hopefully we can get some good expert and honest advice for once.

As we have been pushed around, ignored, and left to deal with him being suicidal on our own, (Over 3 years ago that happened) We now go the direct route and try to miss out the middle men.

 

[Froggie]

((((Amethist)))), this is not an easy moment for you. I do agree with CB that there should be a review of medications. Over here, certain pharmacist do intervene and communicate with family drs. I was doing volunteer work in a residence for homeless people and had one long term renter. After a couple of months, he was sleeping all over the place then his equilibrium went bonkers. He almost fell out a second story window. So keep an eye on H, as there may just be some chem changes (age) or he may be saturated. Will keep fingers crossed and candle burning that you find a Dr who will listen and investigate to see what is going on.

 

[Ladyhope Somerset]

Amethist, to have access to the hospital pharmacist is brilliant, definitely a person I'd put my faith in. I remember when I used to work at the hospital, the pharmacist would sit in on ward rounds to oversee prescribing. Trust me to make assumptions, the laugh's on me, I thought you meant the one at the local chemist. lol :laugh:

Perhaps the pharmacist can write to the GP with recommendations?

You're lucky to have a teaching hospital in your area. Fingers crossed things improve soon and sending you strength and a couple of virtual cup cakes with your favourite flavouring, chocolate perhaps? mmmm, also I just checked and you haven't asked for a hug but I reckon one wouldn't go amiss (((Amethist))) x

 

[amethist]

Thank you all for listening and supporting me with this one. It has been tough on me and yes LHS, a hug is definitely needed right now.

If I confused anyone with the medication list yesterday, sorry my own head was spinning with all this too. It is not Fluoxetine he take, it is Paroxetine and Flupentixol.

I did it I talked to the Pharmacist. Hey and guess what, he agreed things were not right and to go and see a GP who sit and listen to hubby, would not tell him to keep going with his meds as they are, and to suggest they ring him if there were any issues about this. He could only do this as hubby had not been an in-patient at the unit, and he did not know his history.

I then called the surgery, knowing it was a walk in surgery this morning, but hoping a GP would be available who would listen to hubby. The receptionist who took the call told me who was on, and even put his name on the list, (Even though she should not do that by phone) as long as I got him down there int he next 10 mins.

Poor hubby did not have time to think or argue about it, he had his shoes on and was out of the door before he could sneeze.

This GP did sit and listen to him, and read the notes from his therapist, as she talked to him. She agreed that he could not go on like this, even though she openly admitted she knew very little about PTSD, as it was a specialist subject, but would help as best she could today.

She suggested he stop taking the Flupentixol in the mornings altogether, but still take the 1mg at night. She suggested an increase in the Paroxetine to 60mg every morning. To give himself the rest of today and tomorrow to settle after all this anxiety then begin with the baby steps again, doing what he has not been able to do for the last few weeks.

He has to give it 4 to 6 weeks with this new dosage, then go back and see her. If he is feeling as he should by then being able to function better, then she will leave it at that for a while to see how it pans out over a few months. If nothing changes, then she will have to get in touch with the Psychiatrist, so have some input and a possible appointment for hubby to go see her, and get this sorted better.

If that happens he said he wants his community support there, as he refuses to see her with out professional back up with him.

He was in a heck of a mess when we got back, due to the anxiety of not knowing if he would be taken notice of. At least now he has some one else on his side, working to help him.

Like the GP said to him "How can you work on what you know needs to be done, when you are drugged up and can't think clearly".

Going for that hug now.

 

[ISupportHer]

This sounds great Amethist.

Just a comment. Not aimed at you really. Just want to remind people that many of the psychiatric medications should not be stopped abruptly. My wife at times has been admitted during the process of a med change. The withdrawal of one and start of another. Not that a new med equals admission. Just saying that there can be physical side effects if there is an abrupt stop of many of them.

ISH

 

[amethist]

Yes ISH you are right, hubby had been reducing the Flupentixol over a few months, but it was not doing him any good any more in the mornings. Because of the sedative effect it has.