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Suggest Treatment For A Complete Psychotic Bipolar Breakdown With Hyper Anxiety
Question: Doctor Beinenfeld,
Lady friend has had a complete psychotic bipolar breakdown with hyper anxiety in the lead. Cant get her to psychiatrist in Prescott Az until Nov 23. Both breakdowns were work stress activated. Have a good supply of 10 mg Zyprexa from her breakdown 5 years ago and what looks like 2mg Xanax. Starting to run out of Xanax in about 10 days. Have an ample supply of valium from ages ago; so, Its probably weak. Have found the Zyprexa to shut down her negative psychotic self talk and about two hits of Xanax a day to relax her. Xanax without the Zyprexa results in a half awake stumbling about and falling down zombie individual. I know going off Xanax cold turkey is a no no; so I'm cycling in valium to take the place of Xanax about 15 days before the psychologist sees her Nov 23. Holding back a 5 day supply of Xanax in case of withdrawal symptoms.
I did get her into a three day observation at XXXXXXX Psychiatric Hospital in XXXXXXX and the psychiatrist gave me a ten day supply of Seroquel Quetaipine Fumarate 250 mg and DivalProrex DR. Have not started to implement this protocol because I only got a 10 day supply; not enough to get from Oct 23 to Nov 23.
The affirmative action at XXXXXXX was intense and racial charged so I couldn't leave her in longer. The psychiatrist talked with me for about a half hour and was in my estimation top rate
So, she has been on her outdated Zyprexa and Xanax for about 2.5 weeks and migrating to valium to get to Nov 23. Will this be okay in your professional view. The medical doctors in this town are backed up to January in most cases or wont see someone with out a referral. I will be calling the XXXXXXX psychiatrist tomorrow to try and get a refill on his ten day prescription so I can migrate to his updated protocol before the Nov 23 scheduled appointment. Your advice and guidance would be much appreciated.
Her digestion is starting to back up. DOES ANYONE KNOW A PSYCHIATRIST IN PRESCOTT ARIZONA OR A GASTROENTEROLOGIST WHO WILL SEE HER TOMORROW.
XXXXXXX XXXXXXX
0000
Lady friend has had a complete psychotic bipolar breakdown with hyper anxiety in the lead. Cant get her to psychiatrist in Prescott Az until Nov 23. Both breakdowns were work stress activated. Have a good supply of 10 mg Zyprexa from her breakdown 5 years ago and what looks like 2mg Xanax. Starting to run out of Xanax in about 10 days. Have an ample supply of valium from ages ago; so, Its probably weak. Have found the Zyprexa to shut down her negative psychotic self talk and about two hits of Xanax a day to relax her. Xanax without the Zyprexa results in a half awake stumbling about and falling down zombie individual. I know going off Xanax cold turkey is a no no; so I'm cycling in valium to take the place of Xanax about 15 days before the psychologist sees her Nov 23. Holding back a 5 day supply of Xanax in case of withdrawal symptoms.
I did get her into a three day observation at XXXXXXX Psychiatric Hospital in XXXXXXX and the psychiatrist gave me a ten day supply of Seroquel Quetaipine Fumarate 250 mg and DivalProrex DR. Have not started to implement this protocol because I only got a 10 day supply; not enough to get from Oct 23 to Nov 23.
The affirmative action at XXXXXXX was intense and racial charged so I couldn't leave her in longer. The psychiatrist talked with me for about a half hour and was in my estimation top rate
So, she has been on her outdated Zyprexa and Xanax for about 2.5 weeks and migrating to valium to get to Nov 23. Will this be okay in your professional view. The medical doctors in this town are backed up to January in most cases or wont see someone with out a referral. I will be calling the XXXXXXX psychiatrist tomorrow to try and get a refill on his ten day prescription so I can migrate to his updated protocol before the Nov 23 scheduled appointment. Your advice and guidance would be much appreciated.
Her digestion is starting to back up. DOES ANYONE KNOW A PSYCHIATRIST IN PRESCOTT ARIZONA OR A GASTROENTEROLOGIST WHO WILL SEE HER TOMORROW.
XXXXXXX XXXXXXX
0000
Brief Answer:
Consultation
Detailed Answer:
Hello, and thanks for your question.
This is a highly dangerous and untenable situation. This woman is currently manic and psychotic and needs to be in a hospital to get rapid medical attention. She needs to be given a loading dose of Depakote, high doses of Zyprexa, and not use Xanax as this is too short-acting and leads to rebound anxiety -- Klonopin would be a safer choice. You need to call 911 or take her to the nearest emergency room to pursue inpatient hospitalization. Anything less than this is patently unsafe.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Consultation
Detailed Answer:
Hello, and thanks for your question.
This is a highly dangerous and untenable situation. This woman is currently manic and psychotic and needs to be in a hospital to get rapid medical attention. She needs to be given a loading dose of Depakote, high doses of Zyprexa, and not use Xanax as this is too short-acting and leads to rebound anxiety -- Klonopin would be a safer choice. You need to call 911 or take her to the nearest emergency room to pursue inpatient hospitalization. Anything less than this is patently unsafe.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by :
Dr. Raju A.T
Her digestion has shut down but she is not eating much but should I think be having a bowel movement ? Got one via a colonic last week but was a plug and not the entire digestive tract. She is deathly afraid of going back to the emergency room and being shipped to a psychiatric hospital for medical care. Can you state some more detailed worst case possibilities rounding out your "highly dangerous and untenable" comment? I need this to get her in the car and down to the emergency room. Also, the doctors at the XXXXXXX clinic which is not number one, of course, were going to treat her under observation for two weeks
Brief Answer:
Followup
Detailed Answer:
She needs to be in a psychiatric hospital for medical care, as she currently has manic psychosis. This is a psychiatric emergency.
She is currently being given medications without medical supervision. You are not able to manage this by yourself without a physician carefully assessing doses. Giving her too much Xanax, Zyprexa, or Depakote could result in constipation, bowel infarction and rupture, delirium, liver failure, coma, and death. Psychosis can also result in suicide or homicide when left untreated, even when the person has never previously been suicidal or homicidal.
She needs to be taken to the ER immediately. If she will not go, call 911.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Followup
Detailed Answer:
She needs to be in a psychiatric hospital for medical care, as she currently has manic psychosis. This is a psychiatric emergency.
She is currently being given medications without medical supervision. You are not able to manage this by yourself without a physician carefully assessing doses. Giving her too much Xanax, Zyprexa, or Depakote could result in constipation, bowel infarction and rupture, delirium, liver failure, coma, and death. Psychosis can also result in suicide or homicide when left untreated, even when the person has never previously been suicidal or homicidal.
She needs to be taken to the ER immediately. If she will not go, call 911.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by :
Dr. REMY KOSHY
Why is it unsafe? I fed her like meds going to the psychiatrist every two weeks 4 years ago for three years? She had similar psychosis like thinking she was going to starve or she would be left penniless in the street etc. etc.
Also, the psychiatrist released her with a protocol of medication from Haven?
Sure your not overdoing it on the mental risk side doctor?
The digestive problem is new I admit and every home remedy for inducing expulsion has not seemed to work. That might be your winning argument, a gastroenterologist argument. In Prescott az about the only way to to their office is via an appointment in Janurary 23 earliest or through the emergency room. .
Is the Depakote loading dose for the digestive blockage?
Also, the psychiatrist released her with a protocol of medication from Haven?
Sure your not overdoing it on the mental risk side doctor?
The digestive problem is new I admit and every home remedy for inducing expulsion has not seemed to work. That might be your winning argument, a gastroenterologist argument. In Prescott az about the only way to to their office is via an appointment in Janurary 23 earliest or through the emergency room. .
Is the Depakote loading dose for the digestive blockage?
Brief Answer:
Followup
Detailed Answer:
You're welcome. For the record, I believe her digestive problems are the least of her concerns right now. It is absolutely not safe for you to be treating her without medical training, and in doing so you are putting her life at risk. I hope they involve a psychiatrist in the ER to address this life-threatening psychiatric emergency with the proper physician-administered evidenced-based scientifically informed medications and treatment.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Followup
Detailed Answer:
You're welcome. For the record, I believe her digestive problems are the least of her concerns right now. It is absolutely not safe for you to be treating her without medical training, and in doing so you are putting her life at risk. I hope they involve a psychiatrist in the ER to address this life-threatening psychiatric emergency with the proper physician-administered evidenced-based scientifically informed medications and treatment.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by :
Dr. REMY KOSHY
Doc,
I appreciate your concern. But spent a lot of time in far out places where there were no doctors. I'm sure your a hot shot and at the numero uno citadel of psychiatrists but I didn't exactly fall off the turnip truck. Sure you have training and I have loads of in the field experience. Remember I already took her to the emergency room and she got shuttled to an awful experience at a psychiatric clinic. I admit my experience is no trump for your training but I did see a XXXXXXX Hills Harvard trained psychiatrist monkey around with hit or mis titrations of antidepressants and anxiety suppression medications and it looked like he was pot shotting the entire therapy. So, its an art form was my conclusion. My doses of Zyprexa are mild but I have calibrated them to the daily effect of shutting down the anxiety but I do admit the Xanax could probably be improved on per your suggestion. She has been describing life threatening actions but this has been her negative self talk for years.
I will take her back to the ER tomorrow; but right now the more pressing issue is her digestive malfunction and lack of response to natural purgatives and professional colonics.
I will be taking her in to the ER tomorrow for her digestive problems based on your advice. Thank you for your help
I appreciate your concern. But spent a lot of time in far out places where there were no doctors. I'm sure your a hot shot and at the numero uno citadel of psychiatrists but I didn't exactly fall off the turnip truck. Sure you have training and I have loads of in the field experience. Remember I already took her to the emergency room and she got shuttled to an awful experience at a psychiatric clinic. I admit my experience is no trump for your training but I did see a XXXXXXX Hills Harvard trained psychiatrist monkey around with hit or mis titrations of antidepressants and anxiety suppression medications and it looked like he was pot shotting the entire therapy. So, its an art form was my conclusion. My doses of Zyprexa are mild but I have calibrated them to the daily effect of shutting down the anxiety but I do admit the Xanax could probably be improved on per your suggestion. She has been describing life threatening actions but this has been her negative self talk for years.
I will take her back to the ER tomorrow; but right now the more pressing issue is her digestive malfunction and lack of response to natural purgatives and professional colonics.
I will be taking her in to the ER tomorrow for her digestive problems based on your advice. Thank you for your help
Brief Answer:
Followup
Detailed Answer:
Good luck.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Followup
Detailed Answer:
Good luck.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
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Above answer was peer-reviewed by :
Dr. REMY KOSHY
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