psychosis

[22cyclist]

Thanks to everyone who read my suicidal thoughts post. This post is somewhat like that, but about how I did post hospitalization.

First, they never admitted me to a mental hospital because I have a port-a-cath. I don't know what that was all about, it was not accessed. Who was crazy?

So apparently the first night at home, my husband went to Temple for the Jewish Holiday, and left me on my own. Well when he came home, he found me in the driveway at 10:30 at night in the rain. I had on my PJs, my pocketbook and both of the remotes for the TV. I was bound for the car I guess, but luckily I had no key. However that meant I had no key to get into the house.

I had no idea how I got there, don't remember shoving the remotes in my pocketbook or anything else. I do remember him coming home because he was yelling at me. Then stopped once he realized I had no idea where I was.

I drifted in and out of this psychosis for a couple of days before he could get me an appointment with my PCP (the Psychiatrist wouldn't see me because she wasn't accepting new patients.

So finally I get to my PCP and he looks at my new couple of medications, which were Remeron (depression) and Cogentin (muscle spasms) and thought that sense one alone can cause psychosis, and both could, that we should stop the cogentin and go with just the Remeron.

So hopefully there will be no more psychosis of any sort (MS induced or medication induced).

Shew...I am tired just thinking about it. Just wanted to put it out there that psychosis can come from many things. I had it twice in the same week with different causes.

Thanks for everyone's support!

Lisa

[Mamabug]

Oh Lisa. I'm so sorry.

When I'm in flares, I used to regularly experience mania, and sometimes pyschosis. Thankfully, the current MS med that I'm on gives me enough time, after early symptoms of mania begin, to get them under control before they become unmanageable.

I think that it's important for others to know that we, as members, don't always have it all together. And, even as moderators, we don't always have it all together.

We're all just dealing with this MonSter, as best we can, day by day.

~ Faith

[Seasha]

I think that it's important for others to know that we, as members, don't always have it all together. And, even as moderators, we don't always have it all together.

We're all just dealing with this MonSter, as best we can, day by day.

~ Faith

Lisa - I am so glad you are feeling much better and you got into see your PCP. Your experience sounded scary and I hope that once and for all, it is history! You were missed

And Faith - Amen to this! Day by day, things can change. For the better or for worse. We all are wonderful support for one another.

[Tia1]

Wow! What an awful experience! Have they done a complete work-up to make sure that they are not missing any other causes?

Thank you for keeping us updated. I am praying for you.

[Jules A]

If it makes you feel any better it would be more accurately described as delirium secondary to adverse medication reaction not psychosis. Cogentin can cause anticholinergic crisis especially in older people which can result in confusion and agitation. I'm surprised you were on that for muscle spasms its normally given for EPS. In any event, as I'm sure you have, I would get basic labs done just to ensure your liver and kidneys are clearing meds appropriately because that can definitely cause delirium also.

In general most inpatient psychiatric units will not take a patient with delirium unless in the context of intentional overdose or withdrawal and in those cases the patient is often cleared on a medical unit before they are transferred to psych. In those cases there was an underlying psychiatric issue present prior to the delirium which in your case was not so it would have actually done you a disservice to have you admitted on an inpatient unit.

Many are unable to take patients with major medical issues or any indwelling type appliance secondary to infection risk and/or safety risk of tubes/lines. Again generally speaking but most inpatient psych units are unable to do any kind of isolation precautions so there is no way I'd want someone there with direct access like your port-a-cath. Contact precautions are a joke on most psych floors.

Glad you are better.

[hunterd]

just happy that you are ok. if you need any time to yourself please take it. we only want whats best for you! we all love you and are here for you!!

[Kimba22]

Lisa,

I'm sorry to hear this happened. But, glad you didn't have your keys so you didn't drive away in your car! I can't imagine what your husband must've thought seeing you just sitting in the rain. I'm also sorry you had to spend more days drifting in and out of psychosis until you saw your PCP.

Mamabug, thanks for sharing with us. It can be hard to talk about some of these emotional changes, even with our doctors. I remember the psychiatrist I saw after my bout with severe depression explained various emotional changes can happen with MS because of damage being caused by our lesions.

Jules A, thanks for your input. When I had psychosis a few years ago (I was pretty sick with 3 different infections), no one could understand why I wasn't taken to the psychiatric floor. Besides being treated with IV antibiotics, I also had a port (that was eroding through my skin. ).

Lisa, I hope this was the LAST of such a scary symptom. We missed you and are glad you are doing better.

Hugs,

[22cyclist]

Thank you everyone. They did do a basic metabolic panel and checked my vitamin levels, and my medication levels.
I really didn't have the psychosis until the the night after I was released.

My PCP had me stop the cogentin, which I am taking for constant tongue movement that was caused by taking Seroquel for sleep for a while but stopped it over 1 year ago. It left me with the tongue movement that was constant. So the PCP told me to cut the Remeron in half for one week, if there is no psychosis, then go up to the whole pill for the next week. After I am stable on that, he will put me back on the Cogentin. He also is referring me to a Psychiatrist since the one in the hospital who told me she would follow me after discharge now has decided can't see me. Her staff told me I needed to find a new Psychiatrist.

Anyway, I feel better now. No more seeing things that are not real. Plus, I can think again, so good news.

I appreciate all of you!

Lisa

[Cat Mom]

How terrifying but thank you for sharing this experience with us. Glad you're doing much better!

[Jules A]

I'm surprised your PCP is prescribing all these psychotropic meds especially because although it can assist with sleep Seroquel is an antipsychotic. Although everyone is different, it would be rare, imo, for Remeron at a recommended dose to cause delirium especially because it is one that is often used in geriatric patients.

There are other medications that could be considered for movement disorders that might not be as deliriogenic for you as cogentin. I'm glad that you are finally getting to an actual psychiatrist. Best of luck to you.

[22cyclist]

Yeah Jules A., He didn't think it was the remeron causing the delirium, but more the two drugs together at their prescribed doses. I will talk to the Psychiatrist about the Cogentin before I start back on it.

Also, to be clear, my port was not accessed so still not sure why they were worried about that as it doesn't stick out of my skin, its implanted.

Thanks
Lisa

[Jules A]

Yeah Jules A., He didn't think it was the remeron causing the delirium, but more the two drugs together at their prescribed doses. I will talk to the Psychiatrist about the Cogentin before I start back on it.

Also, to be clear, my port was not accessed so still not sure why they were worried about that as it doesn't stick out of my skin, its implanted.

Thanks
Lisa

Interesting about your port because I was picturing something with outside access, maybe they understood also?

In any event a patient with delirium is not a candidate for a psychiatric hospitalization because it isn't a mental health issue it is a medical issue.

The good news is that once the source of delirium is addressed, often times a UTI, the patient clears and is back at their baseline.