Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Extrapyramidal Symptoms From Taking Elicia And Aripiprazole
Question: My husband is a Petroleum Engineer by profession.He was diagnosed paranoid schizophrenia in 2008.
He has ASTHMA too and takes seroflo 250 (by rotahaler)
He got better until july 2014 and had an episode of psychosis.he was experiencing catatonia every evening during last summer.
He was on Olimelt 7.5 and bexol.
After his last relapse he was prescribed bexol dt,etilaam 0.5 and arip mt 30
Next month arip mt 20 and solzam 10
He got very aggressive after taking solzam and even tried to eat harpic.He is a very soft hearted person and never tried to harm himself earlier.Fortunately i could save him.and he became unconscious after that.
After continuing the same medicine he started experiencing catatonia just after he would return.he usually drives to work and return.
This was scary.I stopped giving solzam anymore and he didnot experience catatonia since then.
Then his doctor added Elicia 4 mg.
Elicia helped him reduce his aggression but suddenly he got this.. His lower jaws starts moving and eyes blinking involuntarily.
He is also experiencing agoraphobia and akathisia.
Plz help.
He has ASTHMA too and takes seroflo 250 (by rotahaler)
He got better until july 2014 and had an episode of psychosis.he was experiencing catatonia every evening during last summer.
He was on Olimelt 7.5 and bexol.
After his last relapse he was prescribed bexol dt,etilaam 0.5 and arip mt 30
Next month arip mt 20 and solzam 10
He got very aggressive after taking solzam and even tried to eat harpic.He is a very soft hearted person and never tried to harm himself earlier.Fortunately i could save him.and he became unconscious after that.
After continuing the same medicine he started experiencing catatonia just after he would return.he usually drives to work and return.
This was scary.I stopped giving solzam anymore and he didnot experience catatonia since then.
Then his doctor added Elicia 4 mg.
Elicia helped him reduce his aggression but suddenly he got this.. His lower jaws starts moving and eyes blinking involuntarily.
He is also experiencing agoraphobia and akathisia.
Plz help.
Brief Answer:
Dose of bexol should be increased,inderal can be added,shift back to olimelt
Detailed Answer:
Hello,
Thanks for writing to us.
I appreciate your feelings and care for your husband.
From your narration it seems that your husband is suffering from extrapyramidal symptoms(EPS) likely. They are side effects of anti psychotic medicines(elicia and aripiprazole).
His lower jaw movements and eyes blinking are dystonia, part of EPS.
Akathisia is likely side effect of aripiprazole.It should be stopped in my opinion.
Bexol dose should be increased up to 8 mg to treat EPS as well as akathasia.
Propranolol (inderal) will be more useful to treat akathisia.(note: propranolol can worsen asthma so it must be given for short duration with permission of doctor treating his asthma and deciding risk benefit ratio of propranolol use)
I don't understand why he was given solzam, but it can cause side effects like agitation and catatonia.You have done right thing by stopping it.
If I were his treating doctor, I would like to restart olimelt in this psychotic episode.Guideline says that if any molecule was effective in past in some patient, same should be given in recurrent episode.Olimelt is well tolerated by him in past and it has the least chances of causing EPS or akathisia.
Discuss above aspects with his treating doctor and change the medicines accordingly as doctor suggets.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Dose of bexol should be increased,inderal can be added,shift back to olimelt
Detailed Answer:
Hello,
Thanks for writing to us.
I appreciate your feelings and care for your husband.
From your narration it seems that your husband is suffering from extrapyramidal symptoms(EPS) likely. They are side effects of anti psychotic medicines(elicia and aripiprazole).
His lower jaw movements and eyes blinking are dystonia, part of EPS.
Akathisia is likely side effect of aripiprazole.It should be stopped in my opinion.
Bexol dose should be increased up to 8 mg to treat EPS as well as akathasia.
Propranolol (inderal) will be more useful to treat akathisia.(note: propranolol can worsen asthma so it must be given for short duration with permission of doctor treating his asthma and deciding risk benefit ratio of propranolol use)
I don't understand why he was given solzam, but it can cause side effects like agitation and catatonia.You have done right thing by stopping it.
If I were his treating doctor, I would like to restart olimelt in this psychotic episode.Guideline says that if any molecule was effective in past in some patient, same should be given in recurrent episode.Olimelt is well tolerated by him in past and it has the least chances of causing EPS or akathisia.
Discuss above aspects with his treating doctor and change the medicines accordingly as doctor suggets.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank You Doctor,
Just after an hour i posted this question today one of his collegue informed that my husband experienced catatonia and has been taken to hospital He is at home now .
He was attending a official function .things he is not comfortable with these days.
He is ok now.
Can any food like cauliflower and mushroom trigger catatonia?due to gastric problem?as we have observed this before as well.
Doctor with olimelt he was good but used to drool sometimes.he often had delusions and sometimes highly aggressive too.He wouldnt talk to anyone simply stop eating,refuse medicine sometimes.his weight had increased had breathing difficulties.
He isnt getting any voices or hallucination with arip mt and elicia brought down his aggresiveness.
He feels comfortable at home.
I will be stopping arip mt .
Will it be ok to continue with Elicia only with bexol. It gives him a good sleep too.also prescribe dosage for inderal too.
Just after an hour i posted this question today one of his collegue informed that my husband experienced catatonia and has been taken to hospital He is at home now .
He was attending a official function .things he is not comfortable with these days.
He is ok now.
Can any food like cauliflower and mushroom trigger catatonia?due to gastric problem?as we have observed this before as well.
Doctor with olimelt he was good but used to drool sometimes.he often had delusions and sometimes highly aggressive too.He wouldnt talk to anyone simply stop eating,refuse medicine sometimes.his weight had increased had breathing difficulties.
He isnt getting any voices or hallucination with arip mt and elicia brought down his aggresiveness.
He feels comfortable at home.
I will be stopping arip mt .
Will it be ok to continue with Elicia only with bexol. It gives him a good sleep too.also prescribe dosage for inderal too.
Brief Answer:
Yes it will be ok to go with elicia and bexol, inform your treating doctor
Detailed Answer:
Thanks for writing back.
From your description from this as well as previous query it seems that your occupation is related to medical field or you might have learnt a lot about psychiatric symptoms on your own.
I just request you to clarify what do you mean by, "catatonia"? As this can occur in many psychiatric and neurological conditions and presentation may differ case to case.
I do not think that any food substance can cause/trigger catatonia. It may be an autoimmune response to food product. It means an allergic type of reaction.
Yes, olimelt can cause metabolic and other side effects you have mentioned.
Hallucination as well as aggressiveness both can be controlled by Elicia. But dose of Bexol should be increased as he has EPS at present. Please ask your doctor to change dose as per severity of symptoms.
You want to stop Arip for akathisia and start propranolol that is good.
But please understand that any change in treatment must be informed to the treating doctor in such case. If any urgent need arises, your treating doctor can help you immediately.
About Inderal, I have already mentioned that it should be used under medical supervision. You can call or meet his treating doctor and then can change treatment medicines and get prescription.
Hope this answers your query, I will be glad to answer more.
Yes it will be ok to go with elicia and bexol, inform your treating doctor
Detailed Answer:
Thanks for writing back.
From your description from this as well as previous query it seems that your occupation is related to medical field or you might have learnt a lot about psychiatric symptoms on your own.
I just request you to clarify what do you mean by, "catatonia"? As this can occur in many psychiatric and neurological conditions and presentation may differ case to case.
I do not think that any food substance can cause/trigger catatonia. It may be an autoimmune response to food product. It means an allergic type of reaction.
Yes, olimelt can cause metabolic and other side effects you have mentioned.
Hallucination as well as aggressiveness both can be controlled by Elicia. But dose of Bexol should be increased as he has EPS at present. Please ask your doctor to change dose as per severity of symptoms.
You want to stop Arip for akathisia and start propranolol that is good.
But please understand that any change in treatment must be informed to the treating doctor in such case. If any urgent need arises, your treating doctor can help you immediately.
About Inderal, I have already mentioned that it should be used under medical supervision. You can call or meet his treating doctor and then can change treatment medicines and get prescription.
Hope this answers your query, I will be glad to answer more.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
