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Dr. Andrew Rynne

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What causes prolonged psychotic episodes?

Answered by
Dr. Chintan Solanki


Practicing since :2007

Answered : 2406 Questions

Posted on Tue, 14 Apr 2015 in Mental Health
Question: I have a relative that over the past 20 years has had at least 8 prolonged psychotic episodes (ranging from 3 months to 1 1 /2 years). It seems it is usually triggered by prescription or illegal drugs, but honestly it is hard to tell if the psychosis or the drugs come first. After all these years we still don't know how to deal with someone who doesn't know anything is wrong with them. The counseling center and local police (one guy) won't cooperate to get him help because of "lawsuits" and the county police here are not trained in such cases. When "normal" he is bright, educated and functional. We have tried everything imaginable over the years and yet here we are in the situation again. Usually he has to get arrested before he gets better. Any advice on how to reason with someone with psychosis and who literally think they are fine?
Answered by Dr. Chintan Solanki 1 hour later
Brief Answer:
Such cases are almost diffcult to deal with

Detailed Answer:

I can understand your concern.

From history it seems that he is drug user and also having psychotic disorder. Almost 8 prolonged episodes of psychosis suggest that he is prone to psychotic disorder whether drug use is there or not it does not matter.

According to US laws it is not possible to treat such person forcefully until he is harmful to himself or someone else.

The best approach is when he in state of psychosis, record the same in video according to laws. He can be shown his condition later on and counseled that he has suffered from some psychiatric problem and he needs regular treatment.He also should be admitted in rehabilitation center for deaddiction.Continuous motivational deaddiction counseling is necessary to keep him away from drugs.While in deaddiction center reasons for drug use should be found out and same should be treated to prevent relapse of drug abuse.

When "normal" he is bright, educated and functional.In this state one should try to convince him with his medical records that he has suffered from something.

If these much has been tried and no success , it is really difficult to treat such cases.

I can help you more and may give some clue if I can have more detail history(personal,family,education,occupation,marital) with symptoms and treatment records of him.

Hope this answer is helpful, I will be happy to help further.

Dr.Chintan Solanki.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Chintan Solanki 33 hours later
Thanks! If he is prone to this will drugs like
adderal and hydrocodone cause flare ups. I
am shocked he has been prescribed these but
he has.
Answered by Dr. Chintan Solanki 13 hours later
Brief Answer:
Yes Adderall and Hydocodone may flare up

Detailed Answer:

Thanks for follow up.

Adderall is used for attention deficit disorder in adults(ADD). It is stimulant drug. It can cause psychosis even at therapeutic dose also. And person who abuse the same, chances are more to have psychosis.

Hydrocodone is an opioid. Its abuse as well as withdrawal may precipitate episode of psychosis or some of the psychotic symptoms.

So first target of treatment in his case should be deaddiction and maintenance of abstinence from drugs.

Hope I have answered your query, I will be happy to help you further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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