My son was experiencing extreme paranoia and delusions in mid-June and not sleeping at all -- not even for a few minutes each night.
Pdoc decided that his anti-depressants (depression/anxiety/insomnia) had stopped working for him (dosage had been increasing steadily over the last few months) -- he switched him from remeron (30 mg/day) to seroquel (we went from 300 mg a day to 800 mg a day with it tranquilizing him but not having any effect on the paranoia/delusions) to zyprexa (15 mg/day) which worked.

They left him on the zoloft -- but when the paranoia went, he was almost suicidally depressed. They changed the zolft to prozac (20 mg/day). After a few days, his moods lifted. He wasn't exactly happy, but he wasn't suicidal. He was making an effort to actually do some things -- to get some exercise and work on his art projects.

So, he's been on zyprexa for about 4 weeks & the prozac will be about 3 weeks tomorrow.
At first, it was like he was sleeping too much.
Over the past week, he's started having sleep problems again, is more depressed, and I can see the delusional thinking coming back.
At times, he's very restless & paces a lot.
No where near as bad as it was to start, but I see it coming back.

On Tuesday night, I gave him 10 mg of zyprexa around 9:00 PM. He tried to sleep some -- he was still up & doing things after 11:00 when I went to bed -- but mostly tossed & turned -- he was wide awake when I got up at 6:30 AM but trying to sleep. I gave him his morning 5 mg of zyprexa and the prozac. He passed out around 9:00 AM and slept until 2:30 PM.

Pdoc said to up his nighttime dose to 15 mg -- making his daily total 20 mg of zyprexa.
So after the long story, here's my question -- has anyone on here for any reason taken that much zyprexa?
I've seen some posts where people started at 5 mg and had to back down to 2 1/2 mg.

Everything that works for him just seems to stop working for him right when he's actually showing some improvement.
It's very frustrating -- and if you couldn't tell, I'm a little (or maybe more than a little) scared.
I try not to over-react -- but I'm also trying to head things off before he gets to a paranoid state where he thinks people are coming to kill him
I'm also very afraid that this is something worse than depression or anxiety -- that he actually has a psychotic illness.
I'm also afraid that that knowledge that I have this fear will either make me read too much into it or to ignore something to over-compensate.
oh h---, I'm just afraid.

Any thoughts on anything -- even if you don't have experience with the drug, but want to comment on how crazy I am or what you think of his condition -- would be appreciated.

Thanks for reading if you made it through everything.

I took Zyprexa for about a year. Started on 10mg for a severe manic attack. It helped greatly with my broken sleep patterns. The pdoc slowly reduced the dose to a 2.5mg maintenance with the allowance that it could be increased if a manic episode occurred. 20mg is a fairly high dose, but I met a few people in the hospital who were at that dose or higher. If it's no longer effective for your son's sleep, a consult with his pdoc may be in order for a different medication.
Sheepwoman

Thanks -- I only increased after a phone consult -- if things aren't better by Friday, we will go to the dr's office and he'll work us in.

I'm not sure if it's a timing thing or what -- he had a friend over last night. I wish it was a different night, but it's his only real friend and they only see each other once every week or two and I hated to say no. I gave him his zyprexa at about 9:40 PM and they were still up at 2:30. Next time I woke at 3:45, they were both asleep -- and they're both still sleeping right now -- almost noon.

Sometimes it just takes so long to kick in. At first, it worked quick -- and then it took longer & longer. At first, he slept too much -- then not enough.
I don't want him to sleep all the time and be all drugged up -- but I don't want him to be delusional either.

Yesterday he was talking about being evil. And a few times about how he was really a Russian cosmonaut -- he couldn't even tell me where he got that idea from -- we're from a US lineage that could be almost anything, but I know everything back to before 1900 -- we are mostly English, Irish, German, & American Indian. When he was delusional before, he decided he was an Indian Chief. He doesn't completely lose site of his own identity, it's like it's an extra fantasy kind of thing.

I just keep trying to understand (for the past couple of years) whether the lack of sleep from the anxiety start all of this?
Or does the oncoming paranoia/delusions stop him from sleeping?
I know that one of the problems with alzheimer's patients is that they stop sleeping very much -- but we all stop sleeping as much as we age.
Basically, do mental illness's prevent the sleep or does lack of sleep cause the mental illness?
As background, he's never slept much -- even as an infant, he would stay awake & alert for 8 to 10 hours at a time when he was only supposed to be awake for around 4 hours. My husband doesn't require a lot of sleep either, so I never gave it a second thought then -- but now I wonder.

Sorry -- all off topic and more than anyone probably wants to hear.
Writing it all out though helps me organize my thoughts and I'll go back & read again before we go to the pdoc.
Thanks again for reading and answering.