Starting Antabuse

I started antabuse the other night and have been sober ever since of course.  Starting this drug is naturally a huge deal.  I went into it thinking I could go off and on it so I could drink on special occasions but that won’t be happening.  By taking this you commit to at least six months of sobriety.  Most scripts last three months, this one lasts a year.

The potential side effects of this drug are so serious that my doctor made me sign a contract stating that she had explained the seriousness of it all to me.  So what are these potential side effects?

According to DailyMed,

“Disulfiram plus alcohol, even small amounts, produce flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, marked uneasiness, weakness, vertigo, blurred vision, and confusion. In severe reactions there may be respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death

 

So.  This drug can kill you.

All the websites I’ve looked at recommend not taking it less than 12 hours after drinking but my doctor said 48.  She also said if I wanted to stop taking it it would be a week before I would be safe to drink but I found some websites that said two.  If and when I do decide to go off it I will wait two weeks just to be safe.

I received the script on Thursday but, as I had been drinking the night before I was unable to start that night.  The pharmacy I go to for my scripts is a bit of a drive away so I wanted to make sure they had it before I went and got it.  When I was talking to my psychologist about going on it she told me that antabuse is fairly rare and they probably wouldn’t have it sitting on their shelves.  So I figured I could call them that day, and if they didn’t have it, I could get them to order it in by the time I was headed that way the next day, and could start it that night.

I called them, and they did in fact have it.  They said they would reserve it for me, not something I was aware I could do at the pharmacy.  Clearly there are a few problem drinkers in that area.

When I went to pick up the antabuse the pharmacist said “now I don’t know if you’ve been warned but if you drink on this you’ll get all the effects of a hangover without the fun part beforehand.”  Well that sounds positively tame compared to what I found above doesn’t it?  I told him I understood and I paid for it.  And oh my god it was expensive – $79.99 for…I’m not sure how much is in there actually.  It’s either one months’ worth or three months’ worth.  So it’s not on the PBS.  Pea thinks that’s because the government wants to make up all the alcohol tax they’re losing from the sober problem drinkers.

I started taking it that night, with my nightly seroquel.  Pea thought it would be funny to lick one of my tablets then have a beer.  I was a bit worried about him, but he had no bad effects come of that.

I’ve been taking it for three days now and I feel fine.  I do have a morbid curiosity every time Pea opens a beer wondering if I should take a sip just to see what happens.  But I’ve been told by enough people that would be a bad idea – mum tells me I will want to die.  My psychologist told me about one of her patients who started drinking on antabuse and after only one beer was so violently ill he need to go to hospital by ambulance.

I’m aware that I haven’t talked much about my problematic drinking on this blog (they don’t like to label people as alcoholics anymore) and that’s mainly because I don’t know what to say.  I don’t know when and how it started, I don’t know why I do it and I don’t know how this will affect me long term.  Being in hospital didn’t help, it just dried me out for a little while then I was back at it again.

I had a blood test yesterday to make sure I haven’t damaged myself with all this irresponsible drinking.  I had one in hospital and I was fine but I’ve been doing it heavy since then.  I won’t find out the results until later this week.

Not drinking for five days hasn’t caused me significant distress, ok I cried the first day but only because I had a crutch and now it has been taken away.  I wasn’t experiencing any dependency symptoms apart from that withdrawal episode I had last Tuesday but nothing like that has happened since then.  Antabuse is a prick of a way to get sober because the control is taken away from you.

But I was out of control before.

 

Mac

The Strange Episode Explained

So I went to my doctor yesterday.  Dad was meant to come with me but he was late because he went to the old address that he has in his address book at work.  Which is funny because my psychiatrist has been there for six years but oh well.

After my episode on Tuesday night, Dad sent my doctor a fax detailing what had happened, concluding with the statement that, in his professional opinion as a doctor, I was on too much seroquel.

She asked me if I was still drinking a lot and I said I was.  She said that, in her opinion as a psychiatrist who has dealt with many problem drinkers on seroquel before, my Dad’s conclusion was incorrect.  What he described, she said, sounded like delirium brought on by alcohol withdrawal, compounded by seroquel on top.

I’m on 50mg of seroquel at night.  By accidentally doubling it I had taken 100.  That is a lot for me but, as she explained, not a high dose of sedatives at all.  That alone wouldn’t account for the sleepwalking.

She asked me I if was getting any other symptoms of alcohol dependence like shaking. I said I wasn’t, but that I felt anxious on days where I wasn’t drinking.  And when I do drink, I can’t stop at one.  So I thought that I would have to so something that I have been putting off but now I feel like I’m out of options – go on antabuse, the drug that makes you violently ill when you drink.  She said that if I’m going to do that we need to talk to Dad about it because to take a step like that you need family support.

At which point my Dad entered, apologising profusely for being late.  She reiterated what she had told me about her diagnosis of my episode.  He shot an accusatory look at me and asked if that meant I had been drinking at home.  She said no, I was experiencing withdrawals from drinking heavily at Pea’s place the night before.

We talked to Dad about me going on antabuse and he was a little taken aback but agreed that I needed to take that step to stay sober.  She said that taking this drug meant that I was committing to six months of sobriety, and laid out the facts – I can’t start it until 48 hours after my last drink, and I can’t start drinking until 7 days after to stop it.  And if I do drink while on it, the effects are life threatening.

Because taking this drug is such a big commitment she made me sign a contract stating that I understood the nature of this drug and the ramifications of drinking on it.  That’s a new one – never had to sign anything for any of my meds.

My doctor ended the appointment by telling me to come back in three weeks and telling me that if anything goes wrong, she could get me in that day if need be.  She thanked my Dad for his involvement and told me I was welcome to bring any of my family members to my appointments, including my mum (I’m not sure I’m ready for that.)

Afterwards Dad and I went for lunch at the pub on the corner of the street my psychiatrist’s office is on and I had the most amazing burger (huge beef patty, crispy bacon, American cheese, onion rings, pickles, barbecue sauce and ranch dressing.)  Dad was joking that I should have one last drink but I wanted to start antabuse the next night.  I couldn’t start it that night as I had been drinking the night before.

Well, that’s all for now.  I will be back to talk about my experiences when I start taking the antabuse.

 

Mac

A Strange Episode

I woke up this morning to the familiar sound of my fan humming but something didn’t feel right.  I opened my eyes and sat to see that I was in fact in my sister’s room, in her little single bed, not my own.  I can’t remember how I got here.  Ominous.

My dad came in.  “oh you’re awake.  Do you remember what happened last night?”

“no…”

“I think you’re on too much seroquel.  I want to go with you to your doctor’s appointment tomorrow to talk about this.”

He left me, still feeling confused and I went into my room.  The sheets had been stripped off the bed and there was a towel on the floor.  I went to take my tablets…and found that was impossible because my whole medication drawer was missing.  Someone had taken it right out of the cabinet.

The presence of the kitchen scissors on top of the cabinet gave me pause for thought.  I used these scissors to cut my seroquel, but I remembered putting them away.  Yet I got them out again.  It looks like I might have accidentally taken a double dose of seroquel.

I went downstairs and found mum with my medication drawer sitting on the kitchen bench.  She told me what happened last night from her perspective.

Mum and dad got home to find me trying to get out of my bed room but the wardrobe doorknob was jammed under the door handle so my door wouldn’t open.  My dad fixed the door from the other side and opened it to see why I was unable to do it myself and realised that I was…not awake.  Mum said “Mac, go sit on the bed”  Which I apparently did, then Mum noticed where I was standing there was a puddle.  Of urine.  I pissed myself and now I was sitting on the bed in my wet pjs.

Due to all this activity in my room I started to wake up, but I was groggy and not talking sense.  Mum found some dry pjs and sent me into the bathroom to get changed which I did.  They decided to put me to sleep in my sisters room.  As they were taking me in there, Dad said something about me being on too much seroquel and I said “oh I need to go take my seroquel” to which they both said NO!

Mum took the medication drawer because she reached the same conclusion as I had; that I had taken and accidental overdose.  She wants to keep my meds with her until they can fix me up with a Webster pack or something.

I’m not sure why but I’m surprised my parents aren’t mad at me for peeing on the floor.  I guess it wasn’t really my fault – well it kind of was, if I was more on top of my medications that wouldn’t have happened.  But still, I’m a little old to be wetting myself.  I guess what I’m feeling is embarrassment.

I will see my doctor tomorrow and Dad is either going to come with me or write a note, he hasn’t decided yet.  I’m hoping he isn’t going to try and convince her to take me off it because apart from this episode I have been sleeping well on it.

I will be back tomorrow with more.

Mac

Seroquel Update

So I’ve been on seroquel for a couple of weeks now and this is what I’ve noticed.

The main thing I was worried about was increased appetite and weight gain but to counteract that we increased my Topamax to 50mg twice a day.  That seems to have worked to a point.  Most times of the day I don’t feel increased hunger but at meal times I find I’m feeling less satisfied after I eat.  I just use some CBT and tell myself that I won’t feel satisfied no matter how much I eat and the urge passes after a while.  So far I haven’t gained any weight, even though it’s been only two weeks.

I’ve taken seroquel before and it knocked me for six every time.  I would be out straight away and wake up groggy fourteen hours later and this was just on 25mg.  I’m taking 50 now, and it takes me a little while to get to sleep and I tend to sleep for eleven hours without much hangover effect.

Normally I take my regular tablets at about six thirty like I was before and take the seroquel at eight thirty and get into bed straight after.  The first few days on it I was on my phone in bed then I had a night where I didn’t sleep at all despite taking it so I had to come to terms with the fact that I had some shitty sleep hygiene so now I just get into bed and turn the lights off without doing anything to stimulate myself

It seems that 50mg is a good dose of seroquel for me, and I seem to be getting rest on it for now.  I only hope this lasts.

I Need Some Sleep

I’ve just been to see my doctor and we’ve made some major changes because I’ve stopped sleeping.  After all the trouble we went through to get me onto zeldox I hoped that regime would have lasted longer but nope.

The whole thing started last Monday when I had a follow up appointment with my inpatient psychiatrist at the hospital but I showed up having not slept at all the night before.  I explained to her that I took my PRN temazepam and it didn’t work so she got me some seroquel from the hospital pharmacy and told me to take that.  I did, and it worked after a couple of hours.

I showed up at my psychiatrist’s office and she said she had received a letter from the hospital doctor detailing my sleeping troubles.  I told her what had been happening – my sleeping had been varied, but generally I’ve been getting to bed late, or waking up at midnight and not being able to get back to sleep.  I feel that my mood is suffering because of it.

She told me what I had been dreading, that we had to start regular seroquel again.  I had really been wanting to avoid this because I gained so much weight on it last time I was taking it, plus previously I;ve been super sensitive to it and it has knocked me out for about sixteen hours at a time.

She said that weight gain on seroquel was not a guarantee; just because I might get an increased appetite doesn’t mean I have to give into it.  But to try and assist me she raised my topamax from 50mg a day to 100mg because of its appetite suppressant properties.

She also reduced my zeldox from 160mg to 80mg and ceased my valdoxan.  The only reason I was on so much zeldox was to sleep and it wasn’t working but I still need some for my anxiety.  Valdoxan, the melatonin tablet was originally prescribed when I wasn’t on any antipsychotic but starting on lamotrigine caused me to stop sleeping.  That clearly isn’t doing its job, and may be contributing to some bipolar symptoms so it had to go.  And considering it isn’t on the PBS and was costing me sixty-five dollars every month, I can’t say I’m sad to see it go.

She told me to come back in two weeks instead of my usual six to update her on how the sleep situation is going.  If I’m still not sleeping on 50mg of seroquel, she said we will have to consider hospital again.

I will post again in a few days to update on how I’m going on seroquel.

 

Mac

Mental Illness and Metabolic Syndrome

So as I have documented on this blog I was in hospital recently.  While I was there I made use of the hospital dietitian’s information groups because I had been neglecting that facet of my health recently by drinking instead of eating (bad Mac.)

In one of these groups the dietitian said something that I found interesting; that having a mental illness is a risk factor for developing metabolic syndrome.  He didn’t go into too much detail on how you get that or what it entails, the general understanding being that it happens when you neglect yourself.

I had heard of metabolic syndrome before thrown around as a cautionary tale as a result of a shitty lifestyle.  But I had never heard the mental health angle so I decided to do a bit of investigating to see a) what it is b) what the risk factors actually are and c) whether I am at risk.

Metabolic syndrome seems to be not related directly to your actual metabolism, but rather a collection of risk factors to developing lifestyle disease such as high blood pressure, large waist circumference, high cholesterol and high blood sugars.  Apparently around 35% of Australian adults have it, which I found surprising and a bit alarming.

The causes aren’t known but being overweight and inactive are risk factors.  This has me thinking I might not be a high risk case – I’m not overweight and pretty active, but that could change as I get older.

I found a few different figures for metabolic syndrome in people with a mental illness.  One website said 50% of people with a mental illness will have it, while this article said that in a case study the prevalence was found to be 54%, but people with bipolar disorder had a higher rate of 67% (oh crap) followed by people with schizophrenia at 51%.

The article goes on to say that while the prevalence of metabolic syndrome in patients with schizophrenia has been researched it hasn’t really been in other psychiatric disorders, so those numbers for bipolar disorder might not hold too much weight.

It does make sense; there is a relationship between mental illness and obesity plus other cardiac health risk factors such as smoking and drinking.  In my stays at the hospital I’ve observed that compared to the rest of the population, a much higher proportion of patients smoke, and a much higher proportion of patients are obese.

So where does that leave me?  As I said I am not obese.  I exercise through sport and running.  On the surface it would seem that I am not a huge risk factor but I don’t eat the best and I still drink a bit too much.  These things can and will affect my heart if I don’t reign them in.

So I guess the moral of the story is take care of yourself.  Even when you don’t feel like it.  Even when it feels too hard.  It’s easy to push your health to the back of your mind but developing a serious lifestyle disease is not the wake up call you want to have.

Mac

I Can’t Do Funerals

I went to a funeral for an acquaintance from my sports club this week.  It was a brief, tasteful service followed by lunch at the local RSL.  All of us from the club came wearing our jerseys.  I think his family would say the day went well.

Except I was a mess throughout the whole thing.  There weren’t enough seats available so I stood up the back with Pea and spent the service trying not to break down, wiping tears away on my jersey.  At one point in the service everyone took turns to place a rose petal on his coffin.  When it was my turn I went up with my head down because I was embarrassed at being so upset.  Our friend had more to do with Pea than me and he wasn’t crying.

I’m like this at every funeral I go to.  It doesn’t matter who it’s for, how well I know them – not at all in some cases – funerals turn me into a mess.  I get upset then try to hide my being upset because I worry that people will think I’m being inappropriate crying over someone I didn’t know very well.  And if I do know them well I still question the appropriateness of my grief.

As a person on the spectrum no event makes me question my behaviour more than a funeral.  Am I grieving too much?  What do I wear?  Do I talk to the family or do they want to be left alone?  Should I even be at this funeral?  Did I have enough to do with him to earn a place here?

I’ve got to remember that death and everything around it is awkward for literally everyone.  When I went to this funeral no-one said I shouldn’t be there.  Several people in fact said they were happy to see me.  And as we had lunch at the RSL exchanging stories and memories a sad day turned into a good one.

After all, nothing brings people together like a funeral.