Extended

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From the list of medicine that was prescribed for her short vacation trial (4 days, 3 nights), I noticed that
  • there was no olanzapine during the day (i.e. only the 10mg for night)
  • sertraline was further increased to 75mg
  • clonazepam was re-introduced at 0.125mg (quarter tablet) twice a day
After discussing with my family, I took the opportunity to go back to PJ with Ban for a few days and so the following information was given mainly by my sister:

During her stay, there were a couple of times where she had the urge to hurt herself but she informed someone (I requested her to do so and briefed others) and was given an activity to do. It worked :)

On the morning of the 4th day, my sister and her husband drove my mum back to the ward. My sister managed to meet both the doctor in-charge of my mum's case at the ward, and the psychogeriatric:
  • They strongly believed that mum could continue to be at home and thus extended her vacation trial by a week.
  • Re mum's 'joyless' condition (don't laugh, hardly talk, blank look; all started only after she was on GH's medication), they said that mood stabilisers help in handling the voices, extreme depression/mania etc but (understandably) cannot induce "happiness". Normally, happiness will slowly seep in for most patients, indicated by better appetite, better sleep, smiling at jokes etc, but this joyless period will be long though :(
  • They determined that the current olanzapine dosage is the maximum for my mum because when it was increased, her restlessness increased a lot.
  • If the voice persists, they may substitute olanzapine with lithium.
Unfortunately, the next day, she hurt herself and when we tried to persuade her to go back to the ward, she tried to strangle herself :( After discussing with me, my sister gave my mum two halves, with about an hour gap or so in between, of a tablet of lorazepam, a medicine that was on her prescription for her first vacation trial period but was taken out last minute.

She didn't want to go to the ward. It was a huge effort for my dad, my sister and her maid to partly persuade and partly force my mum into the car. "70% forced, 30% self-willed", paraphrasing my sister's comment. During the journey to the ward, she attempted to open the door three times and succeeded in one of them.

Thank goodness she had more or less calmed down just before reaching the ward. Later, a nurse informed my family that the doctors will attend to my mum the next day and that my sister could attempt to consult them during visiting hours.

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