Major Depressive Disorder Severe With Psychotic Features

Question:

My daughter is in detention, and to my surprise they diagnosed her with major depressive disorder severe with psychotic features, audio and visual hallucinations, and anxiety disorder. They have her on 6 meds and when I visit her she seems so sedated and her eyelids are partially closed, but they tell me she’s not over medicated. The meds they are giving her are: Prozac 80 mg, Paxil 40 mg, Celexa 10 mg, Geodon 60 mg, Trazidone 400 mg, and Vistaril 200 mg. Her appetite ahs increased and she is gaining weight, as well as sleeping a lot. Is this combination of meds safe for her? Would it be harmful if she quit taking these meds? She stays so drowsy and is not functioning on all these meds. Prior to this detention she was on mental health meds, Clonazepam 1 mg, Seroquel 400 mg, and Effexor 150 mg.

This Disclaimer applies to the Answer Below
  • Dr. Schwartz responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
  • Dr. Schwartz intends his responses to provide general educational information to the readership of this website; answers should not be understood to be specific advice intended for any particular individual(s).
  • Questions submitted to this column are not guaranteed to receive responses.
  • No correspondence takes place.
  • No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Schwartz to people submitting questions.
  • Dr. Schwartz, Mental Help Net and CenterSite, LLC make no warranties, express or implied, about the information presented in this column. Dr. Schwartz and Mental Help Net disclaim any and all merchantability or warranty of fitness for a particular purpose or liability in connection with the use or misuse of this service.
  • Always consult with your psychotherapist, physician, or psychiatrist first before changing any aspect of your treatment regimen. Do not stop your medication or change the dose of your medication without first consulting with your physician.
Answer:

Usually the word "detention" refers to some type of jail. However, I am assuming that your daughter is hospitalized for her illness.

Anyway, I want to urge you to speak with her doctors about her treatment. They are the professionals who are in charge of her case and her treatment. They can answer all of your questions as well as provide reassurance for you. The only thing I can say is that each of the medications you refer to has a specific purpose. Ask the doctors about what each medicine does. In fact the psychiatric hospitals or the hospitals with psychiatric wards are always keenly interested in working with concerned parents. They want to see parental and family involvement.

Besides the psychiatrists assigned to your daughter’s case, there is also a social worker whose job it is to work with you and your daughter. The work of the social worker has several purposes in that setting. The purposes range from being a liason or communication network between doctors, who cannot always be easily available, and parents and patient all the way to helping patient and family prepare for a discharge program that will enable everyone adjust to post hospital life. Post hospital life can be stressful for all involved.

I will say that a severe case of Major Depression with Psychotic Features is very serious and not to be taken lightly. That is why the discharge plan for your daughter will be extremely important. In fact, I would guess that a meeting with the patient and the entire family will be called for to do an efficient type of planning. I am certain that your daughter will continue to need a lot of treatment and support when she is discharged.

I know that this is a very difficult time for you and your family. Please use the professional support systems available to all of you at the hospital. Speak to her Psychiatrists and meet with the social worker. Learn all you can from them about this illness and the medications.

I want to wish you, your daughter and your family the very best of luck.

More "Ask Dr. Schwartz" View Columnists