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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
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Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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My son suffered several months of very very low blood sugar

Resolved Question:

My son suffered several months of very very low blood sugar and even a few seizure episodes. After we discovered his pump was doubling the insulin dose, leaving him exceptionally low for extended periods of time, he then became at times very anxious and even almost delusional with times of extreme paranoia. When we finally figured out what was happening he was treated and currently takes a dose of 5mg of Haldol. This has been extremely helpful at night. He sleeps very well and looks normal and rested in morning. However, he can hear conversations in his head that he is completely aware that is not real. He is a young adult and does see someone for the anxiety and prescriptions to help with anxiety and the noise in his head. However, the Haldol seems to wear off around 3pm and he then takes half a dose (2.5mg) but it makes him so sleepy and out of it. He says he feels fine and does not feel weird, however we notice that he looks so "drugged up" and slow. He is very bright and takes the half dose in fear of hearing conversations. He know they are not real but they are loud and very distracting. They do not tell him anything or engage with him. He says its loud though, very distracting and makes him feel very uncomfortable. He says its like having a very loud TV in his head that only he can hear. I am not sure about the Haldol, but do appreciate that it allows him to sleep regularly and keeps his mind quiet. In the morning he is himself, alert and active and engaging. I know he sometimes takes the half dose even before he "hears" anything, just to be safe. When he doesn't it can take about 20 minutes for the pill to have any affect on him to stop the noise, however, he appears so drugged up. I think we should cut the dosage to see what the threshold would be to do the trick yet keep him from looking so drugged up. Or find another prescription that would have the same benefit, yet not the bad side effect of looking like a zombie. Will this ever go away? Is there another medication or therapy that he can benefit from? I hate seeing him looking and feeling the way he does.
Submitted: 11 months ago.
Category: Medical
Expert:  Camille-Mod replied 11 months ago.

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Expert:  Dr. Abid replied 11 months ago.
Hi there.
Welcome to Just Answer and thank you for the question.
I am Dr.Abid a Medical Internist and will help you out.
As Haldol is helping him and issue is only sluggishness in activity at this stage it will be wise decision to seek for the minimum dose of drug at which he feel better as this drug suits him.Trying new drug or adding new one will take long time to show its effect and can also have side effects.So proceed with the same drug and adjust the minimum dose at which he feels better.
Regards XXXXX XXXXX him good health.
Please leave positive feedback for me.
Thanks.
Expert:  Dr. Thomas, MD replied 11 months ago.
Hello from JA
Thank your for requesting me.

Haldol is clearly not a good choice here.

Tell me

What other drugs have been tried.
What is his exact diagnosis. All diagnoses medial and psychological.

With this information I can process a good answer for you
Customer: replied 11 months ago.


Did not get a full diagnosis except for panic and anxiety for which he takes Ambilify. He tells me that the "noise" is like a TV playing really loud at times with lots of information going back and forth. I really think this all happened due to several severe lows of blood sugar where he was seizing and we had to administer glucagon. He has been type 1 since 9 years old. He is 25 now. The lows started about a year after being on the pump. He would continually state that he thought the pump was giving him too much insulin. When we finally decided the pump to be malfunctioning and we went back off the pump and to reg. injections, he was back to normal with just a few instances of anxiety but nothing more than anyone would normally get. He was stressed about not finding a job and worrying about his girl leaving him if he did not find one soon. That is something he talked about reg. He bought her a ring and plans on proposing next month so I am sure that is also stressing him out. He now just got hired and will be in training starting Monday. While that is all good, I am sure he is anxious about that. He says he feels good when he wakes up and we notice that he is pretty normal. He takes 5 mg. of Haldol (which I think is too much) at night, but it does not neg. impact him during the day. At around 3pm like clockwork he says the converstaions start up. I think they scare him and he then takes a half of the pill (2.5mg). But it makes him look drugged up severely. He says he feels good and does not feel drugged up just tired, but he looks aweful. He just wants the conversations to stop. They do not engage with him he is a passive bystander in them. I think when he was suffering from severe lows, they were happening but were aggressive and he felt very paranoid, but now only the conversations are bothering him. He is smart and talented but this is severely impacting his life.


Advice?

Expert:  Dr. Thomas, MD replied 11 months ago.
Have they diagnosed him with skizophrenia, and what type of doctor is prescribing these meds
Customer: replied 11 months ago.


No, I do not think they diagnosed him with skizphrenia at all. He gets the meds from a psychiatrist although the one he sees regularly prescribed him with amilify.........when he had a severe attack and we took him for treatment, his blood sugar was really out of whack and they let him go the next day but with the prescripation of Haldol. I saw the paperwork and it was more about anxiety and stress. I think the Haldol also helps him sleep better


 

Expert:  Dr. Thomas, MD replied 11 months ago.
OK
Haldol is an antipsychotic.
There are sever long term risks in using it, including tardiv dyskinsesia.

Without a diagnosis it is impossible to know what medications are best for him, but I would have increased the dose of abilify before I added haldol.

Haldol and ability together can increase cognitive dysfunction and other problems.

There are much better medications for sleep, if this is the problem.

If he has psychosis, there are better newer medications.

If he has bi polar there are much better medications.

I would tell him to discuss this choice in detail with his psychiatrist, and why it was chosen.

Please let me know if you have further questions.
Please don’t forget a positive rating.


Customer: replied 11 months ago.

I believe it was listed as a psychosis. He understands what is happening and knows that non of it is real for anyone but him. He reverts to the Haldol I am sure because it stops the issue and makes him not care about any issues. But he cannot live like that either. I do not want him on the Haldol and feel like we need to do something about it. He says he feels just fine except when the converstaions start and get loud and distracting. Otherwise he feels and looks fine. When on Haldol he is not sharp at all, very slow. Which is not like him at all! We are concerned and scared. I have an appt with another psychiatrist on Sat. morning for evaluation and a call into his current doctor, but I am uspet with his current one as I leave messages and they of course due to Hippa will not speak with me. I think some other med would be better suited as well as CBT. There was another Dr. on this site who said to stick with the Haldol since it was working...............this was his reply:


 


I am Dr.Abid a Medical Internist and will help you out.
As Haldol is helping him and issue is only sluggishness in activity at this stage it will be wise decision to seek for the minimum dose of drug at which he feel better as this drug suits him.Trying new drug or adding new one will take long time to show its effect and can also have side effects.So proceed with the same drug and adjust the minimum dose at which he feels better.
Regards XXXXX XXXXX him good health.


 


Although I agree with you. I am very concerned and frustrated.

Customer: replied 11 months ago.
Relist: Other.
No answer yet
Expert:  Dr. Thomas, MD replied 11 months ago.
Hello from ja
Please use reply
I disagree with the first doctors reply

Did you read my last post?

I will re post it here

OK
Haldol is an antipsychotic.
There are sever long term risks in using it, including tardiv dyskinsesia.

Without a diagnosis it is impossible to know what medications are best for him, but I would have increased the dose of abilify before I added haldol.

Haldol and ability together can increase cognitive dysfunction and other problems.

There are much better medications for sleep, if this is the problem.

If he has psychosis, there are better newer medications.

If he has bi polar there are much better medications.

I would tell him to discuss this choice in detail with his psychiatrist, and why it was chosen.

Please let me know if you have further questions.
Please don’t forget a positive rating.
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56319
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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