Josh and Medication 01

Josh seems to be reliably taking his medicine. Sometimes he has Zyprexa left in his pill container. But I think he for some reason sometimes takes pills from the bottle instead of his pill container.

On 20 mg/day of Zyprexa Josh is not violent. He rarely screams. He does not actively hallucinate. On most days 20 mg keeps Josh's activity in check. But 20 mg/day of Zyprexa is not enough to prevent Josh from going through manic phases. He is up and down. He goes back and forth. Not most days. But some days.

Josh is also inventing new delusions. It used to be the same delusions over and over. 9/11. Bill Gates. Prince William. Oddly, I have not heard Josh mention any of those. But he thought a song on the radio was a recording of him. And Josh does not sound like Shawn Mendes. Josh thinks that the name 'America' came from the phrase 'a miracle'. And many more.

Josh also does not sleep well. He does sleep at night. Most nights he is more or less in his room for about 8 hours. But he is in and out. Some nights he goes into the living room for long stretches of time. When Josh was living with Joey, Josh would come out once a night to eat. Occasionally twice a night. Then Josh would go right back to sleep. I do not remember him coming out of his room to smoke. Now, some nights Josh comes out several times an hour to smoke. He also smokes in his room. Why he comes out to smoke I do not know. Maybe Josh cannot stand his own smoke.

It is tough to know how much of the time Josh spends in his room he spends sleeping. There are often sounds of movement emanating from his room. I am going to guess that Josh sleeps about 5 hours a night. Which is not enough for a normal person. And especially not enough for a schizophrenic.

Josh used to take his Zyprexa all at once. At night. If Dr. Cespon gave any thought to allocating the dose, he probably thought that getting Josh to take medicine once a day was easier than getting Josh to take medicine twice a day. Assuming that Josh will continue to take medicine twice a day reliably, 10 mg of Zyprexa in the morning and 20 mg of Zyprexa at night is probably better. But 20 mg/day of Zyprexa is not enough. 20 mg/day of Zyprexa will keep Josh from hallucinating. 20 mg/day of Zyprexa will turn a strong manic phase into hyperactivity. But 20 mg/day of Zyprexa will not prevent a manic phase. 20 mg/day of Zyprexa will not let Josh sleep well at night.