January 28th, 2015

in the flesh, bluemavor, amy
  • merle_p

Interaction between atypical antipsychotics and other medication (Present day, USA)

Hello, and thank you in advance for your help! (And apologies to the mods for screwing up the submission before!)

The setting is present day USA. My character is a middle-aged/older woman who is diagnosed with schizophrenia and permanently hospitalized in what I think is a fairly expensive private clinic. She is mostly stable when on medication. I'm assuming that she would be given Clozaril/Clozapine or another atypical antipsychotic drug, but please correct me if that sounds wrong.

I want her to fall ill with something that would require for her to be transferred to a "regular" hospital, and would require for her to take medication that would somehow interfere with the antipsychotics, but not in an extreme or life-threatening way.

My thought was to have her contract pneumonia because it seems that the currently common antipsychotics actually cause an increased risk for pneumonia. I found a study that says that the dosage for antipsychotics would need to be decreased if symptoms of pneumonia were apparent.
The pneumonia would obviously need to be treated with antibiotics, and my research tells me that there are certain interactions between Clozaril and antibiotics, although they seem to be mostly long-term effects? Is that correct?

Now my question is: Would it be realistic for the patient to (a) contract pneumonia at the clinic, (b) be transferred to a regular hospital for the duration of her illness, (c) be given a much reduced dose of her antipsychotics while treated for acute pneumonia? And (d) is it possible that this could lead to a certain confusion in the patient without causing a full-blown relapse/episode? Or is that an unrealistic effect?

Here are search terms I tried to google (in a variety of combinations):
Treatment of schizophrenia
Interaction of [Clozaril][antipsychotics] with [other drugs] [medication] [antibiotics]
Treatment of pneumonia
Schizophrenia and pneumonia
Antipsychotics and pneumonia
Effects of [lower][decreased] dose of antipsychotics

I found a lot of medical studies on the interaction between drugs, and the increased risk for pneumonia in patients on second-generation antipsychotics, but I couldn't really find much on the practical implications (i.e. what do the doctors do, how does it affect the patient's mental state etc.).

Laws affecting 19th century European Romani

Setting: 1830-1870 Central Europe (France, Germany, Austria, and Bohemia mostly)

Google Search: "Romani in 19th century Europe", "19th century laws relating to Romani, "19th century romani regulation", "19th century romani persecution"
Same search terms used with 'gypsy' and 'Roma' to see if anything different came up (and because I'm not entirely sure which term is the most appropriate/commonly used).

One of my PoV characters is a man of Romani (specifically Sinti) descent who wound up in the care of the Catholic Church when he was very young. They kept him around effectively as slave labour until someone higher up decides to put him to a different use by making him a secret agent in their super secret supernatural evil fighting order. What I'm basically having trouble with is working out how much trouble his Romani heritage would get him in when he starts getting sent out and about on the business of this order. I've found a variety of laws regarding the treatment of Romani in the relevant parts of Europe for various different time periods, but none of them are particularly good matches for the period I want. The best I've found is vague mentions that some of the harsher laws were relaxed towards the end of the 19th century, but nothing about which ones those were or how far they were relaxed. I'm also trying to find out how the wider Catholic Church might react to him. I have found a few things there, but the messages have been very mixed (some saying giving alms to the Romani is a greater sin than theft and refusing to bury them or baptise their children even if they claimed to be Catholic, others implying all was fine so long as they would convert).

Any light shed on the subject would be appreciated.