October 2025 — pre-crisis baseline regimen

The list, as written

Faithfully transcribed. The original used a "Taking" column — ✅ = actively taking, ⬜ = prescribed but not taking. The not-taking items are as informative as the active ones.

🫀 Regular meds

🧠 Mental health

🤕 Severe pain

⚠️ What this forces us to correct

Several things the repo had inferred turn out to be wrong or incomplete. Folding these in:

• Olanzapine is NOT a crisis-initiated med. He was on olanzapine 5 mg for "Depression/Sleep" in Oct 2025 — it was doubled to 10 mg during the crisis and later relabeled "Tourette's" by NP Alyssa (6/8). The timeline's "olanzapine likely initiated during the Baker Act" was a guess, now corrected. It's a long-standing depression/sleep med that got uptitrated and reassigned, not a purpose-built tic drug.
• The cardiac + GI block predates the detox by months. Clopidogrel, metoprolol, amlodipine, atorvastatin, and pantoprazole were all already on board in Oct 2025. The 2026 "start dates / 30-day" windows on the current page are facility re-orders on admission, not true starts. One real exception: aspirin — it's on the Oct 2025 sheet, but per family he wasn't consistently taking it until recently (likely the lifelong charted aspirin allergy). So clopidogrel was the long-standing antiplatelet; adding aspirin recently is what makes it dual antiplatelet therapy.
• Dose changes since Oct 2025:
  • Atorvastatin 10 → 40 mg (intensified to high-intensity statin — appropriate for CAD + stroke)
  • Amlodipine 10 → 5 mg (halved — worth asking whether cutting his BP med contributed to the current 160+ creep)
  • Olanzapine 5 → 10 mg
  • Duloxetine 40 mg → 40 mg BID (80 mg/day)
• His cardiac history is deeper than "AFib." Amiodarone — a serious antiarrhythmic — was prescribed for ventricular arrhythmias (not just AFib), stopped apparently over "vision problems" (a classic amiodarone ocular side effect). A documented ventricular-arrhythmia history materially raises the stakes on every QT-prolonging med he's on (olanzapine, duloxetine, and any tic antipsychotic). Flag for cardiology.
• Eliquis (apixaban) prescribed but stopped — consistent with the Watchman story (the device exists precisely so you can come off anticoagulation). Confirms the antiplatelet-only strategy was already in place by Oct 2025.
• Opioid: the documented opioid regimen was hydrocodone-acetaminophen (4–5/day) + morphine 15 mg PRN + cyclobenzaprine — confirmed by Paul (earlier "oxycodone" references corrected to hydrocodone throughout the repo).
• Quetiapine is in his history (prescribed, not taken). Relevant to the standing "quetiapine vs olanzapine" open question — he has prior exposure, so it's not a from-scratch trial.

🧩 The tic story, re-analyzed

This is the big one. Paul's question was: what was prescribed to help the tics, and has it been removed or changed? The Oct 2025 list answers it cleanly — and the answer is uncomfortable.

What was actually holding his tics in Oct 2025

• Haloperidol 0.5 mg — the one med literally labeled "Treat Tourette's" — he was NOT taking. A dedicated, FDA-approved tic drug sat unused on his list.
• Alprazolam ~2–2.5 mg/day (4–5 × 0.5 mg) — the de facto tic suppressant. Labeled "anxiety" here, but per About Dad the lifelong original indication for his benzo was tic + anxiety control. GABAergic suppression is almost certainly what kept the tics tolerable for ~30 years.
• Olanzapine 5 mg ("Depression/Sleep") — some incidental dopaminergic tic benefit, but not prescribed for tics.

So his tics were being held by Xanax — while a real tic drug (haloperidol) went untaken. There was never an intentional, purpose-built tic regimen; the benzo was quietly doing that job.

What happened to each since

The headline: the only thing that was actually suppressing his tics (the benzo) was removed — correctly, it had to go — and nothing was ever intentionally built to replace its tic-suppressing role. Olanzapine was relabeled into the gap, not designed into it; clonidine came and went; NAC is a token dose. That is a coherent, predictable reason the tics have flared to self-injury (raw tongue) — and it's the strongest argument yet for prioritizing the movement-disorder neurology referral. There is even a dedicated tic med (haloperidol) already in his history that was never optimized — a neuro would either rationalize it or, better, move to a modern, better-tolerated agent (aripiprazole / a VMAT2 inhibitor) plus CBIT, plus targeted botulinum toxin for the injurious tongue tic.

🆕 New threads this surfaces (currently unaddressed)

Family advocate's running record. Faithful transcription of a provider-compiled list + reconciliation analysis. Not medical advice — a structured capture for productive questions with the care team.