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Has schizophrenia. Strong suspicion. Discontinued olimelt. What can be done to treat him without his knowledge?

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I am writing this regarding my father.
A little background about my father, he used to be a daily wager ( now he is retired), and we were brought up in a poor economic condition with his only income. with difficulties he managed to bring us up and run the family. when I was in 9th/10th standard, my father showed up the symptoms of Schizophrenia, which we were not aware by that time. Initially we thought he was irrational, but then slowly come to know that he is really affected by the disease.

The major symptoms included,

1. Strong suspicion that other people are against him and he used to visualize people following him wherever he goes, and he used to hear voice that is against him.
2. Belief that others are going to plot against him to kill him.
3. He often tells that others are planning to move him out of current home and there are various plans people around are doing.
4. He always used to watch if others are watching him

We had diagnosed this 6 yrs back ( of course he was not ready to come to doctor - he says he is perfectly alright) some how managed to get him to doctor and had treatment. Olimelt was prescribed and he was taking for a while and after 1 year he discontinued. But the symptoms often appears and we could see the same symptoms as above. So we decided to give the olimelt tablet without his knowledge and we were doing this for last 4yrs. But still at times, he used to show same symptoms.

Even though we could understand the fact that father will not come to doctor, we could not really convince him to visit the doctor, and we have failed many times taking to him without his knowledge because usually doctors prescribe some medicine and ask for a further visit and we were not be able to make it because by that time he would know the fact we are taking him to a doctor.

Now we are in good economic condition and really want to treat my father, but we are really not finding ways to get him to a doctor at regular intervals. your valuable suggestions on how to bring him to a doctor would really help.
The other fact which concerns us is that mom even though understands this, sometimes gets frustrated and loose the hope when he relapse on the symptoms.


Please suggest me how we can cope with him and get him to doctor, and what are the better ways to make sure it does not relapse. Also is there any medication that is recommended in place of olimelt.
( Note: currently he is not in condition which was 6 yrs back, but once in a while he used to relapse the symptoms)
Posted Tue, 22 May 2012 in Mental Health
 
 
Answered by Dr. Ashish Mittal 12 hours later
Hello,
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     59 year old male
•     Known case of Schizophrenia
•     Complaints of: fearfulness, suspiciousness, absent insight for illness and auditory hallucination.
•     Concern related to treatment compliance

Many time in patients are not able to identify symptoms of their illness. In schizophrenia, Loss of insight is the first symptom of the illness.

From your history it is clear that your father are suffering one of the long term illness called schizophrenia. Stoppage of drug frequently lead to recurrence of symptoms, as drug control the symptoms but not cure illness process.

Frequently psychiatric illness are chronic illnesses like high BP. You stop the drug and BP rises. So there is need for uninterrupted treatment. Olimelt on of the very good medicine available for schizophrenia. Your father also responding to it partially.

He may need alteration in olimelt dose or addition of other drug for complete relief. In person physical examination, mental status examination and patient specific lab tests are must before deciding any change in medicine dose or starting new medicines. Due to that, according to guidelines we are not allowed to prescribe medicine here.

Following are usual methods practiced by family members to bring uncooperative patient in treatment:
-Forceful consultation
-Meet doctor without patient and get prescription of medicine. Start treatment without knowledge of patient. When patient become well, bring him to the doctor.
-Call doctor for home visit
-If patient refuse taking medicines: give medicine in food or drinks. Treatment with long acting injection which needed once in 2-4 weeks

I hope this information has been both informative and helpful for you.
Wish you good health.
Regards,
Above answer was peer-reviewed by
 
Follow-up: Has schizophrenia. Strong suspicion. Discontinued olimelt. What can be done to treat him without his knowledge? 10 hours later
Thanks for your reply.
Following are usual methods practiced by family members to bring uncooperative patient in treatment:
-Forceful consultation
This did not work out for us
-Meet doctor without patient and get prescription of medicine. Start treatment
without knowledge of patient. When patient become well, bring him to the doctor.
The doctors we met asked us to bring the patient without which they could not help.
-Call doctor for home visit
This is a good option we are looking for in my city(Erode, Tamilnadu). would XXXXXXX be helping us to locate the doctors who could visit our home

-If patient refuse taking medicines: give medicine in food or drinks. Treatment with long acting injection which needed once in 2-4 weeks
we are following this approach ( give medicine in drinks).
 
 
Answered by Dr. Ashish Mittal 2 hours later
Hello,
Thanks for follow up

Sorry, XXXXXXX do not provide home visit. Ask from psychiatrists in your city. But they may charge extra for home visit.

Continue giving medicines in food.

Wishing him good health.
Regards,
Above answer was peer-reviewed by
 
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