Brief Answer:
Olimelt and Arpizole are safe drugs.

Detailed Answer:
Hi, Thanks for asking from HCM for your health related queries

I can understand your concern. First of all I'd like to tell you that Schizophrenia is a chronic illness and the disease follows a long course. In most individuals the course is continuous with intermittent exacerbations. The exacerbations can occur due to a number of precipitating factors like stress, some emotional issues, some loss or even without any reasons. So if she has been diagnosed with Schizophrenia and is having relapse of symptoms even with medicines this means that this is occurring due to natural course of illness or due to some precipitating factors.

Coming to your questions directly-

- Olimelt and Aripiprazole both belong to second generation antipsychotic (SGA) drugs. Both are safe drugs and have good efficacy. Olanzapine at high dose cause metabolic side effects and weight gain while Aripiprazole is relatively safer in metabolic effects. Both helps to treat psychotic symptoms. Both drugs have been added to her prescription probably to achieve good control of symptoms.

- She can take both together without any worries. But in my opinion its better to give 20 mg Aripiprazole in morning after break fast and 20 mg Olanzapine in evening. Aripiprazole doesn't cause much sedation and this can be given in day time also.

- Illness is relapsing because Schizophrenia is a continuous illness with episodic exacerbations. These episodic worsening is causing relapse of symptoms.

- The trembling or sudden blinking of eyes could occur due to EPS (extra pyramidal side effects). As she is on high dose of SGAs and at high doses these drugs can even cause EPS. Drugs like Trihexyphenidyl can help to reduce the trembling. Please consult her psychiatrist for these symptoms and the medicine I have mentioned. With this medicine her symptoms will remit completely.

- Wait for the improvement of the symptoms. If symptoms don't remit completely then long acting injectable drugs like Haloperidol Deconate, Risperidal Consta, Fluphenazine LA etc can be given. These injections are given at 15-30 days interval and provide effective symptoms control in most of individuals. You can discuss with her doctor for these medicines also.

Thanks. hope this helps you. Please don't hesitate to ask again for more doubts.

Take care

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Brief Answer:
She is on right medicines.

Detailed Answer:
Hello thanks for asking again.

1) Though she is on second generation antipsychotics which are relatively safer but even these medicines can cause increased prolactin in brain which might result in milk discharge from breasts, irregular menstruation etc side effects. The side effects are reversible and reverse on stopping the medicines. No need to worry.

2) This is happening because of her illness as well as medicines. Lack of focus, distractibility, poor concentration can occur due to high dose of medicines which causes sedation and drowsiness.

3) She is getting fatigued and tired because of the high dose of medicines. High dose of Olanzapine cause sedation which reduce the activity levels and thus result in tiredness.

4) She is an adult and some times intrusive repugnant thoughts related to sex might come. This also aggravates because of illness also. Best thing that can be done in such cause is to ignore these thoughts. If she is not able to control the thoughts then ask her to divert her mind by exercise or yoga. No need to worry.

5) I will not advise the homeopathic treatment. Allopathic drugs are researched and their use is based upon various studies. For psychiatrist treatment she is on right medicines. Other treatment methods will deteriorate her clinical course only.

Thanks, Please if you have more doubts ask again.

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Brief Answer:
No need to increase the dose of Antipsychotics

Detailed Answer:
Hello again, thanks for asking a follow up

No need to increase the dose wait for few more days. She is already on high doses of the drug. If the aggression is increasing then for some time sedation with some benzodiazepine drug can help. Clonazepam or Lorazepam can help to achieve sedation and will help in reducing the aggression.

Thanks. Hope this helps you. Please excuse me for late reply because busy with some health issues.

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Brief Answer:
Diets rich in proteins help a lot.

Detailed Answer:
Hello again, thanks for asking a follow up

- Any diet that is rich in proteins and complex carbs and low in fats is considered as good for mental disorders. Diets with high tryptophan, omega-3-fatty acids like Walnuts, Salmon fish, Sardine fish are considered good.

- With regular treatment her mind will start improving. For persistent dull mood drugs like low dose antidepressants like Armodafinil etc can help.

Thanks, Hope this helps you. Still have more doubts please ask again.

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