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Dr. Andrew Rynne

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Diagnosed with acute psychosis. On antipsychotic medication. Will it cause any effect in married life?

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Dr. Jonas Sundarakumar

Psychiatrist

Practicing since :2003

Answered : 2190 Questions

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Posted on Sat, 22 Dec 2012 in Mental Health
Question: I was diagnozed acute psychosis in 2005. The report said I was restless,sleepless and behavioral problems for duration less than a month.It also said I have acute psychosis. Since then I am on antipsychotic medication and I am much better now.My age is 34. Now problem comes in marriage proposal. Although my psychiatrist said I could marry, people are not accepting the reasons I am saying due to stigma associated withe illness. My psychiatrist tells that I should talk with the girl and tell her that why you are taking antipsychotic tablet. I need some expert guidance from the forum on what to tell the girl I should marry so that it doesn't affect my marriage prospects.Thanks for your help.
doctor
Answered by Dr. Jonas Sundarakumar 2 hours later
Hello XXXXXXX
Welcome to Healthcare Magic.

Firstly, psychiatric illness is not a barrier to get married. Many people with psychiatric illnesses do get married, and if on regular medication and follow up, are able to lead normal lives and fulfill their marital, family and social responsibilities. Moreover, in your case, you have had only one episode of acute psychosis in 2005 and you have been doing well on medication for the last 7 years. So, there is no barrier for you to get married.

However, it is definitely good for both yourself and the girl to tell the girl about your psychiatric problem. The reasons are:

1) You have a moral responsibility to let your partner know about this, so that you do not feel guilty that you have hidden something important from her.

2) Since you are on regular medication, it is very difficult to hide the fact that you are taking medication for some psychiatric problem. If at all, she comes to know about your problem, at some point of time, through some source, then the consequences can be bad.

3) Not telling your partner can be a constant stress or fear in the back of your mind and can affect your peace of mind and also your relationship.

4) Psychiatric problems are very common, and nowadays, people's perspectives are changing. So, it is not a big deal that someone has had a psychiatric problem before, has been taking medication and is doing well now.

Now, it is indeed true that many people in our culture have a stigma and hesitation in accepting people with psychiatric problems. So, it would be wise to tell it in a tactful way, so that other people don't misunderstand and make false conclusions. So, it would be okay to tell the girl that you suffered from "an emotional problem" or "psychological problem" many years ago, which lasted for a brief period; and that you consulted a psychiatrist and had medication and counselling; and that you got well within a month and have been doing well since then; and that as a precautionary measure to prevent any recurrence of the problem, you have been advised to continue a small dose of medication. You have to remember that marriage is a life-long committment and for a relationship to be successful, each person should accept the other person as they as, with their positives and negatives - only then the marriage will be successful. So, it is important to find a girl who is willing to accept you despite your problems, and only such a girl will be committed and loving till the end. Also, when you be open and tell the truth, the other person will know that you are really an honest and trustworthy person.

So, don't worry, be patient and I'm sure that you will find the right life partner who will be supportive and committed to you life-long.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jonas Sundarakumar 8 hours later
Thank you doctor for your advice.I will follow the same.Actually I had my first episode of psychosis at 2005. I was taking chlorpromazine and haloperidol with nitrosun and parkin. Then I had a couple of replases and then I changed my doctor in 2008 and he prescribed loxapine succinate 25mg,paroxetine hydrochloride 25 mg, nitrosun 10 mg and parkin 4 mg. Then he gradually reduced it and I am doing better now with only loxapine 10 mg at night. I did not suffer any relapses from 2008.I would also like to know whether loxapine is the right antipsychotic for acute psychosis. Can acute psychosis be completely cured? Many doctors say that there are many other medicines like risperidone, olanzapine that can cure my problem. Kindly clarify whether my medication is on the right track. Thanks once again for your reply.
doctor
Answered by Dr. Jonas Sundarakumar 6 hours later
Hello again,

Chlorpromazine, Haloperidol and Loxapine are all antipsychotic medication, belonging to the class of 'typical' or older generation antipsychotics. Paroxetine is an antidepressant medication, belonging to the class of SSRIs. Nitrosun is a sedative medication, belonging to the class of benzodiazepines. Parkin (Trihexyphenidyl) is an anti-cholinergic medication which is given to minimize the possible side effects of the antipsychotic medication (since antipsychotics, especially the older generation antipsychotics have a tendency to cause movement-related side effects). However, currently, you seem to be doing well on Loxapine alone.

Now, since you have had a few relapses, your diagnosis may actually be episodic psychosis or Schizophrenia, since acute psychosis refers to just one episode of psychotic syptoms. The importance of this fact is that you need to continue antipsychotic medcation on a long term basis, since there can be a risk of relapse if you stop medication.

Loxapine is an effective antipsychotic medication and is considered to have almost the same effects as the atypical antipsychotics like Risperidone, Olanzapine, etc. and so your treatment is on the right track. Now, you have to realise that Risperidone, Olanzapine, etc. are just antipsychotic medication belonging to a different class, and that no medication can completely "cure" your symptoms. All antipsychotic medication can only control your illness and make you symptom-free. Another thing to be remembered is that it takes a lot of time for a particular medication to get 'set' to your body and keep the illness under control, and you say that you have been doing well with a 10mg dose of Loxapine. So, my opinion is that it is better to continue the same medication with which you have been doing well, rather than experimenting with some other new medication.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jonas Sundarakumar 5 hours later
Thanks doctor for your advice. I will continue loxapine as per your advice and pray God that I won't have relapses. I have one more question that since I am on antipsychotic medication and SSRI's for a long time, after marriage would there be any problem in sexual intercourse. Can I get back to normalcy and live normally without medication after 3 or 4 years? Can I have a normal sexual life with my wife? Will I have normal kids such like others? Kindly clarify.
doctor
Answered by Dr. Jonas Sundarakumar 13 hours later
Hello again XXXXXXX

Psychiatric medication like anti-psychotics and SSRI anti-depressants are known to cause sexual problems in some people, like erectile dysfunction, delayed ejaculation, anorgasmia, etc. But it is to be remembered that most of these side effects are only mild and tansient. Moreover, they do not affect the fertility or child-bearing capacity of an individual. In your case, you seem to be on low doses of medication and so, it is unlikely that you are going to have any major sexual or fertility problems after marriage. Even if you do experience any sexual problems, there are effective remedies to counteract such side effects.

So, you can have a normal marital, sexual and family life like others, and can have normal kids like others. Since pychotic disorders and schizophrenia run in families, there may be a slightly increased risk for your kids to develop similar problems in the future. But this is only a minimal risk and you don't have to worry about this at all now.

Regarding the duration of taking medication, if you are comlpetely symptom-free for a few more years, then the possibility of gradually reducing or further minimizing your medication can be considered.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jonas Sundarakumar 10 hours later
Thanks doctor for your reply.One last question. I came across a relative of mine who was not good at studies and had difficulty in completing his B.E degree. But fortunately he landed in a software job and he is doing well now. I asked him the reason behind his success and he said that he tried self-hypnosis(auto suggestion) when he was in a difficult situation. But he did that without professional help, he kept saying things like "I can do it" repeatedly to himself when given a tough project(an example) and he seems to be doing ok with it. My question is I have not tried all those methods till now but can self-hypnosis be an alternate cure to my problem? Is is the right way? If so I will ask my psychiatrist to try self-hypnosis so that I can be cured(ofcourse along with taking loxapine and other medications)? Please clarify
doctor
Answered by Dr. Jonas Sundarakumar 5 hours later
Hi XXXXXXX

Self-hypnosis for the purpose of enhancing motivaton, self-confidence and promoting positive thinking is a good option. It can work for a variety of psychological problems as well as improve your overall level of functioning. But, please don't forget that you should consider this only as an additional therapy and should continue to take your medication properly and regularly at all means.

I can see that you have lot of determination and will to overcome your problems, however difficult they may be, and I appreciate you for that. So, don't worry, with continued therapy and with your persistent efforts, you will be able to do very well in life.

I wish you good health and all the very best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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