Hello,
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress and concern for health of your brother.

Your brother approached us only for sleep problem. As in schizophrenia, patient do not have insight, so they do not ask about schizophrenic and I ask non specific things like about: sleep, appetite, drug side effects and pain complaints.

We gave following reply for his sleep problem (in short):

Common causes of poor sleep are (in order of preference):
-Poor sleep hygiene
-Stress, Anxiety and Depression
-Use of excessive tea or coffee
-Substance use
-Thyroid hormone problem

For sleep difficulty follows below principles of sleep hygiene which will help you in long term.
Your main problem appear to me, is in sleep induction. For long term management you should follow sleep hygiene (even on holidays) as above and treatment of above mentioned causes (if present). You can take help of sleep inducing medicines (like zolpidem), after physician prescription for short duration to correct your sleep wake cycle.

SO WE DID NOT ADVISED HIM TO STOP CURRENT MEDICINES.

NOW COME TO THE CURRENT PROBLEM OF STOPPING EXISTING TREATMENT BY YOUR BROTHER:

In his medicines arpizole used for schizophrenia and clonotril used for sleep. So, giving arpizole much more important than clonotril alone.

Although there is no guideline regarding how to bring these patient in treatment who refused treatment, but following are usual methods in practice by family members to bring them in treatment:
1-Forceful consultation
2-Meet doctor without patient and get prescription of medicine. Start treatment without knowledge of patient. When patient become well, bring him to the doctor.
3-Call doctor for home visit or online help.
4-If patient refuse taking medicines: give medicine in food or drinks. Treatment with long acting injection which needed once in 2-4 weeks

So you are already following step 2, 3 and 4. Medicine usually take 3-4 weeks to show its effect (when effective). It may take some till effect of injection come, so continue with injection treatment with gap of few weeks as advised. Till that time try to give medicines in food.

Wishing him good health.
Regards,

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