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Dr. Andrew Rynne

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Suggest treatment for schizophrenia

Answered by
Dr.
Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Posted on Wed, 6 Aug 2014 in Mental Health
Question: My brother is suffering from schizophrenia.since 8 years... tried everything..but he seems not improved ...he lacks in confidence..sleeps more..and little essential symptoms.
He is under medication but still he doesnot look like a normal person.
I have gone through every article about schizoprenia to help him with his problem.He was under rhab as well.
please suggest best possible solution for this.
doctor
Answered by Dr. Chintan Solanki 27 minutes later
Brief Answer:
medicines,psychotherapy,occupational therapy

Detailed Answer:
hello XXXXXXX
Thanks for using healthcaremagic.
I can understand your concern about brother.
But you already knew that schizophrenia is a disease with poor prognosis in many cases as you gone through many articles regarding that.
I want to know from your side," his symptoms and history of illness with detail,medicines given to him current and past and any other approach of treatment like psychotherapy and ECT and his work-occupation "After that I can provide some specific solution.
However few points.
Prognosis of schizophrenia depends upon age of onset , duration of treatment started and illness begun, treatment adherence and family support, type of schizophrenia, education of patient.
There are many medicines recently came into filed for treatment.
If education is good some psychotherapy can work.
One thing also needed is that reconfirmation of diagnosis.
I will wait for your follow up question to inform you more.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Chintan Solanki 1 hour later
Hi,
Thanks for the reply.
I want to know from your side," his symptoms and history of illness with detail,medicines given to him current and past and any other approach of treatment like psychotherapy and ECT and his work-occupation "After that I can provide some specific solution.

[Sunil]
1. Since 2005-2006 , he has this disease.
2. He was pursuing engineering and during his 6th semester first occurrence appeared.
Initially his symptoms involved- angryness, frustrated, drinking lot of water/tea, chanting gods' name, shouting, thinking much. You can say severe symptoms.
Then we showed to doctor , after some treatment he seemed recovering but again symptoms worsened.
We showed to may docs including NIMHAS XXXXXXX but couldn't help much.
Also he went into rehabilitation once.
3. Shock treatment once given but was mild one.
4. Currently he is pursuing B.A but not seriously.
He sleeps a lot, thinks much, no mingle in society, You can say a different person altogether from earlier.
Current meds

sizopin - 50mg - nightly 1.5
dicarate- 500gm - 1 nightly
waklert 150 morning 1

I don't have details about past meds, but I will try it to get for you from home.

I understand its a complicated disease, but there has to be a way to get over of it.

Please go through once and let me know anything else would needed.

Thanks
doctor
Answered by Dr. Chintan Solanki 2 hours later
Brief Answer:
Medicines are not sufficient in dose and in choice

Detailed Answer:
hello XXXXXXX
Sorry for late reply.
Now I got some clue about his illness.
For anger typical antipsychotic like haloperidol or trifulopearzine is good choice with benzhexol to prevent its side effects like tremors,dystonia(extrapyramidal symptoms).
If he can not tolerate typical first generate antipsychotic olanzapine is good choice as it is helpful in aggression also.
Another option is quetiepine which is approved in schizophrenia and depression.

His thorough evaluation is also needed currently for specific diagnosis like negative symptoms schizophrenia, post psychotic depression or it might be totally reverse depression with psychotic features and medicines should be changed accordingly.

Clozapine we generally used in resistant schizophrenia, but it's optimum dose 150 mg if no other antipsychotic medicne is used. Here it is only 75 mg.
Valproate is I guess given for anger otherwise not useful in schizophrenia.
Armodafinil generally used in depression or narcolepsy.

As you mentioned previously that he lacks confidence and there is anger so I guess two possibility.
One is negative schizophrenia and amisulpride or aripirazole are good drugs for that.
Another is depression and for that lots of antidepressant drugs available.
For cognition multivitamin including methylfolate or even piracetam can be used.
So overall I can say he is not treated properly.

So with above notes you can consult to any good psychiatrist in private or even at NIMHANS and move forward for treatment as he is still young man and better the outcome if treated sooner in proper way.
All the best and hoping for your brother's recovery.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Chintan Solanki 37 hours later
Hi,
okay.
But we do shown him to different docs across XXXXXXX But couldnot help, one doc say one med and other say other.
We are not sure what exactly causing this and how to eradicate it.
There should be some way to deal with this, may be any new meds or something.
As fas as I spoke to doc, there is a chemical changes in mind would be causing this but I am not sure how it can be controlled.
Because it all comes to his life when he has to live by himself without depending upon others whole life.
Please let me know how to proceed on it. Its already 8 years and he is still suffering on it.
thanks
doctor
Answered by Dr. Chintan Solanki 2 hours later
Brief Answer:
Continue treatment with one doctor for long

Detailed Answer:
Hello XXXXXXX

I can understand your worry. But I would like to tell you frankly that schizophrenia is the mental illness with worst prognosis among all. Many of patients like your brother consult one doctor to another.
Please consult some good doctor continuosly for long atleast one year I mean. This will help doctor to understand his case better and effects of medicine on him.Sometime by a click some medicine works good.

One suggestion go to XXXXXXX , an association called SCAARF is working for schizophrenia patient, you can search on net about them.

Hope he will have some improvement in future.
All the best & Regards.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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