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Taking Lithium Xr, Trihexyphenidyl Hydrochloride, Livogen And Haloperidol For Schizophrenia. Second Opinion?

Posted on Mon, 11 Feb 2013

Question: i am suffering from schizofrenia as per my psychiatrist. I am taking medicine lithium xr 600 mg in night and trihexyphenidyl hydrochloride 2 mg three times a day livegen capsule in night and halperidol 1.5 mg two times a day. The physician says me that ask to a better doctor because you are only 21 year old now.

Answered by Dr. Sundar Gnanavel (1 hour later)

Hello XXXXXXX

Thanks for your query.

Haloperidol is a first generation antipsychotic that can be given for treatment of schizophrenia. Lithium is generally given for mood stability that can be associated with schizophrenia. In general haloperidol is nowadays avoided in favour of newer second generation antipsychotics considering the propensity of haloperidol to produce extrapyramidal side effects i.e rigidity, tremors. In a few cases haloperidol may be used considering that it is cheaper than the newer drugs.

Trihexyphenidyl is given to reduce side-effects of haloperidol. Hence, a review of how well you are tolerating the medication and if lithium is actually warranted in your cases after review of your symptoms is essential to comment if the drug regimen is advisable.

Kindly message me if you have history of any mood instability and how well you are tolerating the medication i.e list of any side-effects you are experiencing.

Regards

Dr Sundar
Psychiatrist

Above answer was peer-reviewed by : Dr. Mohammed Kappan

Follow up: Dr. Sundar Gnanavel (15 hours later)

the situation is right but I want to reduce the medicine so how can I reduce the medicine because my hand is vibrating and when I try to remember my lesson it not be remembered easily.

Answered by Dr. Sundar Gnanavel (9 hours later)

Hello,

Treatment of schizophrenia and modification of antipsychotic drugs need to be done under careful supervision of a psychiatrist. A competent psychiatrist who can visibly monitor the progress is essential for successful treatment of schizophrenia. Therefore I encourage you to consult a psychiatrist nearby to do any dose changes.

If a visit to a psychiatrist is not feasible, your current treating doctor can try reducing the frequency of trihexyphenidyl to twice a day. Additionally, for vibrations/tremors in your hands, propranolol can be added.

Alternatively as tremors and vibrations are most probably the side-effect of lithium that you are taking currently, after review by your consulting psychiatrist the dosage of lithium can be reduced or tapered if your symtoms are under control. Haloperidol needs to be continued.

Hope you found my suggestions useful. Let me know if you need further clarifications.

Regards
Dr Sundar Gnanavel
Psychiatrist

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sundar Gnanavel (16 hours later)

My father is also suffering from schizophrenia since 1993. Now he is taking carbamazepine controlled release 200 mg two times a day and thioridazine 50 mg in the night. He is ok and working well.

Answered by Dr. Sundar Gnanavel (5 hours later)

Hello........
Carbamazepine is a mood stabiliser and thioridazine is an antipsychotic. As i told if dosage and number of medication are carefully selected, it is possible to maintain well without symptoms and minimal side-effects. It is encouraging to note that your father is maintaining well on medication.
Regards
Dr Sundar Gnanavel
Psychiatrist

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar