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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How An Schizophrenia And Bipolar Disorder Be Treated?

My brother who is 57 is both schizophrenic and bipolar. These disorders began when he was in his early teens. He always takes his medication. There are times when he does a lot, helps out a lot and times when he says he just can t. One of my brothers thinks he is lazy and that he should force himself esp when he hangs around all day smoking a cigar. He doesn t bathe often. How do I make him understand that he just can t do certain things at certain times? Thanks
Fri, 23 Feb 2018
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Psychiatrist,  's  Response
hi Madam
I have gone through your question and understand your concerns regarding your brother.

As per the history provided by you, your brother is suffering from a disease which needs somuch of personal care.Schizophrenia is a chronic disease where medications should be used regularly. Mostly, this disease can't be cured completely.With medication, we only suppress the symptoms of the disease similar to diabetes or hypertension. So, when medication stopped suddenly or taken itregularly, disease revert back. So, my advise is to take medication regularly and in prescribed form as advised by the psychiatist.

Regarding course of illness in schizophrenia, we commonly talk about drift hypothesis. In schizophrenic patients, they gradually deteriorate in all fields involving social, emotional, occupational functioning. so, gradually they don't study, don't participate in family interactions, lack judgemental capacity, stop going to job, soon...

so, my final advise:
1)never discontinue medications.
2)gather information and understand disease process in schizophrenia
3) please understand that he's not pretending
4) always be emphatic and caring towards schizophrenic
patients in any time and in any situation.
5)be ready to accept the truth that he will have problems with judgemental capacity, contact with reality and insights regarding his disease.


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Psychiatrist,  Dr. Gayathri's  Response
Hello! Welcome to HealthcareMagic!

In my opinion, it is necessary to do complete blood investigations like thyroid profile, blood sugars and lipids. Then it is necessary to go for Amisulpride at higher doses. Please arrange behavioral therapy sessions with a trained therapist.

Hope this clarifies your concerns. Thank you for the query.

Take care

Regards,
Dr. Gayathri, Psychiatrist
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How An Schizophrenia And Bipolar Disorder Be Treated?

hi Madam I have gone through your question and understand your concerns regarding your brother. As per the history provided by you, your brother is suffering from a disease which needs somuch of personal care.Schizophrenia is a chronic disease where medications should be used regularly. Mostly, this disease can t be cured completely.With medication, we only suppress the symptoms of the disease similar to diabetes or hypertension. So, when medication stopped suddenly or taken itregularly, disease revert back. So, my advise is to take medication regularly and in prescribed form as advised by the psychiatist. Regarding course of illness in schizophrenia, we commonly talk about drift hypothesis. In schizophrenic patients, they gradually deteriorate in all fields involving social, emotional, occupational functioning. so, gradually they don t study, don t participate in family interactions, lack judgemental capacity, stop going to job, soon... so, my final advise: 1)never discontinue medications. 2)gather information and understand disease process in schizophrenia 3) please understand that he s not pretending 4) always be emphatic and caring towards schizophrenic patients in any time and in any situation. 5)be ready to accept the truth that he will have problems with judgemental capacity, contact with reality and insights regarding his disease.