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Dr. Andrew Rynne

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Schizophrenia, Taking Olimelt And Lopez. Will Hospitalization Help Recover Faster?

Hi, This regards my younger brother, He was diagnosed with short term schizophrenia last october & was treated. he got back to normal within 3 months and started work, however almost a year later, last week he again showed symptoms like halucinations, anxiety & depression . I consulted the same psychiatrist , who prescribed (Olimelt 5mg) twice a day & (Lopez 2mg) at night to help him sleep. he refuses to take medications hence we mix it in his food. he also refuses to visit the psychiatrist. he is not violent & neither does he have any negative thoughts. Kindly advise, 1) since this is a recurring illness , will hospitalisation help him recover faster ? 2) can we forcibily get him to visit a psychiatrist, will it help ? Thank you.
Tue, 12 Feb 2013
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Psychiatrist 's  Response
Hello and welcome to Healthcare Magic. Thanks for your query.

I appreciate the concern you have for your brother. Yes, like you mentioned Schizophrenia is a chronic illness which can have relapses and fluctuations, especially if the person is not on regular medication. Now, refusal to take medication is a common problem with these patients and the reason is that they lack 'insight' into the illness. i.e. they lose touch with reality and hence don't understand the fact that they have an illness or that they need treatment. In your brother's case, I feel that a short period of admission will help, especially since you mention that there is an exacerbation of symptoms. Once the symptoms are reasonably under control after the admission, there is a chance that he may be more co-operative to take medication. There is also an option of giving long acting injections (once in two weeks) which can be given if he still refuses medication. If he refuses to come to hospital, it should be okay to sedate him and take him to hospital. Once in the hospital, he can be given adequate medication to keep him calm till his psychotic symptoms come down. There is a legal provision also for involuntary admission and treatment for such patients.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
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Psychiatrist Dr. Gourav Monga's  Response
hello

welcome to health care magic

Answers to your queries are as follows-

1) Schizophrenia is a chronic illness which requires continuous medication. So don't stop his medication this time and consider long term treatment. You can consider hospitalisation initially as he is refusing treatment. Once he is stabilised and agrees to take treatment, you can easily continue treatment at home.

2) If you try force on such patients, they can get violent. Try to convince him calmly to visit a psychiatrist (as he is refusing all this due to his delusions and hallucinations). Secondly, if he is still refusing, continue giving medication without his knowledge and when he starts improving, take him to psychiatrist.

Hope it helps

Good Luck

thanks
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Psychiatrist Dr. Saikat Mitra's  Response
hi
1. If he refuses medicine, short-term admission in a mental health care facility would work..by the care-givers there, he would be taught to be compliant with the treatment..the diagnostic dilemma between schizophrenia and psychotic depression may also be in in need to be solved of which the latter has a better prognosis
2. He needs a thorough assessment and serial mental status examination..if he does not want to visit a psychiatrist, force is not a good idea..rather, confinement is
Thanks
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Psychiatrist Dr. Sundar Gnanavel's  Response
Hello.........
Thanks for your query. Schizophrenic patients have no contact with reality i.e do not accept the fact that they suffer from mental illness. Compliance to drugs is vital for control of symptoms. Inpatient treatment even for a short period can be beneficial in some cases. Depot injections, alternative antipsychotic formulations, addressing concern about side effects of antipsychotics are other measures that can be tried.
Regards
Dr Sundar
Psychiatrist
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Schizophrenia, Taking Olimelt And Lopez. Will Hospitalization Help Recover Faster?

Hello and welcome to Healthcare Magic. Thanks for your query. I appreciate the concern you have for your brother. Yes, like you mentioned Schizophrenia is a chronic illness which can have relapses and fluctuations, especially if the person is not on regular medication. Now, refusal to take medication is a common problem with these patients and the reason is that they lack insight into the illness. i.e. they lose touch with reality and hence don t understand the fact that they have an illness or that they need treatment. In your brother s case, I feel that a short period of admission will help, especially since you mention that there is an exacerbation of symptoms. Once the symptoms are reasonably under control after the admission, there is a chance that he may be more co-operative to take medication. There is also an option of giving long acting injections (once in two weeks) which can be given if he still refuses medication. If he refuses to come to hospital, it should be okay to sedate him and take him to hospital. Once in the hospital, he can be given adequate medication to keep him calm till his psychotic symptoms come down. There is a legal provision also for involuntary admission and treatment for such patients. Wish you all the best. - Dr. Jonas Sundarakumar Consultant Psychiatrist