How To Diagnose Schizophrenia?

Posted on Fri, 7 Aug 2015

Question: I have been diagnosed as having chronic paranoid schizophrenia, however, I cannot tolerate the dosages of medications that are usually prescribed for that condition. For many years I only took 0.5mg - 1mg of Risperidone per day and that kept me on the straight and narrow. I am now on Seroquel, 100mg per day, however, I am finding that is too much and am going to drop it down to 50mg per day because I am sleeping excessively and can't get out of bed before 10am each day and even then I have to have 3 strong coffees before I am awake.

I see this as a very strong indication that I do not have schizophrenia. Would you agree? If it isn't schizophrenia then what would it be? Maybe schizoaffective disorder?

Answered by Dr. Manisha Gopal (54 minutes later)

Brief Answer:
take seroquel by 7pm/ can try amisulpride

Detailed Answer:
Hello,

Inorder to diagnose or rule out schizophrenia one needs complete history of the patient. Without this it is impossible to make or refute a diagnosis.

It is not that your diagnosis changes if you are unable to tolerate medicines. Seroquel has an inherent property of sedation and almost all patients have this problem. This thing weans down after some time. It is best if you take seroquel by 6-8pm- then the sedative effect will get away early next day and you will feel good and alert.
Taking adequate water all day long also helps in clearance of drug from the body and lessening sedation.

Drugs like amisulpride are better if someone is prone for sedative and other side effects of anti psychotics. You can try to talk to your doctor about it.

Whatever the diagnosis be - schizophrenia or schizoaffective- both have schizophrenia criteria fulfilled. In schizoaffetive disorder, the criteria of mood disorder is also fulfilled simultaneously. And as I mentioned earlier, untill and unless a detail symptom history is given -its difficult and even wrong to say anything about the diagnosis.

So, try to take drug early in evening; take more water; or change to amisulpride if needed after discussing with your team!

You may try reducing the seroquel dosage to 75mg and not 50mg directly.

Wish you luck and best health.

Do ask more queries for clarification.
Dr. Manisha Gopal
MD Neuropsychiatry

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

Follow up: Dr. Manisha Gopal (33 minutes later)

Thank you Dr XXXXXXX

Answered by Dr. Manisha Gopal (2 hours later)

Brief Answer:
imipramine also gives drowsiness- check it also

Detailed Answer:
Thank you too! And have a speedy recovery..

P.S. imipramine is also a drug which gives sedation or drowsiness to many people. So check that too!

Dr. Manisha Gopal
MD Neuropsychiatry

Note: For further guidance on mental health, Click here.

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