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Suggest Treatment For Schizoaffective Disorder

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Posted on Mon, 2 Jan 2017
Question: My son was hospitalized once 6 years ago, he was in psychosis and doctors had a difficult time stabilizing him. Not sure if it was the constant medication switch. He has been stable ever since.
Diagnosis was schizo affectice disorder but they are not sure. As a child he always lacked focus, so we tried different meds. He has been on 5 mg Abilify and it keeps him stable but very flat. Existing, but not functioning very well. At one point when he was weaned off of the heavy amount he was on, Abilify and a tiny fraction of Effexor, he was perfect. Nor sure what the exact dose was.
Here is the scoop: We had a "Gene Sight" testing done. Wellbutrin, which he had been on before, he became overly concerned about small things. Well, this was on the recommended list of the test. His doctor put him on 300 mg of Wellbutrin along with the 5mg Abilify.
Do you think he should on a amount of Wellbutrin ? Daniel's doctor tried 75 mg Effexor with him a month ago and he had to stop because he could not sit still. I told the doctor it was a very small dose long ago when we saw a great improvement, but this new dosage of 75 mg is not small. It is difficult to get doctors to listen as to what is being said. My son went through hell to get to this point. If the Abilify is increased a tad bit would that take him out of this slump?
Thank you so very much for your time.
doctor
Answered by Dr. Alexander H. Sheppe (1 hour later)
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

I would recommend going back to the regimen on which your son was most stable: the Abilify combined with Effexor. Genesight testing might make certain suggestions like Wellbutrin, but I wouldn't switch someone off of a stable regimen based on Genesight testing recommendations. I will note that Effexor 75mg is actually a very small dose... typical dose ranges of this medication are 150-225mg. Abilify 5mg is also a very small dose... typical dose ranges are 15-45mg. So there is always room to increase both of these.

Dr. Sheppe

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tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Alexander H. Sheppe (16 hours later)
Thank you very much for your response. XXXXXXX was on 30mg of Abilify and 75mg of Effexor while he was in the hospital. You could have sent him off a cliff if you know what I mean. He was like a Zombie. We took him to a Holistic Doctor but also a Psychiatrist who started weaning him off of everything very slowly. We had to reduce the Effexor from the above amount to a 1/4 of a pill of 37.5 mg in 3 week increments.
On Abilify, we went down to 1/2 pill of 2mg for 3 weeks and then stopped. Shortly before the last drop in meds, XXXXXXX was perfect. Then he became totally quiet.This Genesight test states that effexor as well as Abilify should be used with caution and in a small dose. Could it be that his needs are well below what is considered a small dose? It is difficult to figure out because both meds were dropped gradually. What then was the correct balance? All I can say is that large doses make him very hyper or shut him down.
doctor
Answered by Dr. Alexander H. Sheppe (10 hours later)
Brief Answer:
Followup

Detailed Answer:
I understand.

I would return to this regimen: Abilify 15mg and Effexor 75mg. These are both small doses. He is currently not receiving enough medication and is relapsing into psychosis.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
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Above answer was peer-reviewed by : Dr. Nagamani Ng
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Dr. Alexander H. Sheppe

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Practicing since :2014

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Suggest Treatment For Schizoaffective Disorder

Brief Answer: Consultation Detailed Answer: Hello, and thanks for your question. I would recommend going back to the regimen on which your son was most stable: the Abilify combined with Effexor. Genesight testing might make certain suggestions like Wellbutrin, but I wouldn't switch someone off of a stable regimen based on Genesight testing recommendations. I will note that Effexor 75mg is actually a very small dose... typical dose ranges of this medication are 150-225mg. Abilify 5mg is also a very small dose... typical dose ranges are 15-45mg. So there is always room to increase both of these. Dr. Sheppe Please ask me future questions directly at this link: tinyurl.com/DrSheppeAnswers