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Suggest Treatment For Schizophrenia
Question: Hi
My brother was once hospitalized because of a catatonic stupor and had ect procedures. My brother is about to be hospitalized tomorrow again this time because he refuses to admit his paranoid schizophrenia (diagnosed by 3 doctors) and use the prescribed medication. His schitzofrenia is getting worse for a few years until recently they became very obvious (delusion (suspicious), expressionless gaze, problems with memory/speech, sits at home for 2 years just thinking, lately attacked our neighbor under the idea that he was secretly harming him by making his head hurt and not being able to sleep.
QUESTION: If the patient does not want to medicate by pills, what other options besides hospitalization do we have? My idea was to somehow inject him with the anti-psychotic that lasts a 3-4 weeks, and let him stay AT HOME while the symptoms go away and he starts to understand he needs to medicate.
My brother was once hospitalized because of a catatonic stupor and had ect procedures. My brother is about to be hospitalized tomorrow again this time because he refuses to admit his paranoid schizophrenia (diagnosed by 3 doctors) and use the prescribed medication. His schitzofrenia is getting worse for a few years until recently they became very obvious (delusion (suspicious), expressionless gaze, problems with memory/speech, sits at home for 2 years just thinking, lately attacked our neighbor under the idea that he was secretly harming him by making his head hurt and not being able to sleep.
QUESTION: If the patient does not want to medicate by pills, what other options besides hospitalization do we have? My idea was to somehow inject him with the anti-psychotic that lasts a 3-4 weeks, and let him stay AT HOME while the symptoms go away and he starts to understand he needs to medicate.
Brief Answer:
Yes,there is another option beside hospitalization
Detailed Answer:
Hello!
I read carefully your query and understand your concern about your brother.
I can imagine how difficult it is for your family all this situation.
You should know that for a patient with Paranoid Schizophrenia it is very important to take regularly the medication prescribed ,in order to prevent reoccurring psychotic episodes .He should be constantly monitored.
During these psychotic episodes ,your brother might be dangerous for himself and others.
He need help because he is not able to care for himself right now.
If he refuses to take the medication ,then you have 2 options left:
1)Hospitalization or move him in a residential living facility in which medical and psychiatric staff can give him the medication and monitor him 24 hours.
2)The other option is to give him an injectable form of medication.
There are several antipsychotic medications that can be administered as an injection in the arm, upper thigh, or buttocks.For example Risperdal Consta It’s typically given twice a month.
These are called Long-acting injectable (LAI) antipsychotics .The injection is administered by a psychiatric nurse or a doctor.
In this way he can stay at home ,with his family.
It is important that you monitor him 24 hours a day.If you can't monitor him constantly then hospitalization should be considered.
Please discuss with his treating doctor to decide which is the best option for him.
Hope it was of help.
Let me know if you have other questions or doubt to clarify.I will be happy to assist you further.
Kind Regards!
Dr.Rovena Murati
Yes,there is another option beside hospitalization
Detailed Answer:
Hello!
I read carefully your query and understand your concern about your brother.
I can imagine how difficult it is for your family all this situation.
You should know that for a patient with Paranoid Schizophrenia it is very important to take regularly the medication prescribed ,in order to prevent reoccurring psychotic episodes .He should be constantly monitored.
During these psychotic episodes ,your brother might be dangerous for himself and others.
He need help because he is not able to care for himself right now.
If he refuses to take the medication ,then you have 2 options left:
1)Hospitalization or move him in a residential living facility in which medical and psychiatric staff can give him the medication and monitor him 24 hours.
2)The other option is to give him an injectable form of medication.
There are several antipsychotic medications that can be administered as an injection in the arm, upper thigh, or buttocks.For example Risperdal Consta It’s typically given twice a month.
These are called Long-acting injectable (LAI) antipsychotics .The injection is administered by a psychiatric nurse or a doctor.
In this way he can stay at home ,with his family.
It is important that you monitor him 24 hours a day.If you can't monitor him constantly then hospitalization should be considered.
Please discuss with his treating doctor to decide which is the best option for him.
Hope it was of help.
Let me know if you have other questions or doubt to clarify.I will be happy to assist you further.
Kind Regards!
Dr.Rovena Murati
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi, thank you for the answear doc, if we decide to leave him at home and pay attention, do you think its a good idea to inject him by force? He will resist for sure resist his very strongly maybe even violently.
Brief Answer:
It might be necessary the first dose.
Detailed Answer:
Hello again!
Hope you are doing well!
It might be very difficult but you should try to convince him to take the medication.
You can do that by rewarding him if he takes the medication for example you can promise things he really likes if he agree to get treated or you can tell that this is the only way he can stay with his family at home.
If he continue to resist then you should give him the medication by force ,probably the first dose so he can improve enough to understand that he need medication.
If giving him the medication at home may result impossible then you should think the idea of living him under professional care at least until he gets better and then would be easier to convince him to take the medication.
Hope it helps.
Take care!
Dr.Rovena Murati
It might be necessary the first dose.
Detailed Answer:
Hello again!
Hope you are doing well!
It might be very difficult but you should try to convince him to take the medication.
You can do that by rewarding him if he takes the medication for example you can promise things he really likes if he agree to get treated or you can tell that this is the only way he can stay with his family at home.
If he continue to resist then you should give him the medication by force ,probably the first dose so he can improve enough to understand that he need medication.
If giving him the medication at home may result impossible then you should think the idea of living him under professional care at least until he gets better and then would be easier to convince him to take the medication.
Hope it helps.
Take care!
Dr.Rovena Murati
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you again DOC, please answer me this last thing. Is it common that a person with paranoid schizophrenia, never admits he is having any sort of hallucinations? Also that he is not sick and that WE the family and doctors are trying to make the sick person out of him? That he just needs to be left alone and not bothered being very negative and not happy to be around ones that loved him the most all his life?
Brief Answer:
It is not uncommon.
Detailed Answer:
Hello again!
Hope you are doing well!
I really apologize for the late reply.
Usually patients with paranoid schizophrenia have hallucinations ,mainly auditory ones (they hear things that are not real) but it is not uncommon for the patient not to have hallucinations.In these cases,the major symptom of schizophrenia are delusions ,which are strong believes or convictions that are resistant to any fact or evidence that proves the contrary.
So in the case of your brother ,he might not have hallucinations (he doesn't hear or see things that aren't real) but he might have strong believes that other peoples (including family members) want to harm him or kill him.He believes this despite any obvious evidence that this is not true.
He is convinced that he is not sick and people around him want to harm it.Even if he hears things that tell him these things ,he may hide this from you because he is convinced that you are the enemy for him and the voices protect him.
Since he has been diagnosed with paranoid schizophrenia from 3 different doctors ,this means that he has specific symptoms that complete the criteria to be diagnosed Paranoid Schizophrenia.
Sometimes it might be very difficult to diagnose mental disorders and for this reason there are some criteria that a patient should have to be diagnosed with a specific mental disorder.
Wish you all the best!
Take care!
Dr.Rovena
It is not uncommon.
Detailed Answer:
Hello again!
Hope you are doing well!
I really apologize for the late reply.
Usually patients with paranoid schizophrenia have hallucinations ,mainly auditory ones (they hear things that are not real) but it is not uncommon for the patient not to have hallucinations.In these cases,the major symptom of schizophrenia are delusions ,which are strong believes or convictions that are resistant to any fact or evidence that proves the contrary.
So in the case of your brother ,he might not have hallucinations (he doesn't hear or see things that aren't real) but he might have strong believes that other peoples (including family members) want to harm him or kill him.He believes this despite any obvious evidence that this is not true.
He is convinced that he is not sick and people around him want to harm it.Even if he hears things that tell him these things ,he may hide this from you because he is convinced that you are the enemy for him and the voices protect him.
Since he has been diagnosed with paranoid schizophrenia from 3 different doctors ,this means that he has specific symptoms that complete the criteria to be diagnosed Paranoid Schizophrenia.
Sometimes it might be very difficult to diagnose mental disorders and for this reason there are some criteria that a patient should have to be diagnosed with a specific mental disorder.
Wish you all the best!
Take care!
Dr.Rovena
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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