What Causes Auditory Hallucinations Along With Suicidal Thoughts?

Posted on Mon, 16 Mar 2015

Question: I'm currently seeing the crisis team as I'm hearing distressing voices and feeling suicidal. I am due to see the team doctor tomorrow to review my medication as I told them it had been six weeks since I had taken my medication (Aripiprazole and Sertraline). This is strictly true as it's been six weeks since I last swallowed a tablet but it's been about six years since I took any medication consistently. I hate swallowing tablets and often have difficulty doing so. I gag and cough them up again, even small ones. It usually takes several attempts to take them by which point the tablet has started to disintegrate and tastes disgusting. Because of this I avoid taking any meds that don't feel necessary - I'll take pain killers if I'm in pain but not the meds I'm prescribed for mental health symptoms. I take them from time to time if the symptoms seem bad. I know these meds need to be taken on a consistent basis and I always have good intentions to do so. I just never carry through. In the past I have told my psychiatrist I have difficulty taking pills and have as a consequence been put on depot injections and liquid lithium but even then I found myself avoiding taking them. I was always paranoid my lithium blood levels would give away that I wasn't taking it properly. I suppose part of me doesn't want to take medication I don't feel like I really need. I can't fully explain my reluctance to take meds but it's there and probably a major reason why I keep having these crises. Should I tell the psychiatrist this tomorrow? Can I be forced to take medication? I'm in England.

Answered by Dr. Seikhoo Bishnoi (48 minutes later)

Brief Answer:
You can't be forced to take medicines

Detailed Answer:
Hello thanks for asking from HCM

I can understand your concern, a lot of individuals find it difficult to swallow pills and this result in development of fear and reluctance to take medicine. You took tablets consistently but stopped them 6 weeks back and this has resulted in development of symptoms again like hearing distressing voices, feeling suicidal etc. A lot of medicines used in mental disorders have side effects which also result in avoidance to medicines. But they are necessary for maintainence of proper mental functioning so you should reassure yourself to take the medicines again.

As you have mentioned that you gag while taking pills in such case medicines which are available in liquid form or in long acting injectable form can be used. Aripiprazole is used as antipsychotic and mood stabiliser so we can use other drug with similar action for your symptoms. Risperidone is a drug that is available in liquid form which is tasteless. You can take the drug by mixing with food or water also.

Fluphenazin, Haloperidol etc are available in long acting injectable form can also be tried. These medicines are better tolerated and are free of serious side effects. You can tell your psychiatrist about the problem you are having while taking medicines and then can discuss for the drugs I have mentioned. These drugs are better tolerated and would not cause much side effects.

They can't force you to take drugs.

Thanks, hope this helps you, if you have more doubts ask again.

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Above answer was peer-reviewed by : Dr. Shanthi.E