Question: Hi, my mom has been diagnosed with schizophrenia. She is ok now. She was prescribed oral invega + aloperidol + akineton (biperiden), but after 1 week of treatment had severe palpitations and felt like suffocating and needed an ambulance. The doctor told to reduce invega to half. 1 week after, no severe palpitations, but the other insupportable effects lasted(including dry mouth).
She was told akineton causes these effects.
I read about it and it only seems to treat parkinsonism and tremor(which are common side effects of anti-psychotics, I know), but my question is: is it really necessary, especially when it causes such awful side-effects? She reduced the biperiden dose to half and had no changes, so it seemed like the drug didn't do any good for her, only harm. She didn't acquire any tremor because of the reduced dose. So, why take it? Tremor is 100x better than those side effects.
The psychiatrist told us to restore the akineton to one full pill and didn't listen too active on my rationale.
Thank you so much and I look forward to your expertise!

Thank you

The doctor has changed the medication 2 days ago, because of the major side effects.
Now instead of Invega + Aloperidol, it only takes one medication: olanzapine
Can you tell me more about what's different for this one(but only if you think it's relevant to talk about it)?

More importantly, can you tell me if the major effect of not taking anticholinergics with antipsychotics (stiffness, rigidity, permanent brain damage) appear suddenly or slowly?
I'm asking because chronic constipation is a trigger for many health problems, including cancer. Also, lack of saliva in mouth is a paradise for invaders, causing a lot of problems, tooth decay being the least concern.
I'm thinking if there's a better way to find what's optimal to do considering her treatment.

Even more importantly, can you please tell me your experience with patients taking these drugs, especially what happened to them long-term and if they ever stopped needing them?
I know my mom was always suspicious about things, but in her first and only psychotic episode (threw some stuff over the window) I can understand why she did what she did. She was VERY stressed about her work (cleaning, child-care), her patron being mean to her, she always felt cornered and forced to work, even when we told her she shouldn't work 7/7 days a week.
I know she's genetically predisposed to this condition and that she's more sensible to stress and its negative effects, but if she'll eliminate the majority of the stress in her life AND sleep at least 7 hours per day, drink no stimulants(caffeine, alcohol), exercise, shouldn't she feel better, without anti-psychotics?
I mean, her paranoia was just very elevated during the time of high stress and/or exposure to continuous mild stress. It's not that it appeared suddenly. She hadn't had hallucinations or anything. She just fell into a vicious circle of stressing-> thus, not sleeping-> thus, stressing more .. etc which obviously altered her thinking. She behaved (almost) amazingly well after the doctors at the hospital made her sleep.
Even I, if I sleep too little, begin to have some thinking gaps, but this is normal - I've seen it in a lot of people who were tired. It's just that she gets stressed too easily and has a constant mild background stress - this destroys her slowly, more than anything else, I'm almost sure of it.
What are your thoughts on this?

I really appreciate your answers. Thank you