Schizophrenia: Cognitive Decline and Treatment Challenges

Schizophrenia

I have been taking Risperidone 2mg for two years and ten months.
Initially, I was concerned about others' attention, and I had delusions without hallucinations.
However, during the medication process, I gradually experienced a decline in judgment, emotional flatness, and a vacant stare.
Since last November, I have started to feel numbness in my head (I haven't undergone an EEG, but the nerve conduction study showed slower wave speeds on one side compared to my peers) and simple sexual fantasies (just talking to someone of the opposite sex for a while weakens my awareness and creates sensations).
I also try to suppress these feelings.
A month ago, I stopped taking the medication for a few days, and by the third day, my body was completely unresponsive.
Looking back, the best way to describe it is like being as ignorant as a newborn baby.
My father asked me to eat, and I almost forgot how to eat.
Oh my God, can severe cognitive impairment from schizophrenia make one as ignorant as a newborn? Now, I can only take it one day at a time.
My family took me to the hospital, insisting I undergo inpatient evaluation.
I firmly refused, worried about the high dosage of medication.
I feel so helpless and am gradually losing more abilities.
I currently have a prescription for 30mg of Olanzapine from the doctor, but I am afraid to take it and just want to end this.
Can severe cognitive impairment from schizophrenia make one as ignorant as a newborn? I sincerely thank the doctors for answering this question.

Jenny, 10~19 year old female. Ask Date: 2017/06/01

Dr. Zhang Fangrong reply Psychiatry

Dear Sir/Madam,
Thank you for your inquiry.
Based on your description, I can sense your discomfort and concern.
There are several aspects of your symptoms and changes that need to be considered.
Your worry about "cognitive decline leading to ignorance akin to that of a newborn" is, in my estimation, unlikely, as your writing and cognitive abilities appear to be quite intact from your correspondence.

Regarding the "gradual decline in judgment during the medication process," it is important to consider that this could be a side effect of the medication.
Additionally, the "cognitive decline resembling the ignorance of a newborn" may also be a withdrawal symptom after discontinuing the medication.

I recommend that you have a thorough discussion with your physician about the changes in your symptoms and consider adjusting your medication.
I believe there is a good chance to stabilize your condition and restore your daily life.
Wishing you good mental and physical health.
Sincerely,
Dr.
Chang Fang-Jung
General Psychiatry

Reply Date: 2017/06/01

More Info

Understanding schizophrenia and its associated cognitive decline can be a complex and challenging journey, particularly for those who have been diagnosed and are undergoing treatment. Your experience highlights several important aspects of this condition, including the impact of medication, cognitive function, and the emotional toll it can take on individuals.

Schizophrenia is a chronic mental health disorder characterized by a range of symptoms, including delusions, hallucinations, disorganized thinking, and cognitive impairments. Cognitive decline is a significant concern for many individuals with schizophrenia, as it can affect their ability to think clearly, make decisions, and interact socially. This decline can manifest as difficulties in attention, memory, and executive functioning, which can be exacerbated by the side effects of antipsychotic medications.

In your case, you mentioned taking Risperidone (理斯必妥) for over two years, which is an atypical antipsychotic commonly prescribed for schizophrenia. While these medications can be effective in managing symptoms, they can also lead to side effects such as emotional blunting, cognitive slowing, and decreased motivation. The experiences of feeling "numb" or having a "blank stare" can be distressing and may contribute to a sense of disconnection from reality.

The cognitive decline you described, particularly the feeling of being like a "newborn baby" in terms of awareness and understanding, is concerning. It is essential to recognize that cognitive impairments can be a direct result of the disorder itself or a side effect of the medication. In some cases, individuals may experience a phenomenon known as "neuroleptic-induced cognitive impairment," where the cognitive side effects of antipsychotic medications can mimic or exacerbate the cognitive deficits associated with schizophrenia.

It is crucial to communicate openly with your healthcare provider about your symptoms and concerns. If you are experiencing significant cognitive decline or side effects from your medication, your doctor may consider adjusting your treatment plan. This could involve changing the dosage, switching to a different medication, or incorporating cognitive rehabilitation strategies to help improve cognitive function.

Additionally, it is worth noting that the process of recovery from schizophrenia is often non-linear. While some individuals may experience periods of stability and improvement, others may face setbacks. Engaging in supportive therapies, such as cognitive-behavioral therapy (CBT), can be beneficial in addressing cognitive deficits and improving coping strategies.

Regarding your concerns about hospitalization, it is understandable to feel apprehensive about being admitted for treatment. However, hospitalization can provide a structured environment where you can receive intensive support and monitoring, especially if you are experiencing severe cognitive or emotional distress. It is essential to prioritize your well-being and consider the potential benefits of receiving comprehensive care.

In conclusion, navigating the complexities of schizophrenia and its cognitive effects can be challenging. It is vital to maintain open communication with your healthcare team, advocate for your needs, and explore various treatment options to find what works best for you. Remember that recovery is a journey, and seeking help is a courageous step towards regaining control over your life.

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