Schizophrenia: Medication Costs and Social Interaction Challenges

Q: Schizophrenia: Medication Costs and Social Interaction Challenges

Hello, online user： <br>Q： Will taking medication for schizophrenia lead to brain atrophy in the long term? <br>A： No, in fact, not taking medication and experiencing repeated episodes can lead to brain atrophy.<br>Q： Although delusions and hallucinations have resolved, is there

Schizophrenia and Medication Costs Issues

Dear Dr.
Wu,
I was diagnosed with delusional disorder (mild schizophrenia) at the beginning of last year.
I experienced auditory hallucinations for about two months, which later resolved on their own.
The delusional aspects have stabilized and have not recurred since I started taking Aripiprazole.
However, I am facing issues that I am unsure are negative symptoms, specifically difficulties in interpersonal interactions.
When I engage in conversations, aside from basic phrases like "please," "thank you," and "I'm sorry," as well as simple questions based on the current situation, I find it hard to express anything else.
This was not the case for me before.
For example, if someone mentions they are volunteering, I might ask where they volunteer, and when they respond, I would inquire about what they do there.
After their brief answer, I often find myself stuck, unable to think of any further responses.
Previously, I could navigate social interactions smoothly, but now, whether with acquaintances or strangers, I struggle to continue the conversation after just a few exchanges, which feels awkward and impolite.
I have noticed that my cognitive abilities seem to be declining; I am less agile in responding and my memory and reaction times are not as good as they used to be.
I have the following questions:
1.
Will long-term use of antipsychotic medications for schizophrenia lead to brain atrophy?
2.
Even though the delusions and hallucinations have resolved, is it possible that my brain is still impaired or deteriorating in terms of memory, cognitive function, and reaction time? Is recovery possible?
3.
Are the communication issues I am experiencing considered negative symptoms, and will they disappear with long-term medication use, or might they persist?
4.
I received my treatment at Far Eastern Memorial Hospital without being charged for medication.
Now that I want to transfer to Chang Gung Memorial Hospital in Tucheng, which is a teaching hospital, will the medication costs increase, and will they be expensive?
Thank you for taking the time to respond.
Wishing you peace and health.

Xiwang, 40~49 year old female. Ask Date: 2020/06/24

Dr. Wu Enliang reply Psychiatry

Hello, online user:
Q: Will taking medication for schizophrenia lead to brain atrophy in the long term?
A: No, in fact, not taking medication and experiencing repeated episodes can lead to brain atrophy.
Q: Although delusions and hallucinations have resolved, is there still damage or degeneration in areas such as memory, thinking, and reaction time? Is recovery possible?
A: Recovery is possible; it requires some training, such as engaging in psychiatric rehabilitation.
Activities that stimulate the brain and learning are necessary for recovery.
Q: Are issues with interpersonal communication considered negative symptoms? Will they disappear with long-term medication, or will they continue to persist?
A: Currently, there are no effective medications for negative symptoms.
Some new medications seem to have some effects that can be explored, but psychiatric rehabilitation is also necessary for better outcomes.

Dr.
Wu Enliang

Reply Date: 2020/06/24

More Info

Hello, thank you for your thoughtful questions regarding your experience with schizophrenia and the challenges you face in social interactions. It’s commendable that you are seeking to understand your condition better and are proactive about your health.

1. Long-term Effects of Antipsychotic Medications: Concerns about the long-term use of antipsychotic medications, such as the one you mentioned (likely Aripiprazole), leading to brain atrophy or shrinkage are common. Research indicates that while some studies have suggested a potential for brain volume changes in individuals with schizophrenia, it is not solely attributable to medication. The underlying pathology of schizophrenia itself may contribute to these changes. It’s essential to have regular consultations with your psychiatrist to monitor your health and adjust medications as necessary.
2. Cognitive Functioning Post-Symptoms: You mentioned that while your delusions and hallucinations have subsided, you are experiencing difficulties with memory, thought processes, and reaction times. This can be a result of both the illness and the medications. Cognitive deficits can persist even after positive symptoms are managed. However, there is potential for improvement. Engaging in cognitive rehabilitation strategies, such as cognitive-behavioral therapy (CBT) or cognitive training exercises, can help enhance cognitive functioning over time.
3. Negative Symptoms and Social Interaction: The difficulties you are experiencing in social interactions may indeed be classified as negative symptoms of schizophrenia. These symptoms can include reduced emotional expression, social withdrawal, and difficulties in initiating and maintaining conversations. While some individuals may find that these symptoms improve with treatment, others may continue to experience them. Ongoing therapy, particularly social skills training or group therapy, can be beneficial in developing your communication skills and boosting your confidence in social settings.

4. Medication Costs and Transitioning Care: Regarding your concern about medication costs when transitioning to a teaching hospital like Tucheng Chang Gung Hospital, it’s important to note that costs can vary based on the specific medications prescribed, the hospital's pricing policies, and whether you have insurance coverage. Teaching hospitals may have different pricing structures, but they often provide comprehensive care, which can be beneficial in managing complex conditions like schizophrenia. It’s advisable to discuss your financial concerns with the hospital’s billing department or your healthcare provider to understand potential costs and explore any available financial assistance programs.

In summary, while you may face challenges related to cognitive functioning and social interactions, there are avenues for improvement through therapy and support. It’s crucial to maintain open communication with your healthcare providers about your concerns, medication side effects, and any changes in your symptoms. They can help tailor your treatment plan to better suit your needs and improve your quality of life. Remember, recovery is a journey, and seeking help is a significant step towards managing your condition effectively. Wishing you peace and health on your path forward.

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