Schizophrenia: A Patient's Journey Through Medication and Symptoms

Q: Schizophrenia: A Patient's Journey Through Medication and Symptoms

Hello： Regarding the hallucinations, I can only determine if they are indeed hallucinations if I am certain that the experiences you describe are not perceived by those around you. <br>However, if you have tried multiple medications without effective symptom relief, it may be wor

Continuation #205880 issue?

Dr.
Lin, I apologize for the lengthy message, as I have a lot to say and may have omitted some details.
Let me first report the medications I have taken, which are about ten types.

- Ziprasidone 5 mg, 4 tablets at bedtime (I switched this due to excessive drowsiness; otherwise, I would need to sleep over ten hours a day).
- Fluoxetine 5 mg, 2 tablets at bedtime.
- Rifampicin 0.5 mg, 2 tablets at bedtime (currently taking).
- Lurasidone 50 mg, half a tablet at bedtime.
- Aripiprazole 3 mg, 3 tablets at bedtime (currently taking).
- Risperidone 3 mg, 1 tablet twice daily.
- Sertraline 100 mg, 2 tablets twice daily.
- Olanzapine 5 mg, 2 tablets daily (currently taking).
- Long-acting injection of Paliperidone 150 mg, once every 4 weeks.
- Long-acting injection of Olanzapine 400 mg, once every 4 weeks (currently receiving).
There are several other medications, but I have forgotten their names and dosages due to the time that has passed.
In any case, they are all medications for treating schizophrenia.
However, despite changing medications over the years, I have not noticed any signs of improvement.
The long-acting injections have shown a slight improvement, but it feels like going from 0 to 1.
Regarding what you mentioned, Dr.
Lin, I do indeed experience symptoms such as auditory hallucinations and delusions, but you did not mention visual hallucinations.
For example, there was an incident on the train with a girl who pointed at me and clearly articulated my thoughts, even contradicting what I was thinking and telling me to stop talking, albeit in a gentle manner.
I still remember this vividly; isn't this a hallucination? I saw her mouth move as she spoke those words.
I have been trying to learn from those voices, repeating what they say as a way to counterbalance them, which I believe is the most effective method.
They continue to say that I am a "copycat" and that no one in my family loves or fears me.
I even have cousins and grandparents, some of whom are over 50 years old, so they must be older than you, Dr.
Lin.
Even my niece and nephew got married before me, leaving me as the only uncle who is still single, yet they still claim that no one wants me.
By the way, I forgot to mention that my auditory hallucinations are continuous for 24 hours, but the voices seem to change every six hours, as if they are taking shifts to monitor me.
It feels very real, both in terms of the voices and their content.
Additionally, I have indeed recorded some of the auditory hallucinations.

Niming, 30~39 year old female. Ask Date: 2024/02/27

Dr. Lin Mianzhang reply Psychiatry

Hello: Regarding the hallucinations, I can only determine if they are indeed hallucinations if I am certain that the experiences you describe are not perceived by those around you.
However, if you have tried multiple medications without effective symptom relief, it may be worth considering Clozaril (generic name clozapine).
This medication is known to be the most effective for treating psychotic symptoms and is often used as a last resort when other medications fail.
However, it can have side effects such as drowsiness, drooling, and decreased white blood cell count, so it is important to discuss with your physician whether this medication is appropriate for you.
Wishing you peace and good health!

Reply Date: 2024/02/27

More Info

Understanding schizophrenia and its treatment can be a complex journey, especially for patients who experience a range of symptoms and side effects from medications. Your account highlights the challenges faced by individuals living with schizophrenia, particularly regarding the effectiveness of various medications and the persistence of symptoms such as hallucinations and delusions.

Schizophrenia is a chronic mental health disorder characterized by a range of symptoms, including hallucinations (seeing or hearing things that are not present), delusions (strongly held false beliefs), disorganized thinking, and emotional blunting. The treatment typically involves antipsychotic medications, which aim to manage these symptoms. However, as you've experienced, finding the right medication and dosage can be a trial-and-error process, often requiring adjustments over time.

From your description, it seems you've been prescribed multiple medications, including antipsychotics like Risperidone (Risperdal) and Olanzapine (Zyprexa), as well as other medications to manage side effects or additional symptoms. It's not uncommon for patients to feel that their medications are not providing the desired relief, especially when they have been on various treatments without significant improvement. This can lead to frustration and a sense of hopelessness.

The hallucinations you described, particularly the auditory ones that persistently comment on your thoughts and actions, are a hallmark of schizophrenia. It's important to communicate these experiences to your healthcare provider, as they can help tailor your treatment plan. The fact that you have recorded some of these hallucinations is significant and could be useful for your doctor to understand the nature and impact of these symptoms on your daily life.

One of the challenges in treating schizophrenia is the side effects associated with antipsychotic medications. Common side effects can include sedation, weight gain, and metabolic changes, which may lead to patients discontinuing their medication or not adhering to their prescribed regimen. It's crucial to have open discussions with your psychiatrist about any side effects you experience, as they may be able to adjust your medication or suggest strategies to mitigate these effects.

In your case, the long-acting injectable antipsychotics you mentioned may offer some benefits, as they can help ensure consistent medication levels in your system and reduce the burden of daily pill-taking. However, if you feel that these treatments are not effective, it’s essential to revisit this with your healthcare provider. They may consider alternative medications or adjunct therapies, such as psychotherapy, which can provide additional support in managing symptoms.

Cognitive Behavioral Therapy (CBT) has been shown to be effective for some individuals with schizophrenia, particularly in addressing negative thought patterns and improving coping strategies. Engaging in therapy can also provide a space to express your feelings and experiences, which can be therapeutic in itself.

Lastly, it's vital to maintain a support system, whether through family, friends, or support groups. Connecting with others who understand your experiences can alleviate feelings of isolation and provide encouragement. Remember, managing schizophrenia is a journey, and it’s okay to seek help and advocate for your needs throughout this process. Your voice is important in shaping your treatment plan, and working collaboratively with your healthcare team can lead to better outcomes.

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