How Long Does Medication Adjustment Take During Psychiatric Hospitalization?

How long does it take to adjust medication during hospitalization?

The patient was diagnosed with bipolar disorder during an outpatient visit; however, due to poor medication response, they were admitted for inpatient treatment.
They have now been hospitalized for almost a month, but the doctor is currently treating them for schizophrenia.
There are several questions we would like to ask the physician:
1.
Is it possible to be diagnosed with bipolar disorder in an outpatient setting and later found to have schizophrenia during hospitalization?
2.
After nearly a month of inpatient medication adjustment, the patient's condition has gradually improved, but this week, there are suspected side effects from the medication, such as a blank expression and slow walking.
As family members, we feel heartbroken seeing this and are unsure whether to trust the medical team or seek another doctor for the patient.
3.
How long does it typically take during inpatient treatment to find the most suitable medication for the patient?
4.
As family members, what can we request from the doctor? Watching our loved one suffer is truly painful, and we wish we could take their place in their illness.

jing, 30~39 year old female. Ask Date: 2013/04/20

Dr. Zhang Jiafen reply Psychiatry

Hello, from your letter, I can sense your deep concern for your family.
I believe that with such care and support, your family member will surely regain their health.
Regarding your questions, here are some suggestions:
1.
Is it possible to be diagnosed with bipolar disorder in an outpatient setting and later found to have schizophrenia during hospitalization? Suggestion: Yes, this situation can indeed occur.
During acute phases of certain mental disorders, symptoms can sometimes overlap, leading to different differential diagnoses.
For example, a cough is a physical symptom that can present in various conditions such as a cold, pneumonia, or asthma.
2.
It has been nearly a month since the medication adjustment during hospitalization, and there has been gradual improvement.
However, this week, side effects of the medication seem to have emerged, such as a blank expression and slow walking.
As family members, it is painful to see this, and we are unsure whether to trust the medical team or seek a new doctor for the patient.
Suggestion: It is common during the medication treatment process for side effects to raise concerns about the safety of the treatment for both the patient and the family.
However, the best approach is to discuss the observed conditions and key concerns with the medical team.
Some family members may be concerned about the frequency or dosage of the medication.
Clear communication with the current treatment team is advisable.
3.
How long does it typically take to find the most suitable medication for the patient during hospitalization? Suggestion: Generally, hospitalization in an acute psychiatric ward usually takes 1-2 months, although the duration of treatment can vary based on individual circumstances and medication responses.
4.
As family members, what can we request from the doctor? Suggestion: I believe that the medical team and the family should share a common goal: to stabilize the patient as quickly as possible.
However, sometimes differing concerns or priorities can lead to misunderstandings.
The best solution in such cases is to communicate directly and discuss these issues.
Wishing you and your family all the best.

Reply Date: 2013/04/20

More Info

When it comes to psychiatric hospitalization and medication adjustments, it's essential to understand that the process can be complex and varies significantly from patient to patient. Here are some insights based on your questions:
1. Diagnosis Change from Bipolar Disorder to Schizophrenia: It is indeed possible for a patient initially diagnosed with bipolar disorder to later be diagnosed with schizophrenia. Mental health disorders can present with overlapping symptoms, and sometimes, the full clinical picture only becomes clear after a more extended observation period in a hospital setting. Symptoms such as delusions or hallucinations may not have been evident during outpatient visits but can emerge during hospitalization. This is why ongoing assessment is crucial in psychiatric care.

2. Managing Side Effects: It's understandable to feel distressed when witnessing a loved one experiencing side effects from medication, such as a flat affect or slowed movements. These symptoms can be indicative of the medication's impact on the patient's neurological functioning. It's vital to communicate openly with the healthcare team about these concerns. Trust in the medical team is essential, but so is advocating for your loved one. If side effects are severe or concerning, discussing the possibility of adjusting the medication or exploring alternative treatments with the psychiatrist is appropriate. Remember, the goal is to find a balance between managing symptoms of the mental illness and minimizing side effects.

3. Duration of Medication Adjustment: The timeline for finding the right medication can vary widely. In some cases, it may take a few weeks to a couple of months to identify the most effective medication regimen. Factors influencing this timeline include the patient's specific symptoms, their response to medications, and the presence of any co-occurring disorders. Regular follow-ups and open communication with the medical team can help expedite this process. It's also important to remember that finding the right medication is often a trial-and-error process, and patience is key.

4. Family Involvement in Treatment: As family members, you have a crucial role in the treatment process. You can request regular updates from the medical team about your loved one's progress and any changes in treatment plans. Additionally, you can express your observations regarding your loved one's behavior and side effects, which can provide valuable information for the healthcare providers. Participating in family meetings or therapy sessions, if available, can also help you understand the treatment process better and support your loved one effectively.

In conclusion, navigating psychiatric treatment can be challenging for both patients and their families. It's essential to maintain open lines of communication with the healthcare team, advocate for your loved one's needs, and be patient as the treatment plan is adjusted. Remember that mental health treatment is a journey, and finding the right path may take time. Your support and involvement are invaluable during this process.

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