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Antipsychotic tolerence
My mother 58 years old is chronic schizophrenic from 25 years , ect was done 25 years ago ..now she initially respond to each antipsychotic with lowest dose but she can't sustain it after 3-4 months even with the highest dose of that particular antipsychotic ...we have tried resperidon , olanzapine , amisulpride , haloperidol , clozapine with max dose and even the cocktail of all these drug .. initially she responded to each single drug with lowest dose but overtime she does not respond to that drug or we can say she can't sustain the efficacy of any antipsychotic in long time (4-8 month max) ...we can't go for ECT as she is old ...why it is happening ? What this phenomenon is called ? What should be our next approach ? Can we investigate into any synaptic tissue damage ? It is not that she doesn't respond to any antipsychotic but she simply can't sustain in long run even after increasing the dose...
Answers (4)
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Hello there,
Schizophrenia is a chronic mental illness with 20% of patients not responding or partially responding to medications. ECT is a better choice even in old age if medicines are not responding over time.
The family dynamics at home is also important factor which can lead to persistence of symptoms.
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We can consider addingmood stabilizer
First need to rule out comorbid illneeses and compliance of therapy
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Dr. Dinesh Reddy P
Psychiatrist
10 yrs exp
Chittoor
Consult Psychiatrist
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Dr. Priyanka Rani
Psychiatrist
8 yrs exp
Sangrur
We need to ensure compliance firstly. Chronic schizophrenics do have residual symptoms. We need to evaluate whether we are dealing with residual symptoms or relapse or comorbid symptoms from other domains or any other comorbidity overlapping the illness. Next line of management can be decided only after that.
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.