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Couldn't complete fellowship
29. Male. 5'6". 76 kg. Currently taking paliperidone 100 mg monthly depot injection, cariprazine 3 mg, vantaxa 10 mg
I got a fellowship in 2017. I left fellowship after 3 days of orientation sessions. i couldn't summon myself mentally during 3 days and was not interested and was doing it just for the sake of doing it. i felt foggy, disconnected, and had trouble focusing or processing what was being said. I thought the payment was too small for the effort that I was supposed to put in and the idea of completing 6 months felt overwhelming when I couldnt mentally engage for 3 days of orientation. I had no hallucination or delusions. Are my medication correct because I have not felt positive from medications that I am taking?
Answers (8)
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Needs detailed evaluation. It's difficult to make a diagnosis just based on these texts. And it's not legal either. Take proper consultation with a different psychiatrist.
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I can help you better with further treatment course needed. U can connect me via whatsapp on seven zero eight two zero two two zero six two.
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if you’re not feeling emotionally better or mentally clearer, it’s important to have your medication reassessed. Sometimes, high doses or certain antipsychotics can blunt emotions or worsen fog. Medication needs fine-tuning based on how you feel, not just textbook symptoms.
Discuss this honestly with your psychiatrist—they may adjust the dose or switch to a lighter regimen. Also, consider CBT and structured therapy to improve clarity, goal-setting, and motivation alongside medication.
Take therapy, and you can connect with me on nine two six six seven two six zero six five.
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Thank you for sharing this. It’s clear you’re self-aware and trying to understand how your medications are impacting you. The foggy, disconnected feeling and lack of motivation you're describing can be side effects of antipsychotic medications, particularly paliperidone and cariprazine, which may contribute to emotional blunting or cognitive dulling in some individuals- even in the absence of active psychosis.
It's also worth noting that vortioxetine (Vantaxa) is an antidepressant that usually helps with cognitive symptoms of depression, but the benefits vary individually. Since you're not experiencing delusions or hallucinations, your current antipsychotic dose might be higher than necessary, depending on your diagnosis and symptom history.
Next Steps
1. Consult your psychiatrist to reassess the need and dose of antipsychotics.
2. Ask about dose reduction or medication change (e.g., switching to a lower dopamine-blocking agent or evaluating need for continued depot).
3. Discuss whether your symptoms align more with residual depression, avolition, or medication-induced apathy.
4. Consider cognitive testing or therapy that focuses on executive function and motivation (CBT, behavioral activation).
Health Tips
1. Never adjust medications on your own—sudden changes can destabilize your mental state.
2. Keep a symptom diary for 2–3 weeks noting clarity, mood, energy, and engagement—it helps guide meaningful medication adjustments.
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While this isn't enough information to give a personalized opinion, there is enough to say there are several other medications out there of all different classes , however the duration and history of your medication and complaints needs to be noted for further management.
Consult your prescribing doctor or consult for a second opinion.
Thankyou
Next Steps
consult prescribing doctor or seek a second opinion.
Health Tips
avoid making unsupervised changes to the prescription.
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Based on the available information alone, opinion cannot be given. Many a times clinical observation and narrative of relatives/ close ones need to be taken into consideration also.
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Dr. Sunil Nagar
General Physician
17 yrs exp
Rewa
Connect
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Dr. Shailaja Bandla
Addiction Psychiatrist
19 yrs exp
Vijayawada
Hi.. will need further history regarding the same to advise appropriately. Consult online for further evaluation and management
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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.