We as parents having great difficulty in convincing our daughter that she has a problem and she should listen to her family doctor and see a psychiatrist.She is withdrawn and won't communicate with us or others for three weeks now. Once we had to admit her to hospital involuntarily and she was there for three months.She improved very much and she was taking the medication reluctantly for three months after she came home and suddenly she stopped.She is very much afraid to take this type of medication because of a severe reaction she suffered due to a higher dosage prescribed by a psychiatrist at the very beginning.She was diagnosed as paranoid schizophrenia. Now she behaves differently,"excessive cleaning,nail biting, washing her plates and cups many many times.Keeping things in an orderly fashion (excessive). She used to read religious books all the time and now she has stopped.She was writing pages and pages of religious and philosophical stuff and then destroy them.She has stopped that 3-4 wks.Won't talk with us. Will give very brief answers to questions.Won't answer the telephone. She won't face a camera to take a picture.
She is 38 yrs, highly educated with two university degrees.
PLEASE how can we tackle this problem? Any advice you can give will be very much appreciated.
The symptoms seem to be related to a new psychotic episode or negative symptoms of schizophrenia. (Some symptoms may also be obsessive compulsive symptoms but may be caused by the psychotic disorder). Poor compliance to swallow antipsychotic medication is the major reason for relapse of psychotic episodes. New atypical neuroleptics are rather good drugs but the patients usually do not feel any need to swallow a pill feeling "normal". Sometimes the sideeffects of the drugs (weight gain) may be influence this decision. In Germany we would discuss psychosocial
option (e.g. sending a nurse to the patient to optimize compliance or daycare treatment at a hospital). Another option would be an injection of a neuroleptic medication. One new atypical neuroleptic is a rather good and safe option (Risperdal Consta)
http://www.drugdigest.org/DD/DVH/Uses/0,3915,552834%7CRisperidone+Injection,00.html
But the patient needs to agree to this medication as well...