Question:
My stepson, 21, has been diagnosed with
schizophrenia. Problems started from 14
and a half years of age.
We have asked for psychological,
forensic, adult ADHD assessments to be
carried out but are still waiting. He
is impossible to live with as he
becomes very abusive and aggressive,
especially when the word "no" is
mentioned. He has been in the care of
the social services who now cannot find
anywhere for him as he has ruined every
placement. He appears to self
destruct. The only person missing out is
himself. The best way to describe him
is that he keeps cutting off the hand
that feeds him. He is now getting in
trouble with the police as he has nowhere
to stay. I feel I can't help as
he is breaking up the family, but I
still believe he has not had the
correct diagnosis. I could go on, but
this gives a flavour.
Advice?
Dr. Heller's Answer:
It sounds like a heartbreaking
situation. The major treatment for
schizophrenia is an atypical
antipsychotic medication such as
Zyprexa, Risperdal, Abilify and others.
If the BPD is present with
schizophrenia the combination of Prozac
(fluoxetine), Tegretol (carbamazepine)
and Zyprexa (olanzapine) usually gets
them significantly better -- if they'll
take the medication. Since Zyprexa
causes such significant weight gain I
will usually switch to an alternate
antipsychotic once the individual is
stabilized. All three of these
medications have scientific studies to
back them up in the BPD, plus Tegretol
and Zyprexa have been shown to help
with bipolar if that is present.
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