My dad is 73 years old he has slowly developed Schizophrenia . Doctors prescribed me Respiredone 0.5 mg for a week. It's been 2 days he doesn't sleep much at night but sleeps during the day a bit . He is hyper active in the morning narrating his hallucinations and delusions. I hope he improves I have a day job & can't lose it. The doctor asked me to wait at least 2 weeks to see a positive sign. He slightly has speech problems his voice isn't clear in the morning and I consulted the doctor asked me to wait for 2 weeks before side effects go away
This is a difficult situation that many people find themselves in as our loved ones age. In many cases these medication are prescribed off label for dementia due to agitation, hallucinations and other symptoms that look like psychiatric illness. I don't know exactly what the story is but my point is to look at possible medical causes for changes in behavior. It would be rare (although not impossible) for someone at that age to develop schizophrenia. I hope these details help, if your not subscribed to the channel please do and spread the word about what we are doing here
I would probably consider amisulpride with clozapine augmentation as favourable recpetor profiles. Risperidone at its high dose rather has a stronger D2 affinity. Royal college of psychiatrists would overall stipulate poor evidence of combination or HDAT with rather significant adverse risk burden including NMS. Need to consider that dopamine hypothesis may also need further revision and to consider glutamate or GABA is implication and thus any additional conventional antipsychotics may not be any effective and again increase adverse effect burden.
Perphenazine in particular is a nice augment in clozaril partial response. Multiple antipsychotics is still best avoided but I like your emphasis on "rational" polypharmacy.
You do not mention a growing population of elderly people 70's, 80's and 90s with dysphagia, tardive dyskenesia, heart condition and thyroid condtion which has very little science or knowledge from all doctors today. Alternative less side effect non-prescription medication needs to be used so more people are not dying from polypharmacy meds that are overused and missued. Additionally, nutrition is an essential source of life. "Food is medicine and Medicine is food" and this is not studied while in medical school and causes people like myself to believe medical care is a very jaded and a crooked system. Now I am being pushed to use antipsych meds and it is an ongoing horrific experience. The only option I can think of is olanzapine 1.25mg as it also assist with appetite and mood.
I could not possibly comment on what the decision making process was for your medication choice. I would talk with the doctor you are working with and ask the same question. As far as these medications causing anhedonia, it's possible that it's not anhedonia and part of the disease process itself (negative symptoms of schizophrenia or prodromal phase of illness for example can look like depression) hope this helps
@@ShrinksInSneakers nah, it is the haldol that blocks strongly the dopamine and you just lost pleasure of things, like cmon man, is very obvious and you know it
Some SSRIs have been found in some studies to reduce dopaminergic activity (intensity or frequency of firing) but other studies have shown the opposite, particularly with prozac. I don't believe that any antidepressants have shown meaningful clinical efficacy as antipsychotic monotherapy. They have actually been shown to potentiate dopaminergic activity which is potentially related to the mechanism by which they can induce mania
I don't think anyone believes this, there are many ways to address mental health but many people look for the path of least resistance and taking a pill is a lot easier than making real change in your life. Just my opinion
My dad is 73 years old he has slowly developed Schizophrenia . Doctors prescribed me Respiredone 0.5 mg for a week. It's been 2 days he doesn't sleep much at night but sleeps during the day a bit . He is hyper active in the morning narrating his hallucinations and delusions. I hope he improves I have a day job & can't lose it. The doctor asked me to wait at least 2 weeks to see a positive sign. He slightly has speech problems his voice isn't clear in the morning and I consulted the doctor asked me to wait for 2 weeks before side effects go away
This is a difficult situation that many people find themselves in as our loved ones age. In many cases these medication are prescribed off label for dementia due to agitation, hallucinations and other symptoms that look like psychiatric illness. I don't know exactly what the story is but my point is to look at possible medical causes for changes in behavior. It would be rare (although not impossible) for someone at that age to develop schizophrenia. I hope these details help, if your not subscribed to the channel please do and spread the word about what we are doing here
This video is fantastic! I will be sharing it with new NP’s and students! Thank you!!!!
I would probably consider amisulpride with clozapine augmentation as favourable recpetor profiles. Risperidone at its high dose rather has a stronger D2 affinity. Royal college of psychiatrists would overall stipulate poor evidence of combination or HDAT with rather significant adverse risk burden including NMS. Need to consider that dopamine hypothesis may also need further revision and to consider glutamate or GABA is implication and thus any additional conventional antipsychotics may not be any effective and again increase adverse effect burden.
Excellent topic! Keep them coming. Examples; treating agitation in the elderly..
Perphenazine in particular is a nice augment in clozaril partial response. Multiple antipsychotics is still best avoided but I like your emphasis on "rational" polypharmacy.
You do not mention a growing population of elderly people 70's, 80's and 90s with dysphagia, tardive dyskenesia, heart condition and thyroid condtion which has very little science or knowledge from all doctors today. Alternative less side effect non-prescription medication needs to be used so more people are not dying from polypharmacy meds that are overused and missued. Additionally, nutrition is an essential source of life. "Food is medicine and Medicine is food" and this is not studied while in medical school and causes people like myself to believe medical care is a very jaded and a crooked system. Now I am being pushed to use antipsych meds and it is an ongoing horrific experience. The only option I can think of is olanzapine 1.25mg as it also assist with appetite and mood.
Congratulations on the content! I enjoy your videos very much!
i was injected whit haloperidol decanoate and it gave me the worse anhedonia ever, i thought psychiatrist helped people
I could not possibly comment on what the decision making process was for your medication choice. I would talk with the doctor you are working with and ask the same question. As far as these medications causing anhedonia, it's possible that it's not anhedonia and part of the disease process itself (negative symptoms of schizophrenia or prodromal phase of illness for example can look like depression) hope this helps
@@ShrinksInSneakers nah, it is the haldol that blocks strongly the dopamine and you just lost pleasure of things, like cmon man, is very obvious and you know it
Good content
Thanks, I appreciate the support. I find it helps the who want a deeper understanding of decision making and medication management recommendations.
Thanks , good information.
regards from
kashmir
if one is using at least 2 medications but has trouble sleeping, what medication would they use. Say for instance Zoloft and briprofin.
Hi dr hope you well how do i go by arranging a 1 on 1 consult with you?
Hi i was wondering if you knew of a dopamine blocker that lowers even your natural dopamine levels
Do you know if there is a relationship between adrenal hypersalia and psychotic episode
Some doctors are dangerous to patients.
Doc.If SSRI lower dopamine should they help whit Schizo ???
Some SSRIs have been found in some studies to reduce dopaminergic activity (intensity or frequency of firing) but other studies have shown the opposite, particularly with prozac. I don't believe that any antidepressants have shown meaningful clinical efficacy as antipsychotic monotherapy. They have actually been shown to potentiate dopaminergic activity which is potentially related to the mechanism by which they can induce mania
@@Zacharymlane85 If ssri lower dopamine how they arent healpful for Shizo ??????
I want know why is man made drugs the only solution
I don't think anyone believes this, there are many ways to address mental health but many people look for the path of least resistance and taking a pill is a lot easier than making real change in your life. Just my opinion