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Long Term Psychosis
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Dr. Phelps, Re:long term psychosis Our son was diagosned 4 years ago.He went from an active manic situation into a psychotic state and was hospitalized for 3 months. He has been completly med compliant since. He has had two set backs (both psychotic), each time caused by stopping clozaril. These stoppages were with complete agreement with his pdoc. The pdoc now says he will be have to stay on clozaril(now 800) for life. He also takes lithium, klonipin (as a prn 3 to 6 per day), and celexa. Each time before he went back on clozaril we tried other anti psychotics including zyprexa and seroquel. He is 24, lives at home, works about 25 hours a week, good at visiting pdoc every 2 weeks (we can go with him if we want, we also contact when we need to). He sees a therapist every two weeks. He has many of the negative symptons such as lots of sitting around at home and not doing his share of the house work. We accept these as part of the disease. However as good as he is, he continues to write in his journal about voices and thought broadcasting on a daily basis. He rarely shares this with his pdoc or us. We hate to read behind his back but the pdoc says it's okay as we are part of the treatment team. He is a wonderful person and we have hopes for him to thrive in the future. Our question is "What else can you do for long term psychosis?". Thanks Dear Tom
Most experts seem to agree that it's worth trying to treat until all
symptoms are controlled, particularly psychosis. So your quest for
that goal may well be a good idea. Unfortunately, the "negative symptoms"
of thought disorders like schizophrenia seem to correlate with evidence
of brain structure shrinkage, and may be much harder to reverse.
So the sitting around and not weighing in on housework may be harder to
treat than the voices. Very systematic medication trials and
as much behavioral structure as you assemble are already apparently part
of your program, and should continue. |