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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4645
Experience:  MD Psychiatry
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I don't know where to start. I was diagnosed a schizophrenic

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I don't know where to start. I was diagnosed a schizophrenic 7 years ago but I don't hallucinate or hear voisces, only my own internal dialog which interferes with daily life. I am 37 now and and have some delusional thinking like people like things happen because I'm thinking them, its bizzarre. I have no confidence and low self esteem. also music plays in my head and its disturbing. I also have a psychological reversal and it seems to be degenerating. I feel isolated by my family although I spend time with them occassionally. I have trouble thinking and making decisions, sometimes I over commit or don't commit at all. I answer *I don't know* a lot. the thing is I'm brilliant. I know electrical, construction, woodworking, cooking, programming, etc I can figure out, or at least I used to be able to but I don't know what is wrong with me. also I have no feelings. I think I've been depressed for 8 years. it wss never like this, I used to feel love and lust and happyness and joy and cheer and sadness. I can't cry now or emote in any way. I used to put on a poker face but I can't hide anymore. since everything begun I've had 3 relationships all of which were meaningless and completwly devoid of love. I don't even have a libido anymore and feel impotent which is why I do t have a girlfriend. I look at girls but I can't communicate. I've taken the risperdal religiously as the doctor said but I'm confused because I knew another person who was diagnosed paranoid schitzo also and she heard voices and hallucinated. I don't think I'm being treated properly. my psychistrist sees me every 3 months for 30 mins on avg. I pay to see a psychologist every 2 months or so but it gets expensive and feel warm and fuzzy only for a little bit and not make any progress.
the meds I've been on are seroquel, abilify, invega, and the longest I've been on any med is rispedal 7 years. I also take imovane and my sleep cycles. sometimes lucid dreams (more real than while awake) and times or imsomnia. I sometimes double the dosage of imovane to sleep it off.
I've given u a lot to go on. can u tell me what is wrong with me and how do I get my emotions back and my confidence, restore my abilities and talents, and get out of this situation.
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 3 years ago.
Greetings !
Welcome to the site.
I am Dr. Kaushik and i am a psychiatrist with extensive knowledge and many years of experience dealing with schizophrenia.
I am sorry to learn about your condition and i empathize with you.
After going through details of your history i feel that the lack of emotions that you are having which is clinically termed as Emotional blunting or flattening and depressive features that accompany them are a part of negative symptoms of schizophrenia and for this you got to ask your doctor to add to your current drug regime one anti depressant drug such as lexapro ( generic name - escitalopram ) at dose of 10 mg / day to be taken in the morning. This drug shall start improving your negative symptoms within 2-3 weeks or so but for full recovery from these you shall have to take this drug for at least 3-4 months.
An alternative for lexapro can be a drug called as Prozac (fluoxetine)
which can be taken at dose of 40 mg / day to counter these negative symptoms.
So i suggest that you ask your psychiatrist to consider this angle of Negative symptoms and also the use of one of these drugs to counter these symptoms which risperdal or any other anti psychotic drug cannot treat on it's own.
I hope this helps.
Kindly see link below to know more about Negative symptoms.
Wish you all the best.
Please kindly leave a Positive rating if you are satisfied with the answer.
If there is any further assistance needed please feel free to ask using the reply button.
Customer: replied 3 years ago.
Im not sure what to tell you, Ive taken prozac before but usually dont take it for more than 2-3 days (20mg). It usually causes mood disturbances and issues with sleep and I dont want to alter my homeostasis (i know I sound contradictory). I'm also afraid of taking medications for life, especially if I dont know that they are going to improve my mood substantially and I'm going to be having withdrawl symptoms if I discontinue if Im not satisfied with the results. You know, here in Canada you can purchase an item, and if youre not satisfied you can return it to the store for a refund. I want the same policy for drugs, so they dont become an habitual.
Can you address my concerns?
Expert:  Dr. Kaushik replied 3 years ago.
Thanks for the valuable inputs.
Well you see i can understand that if you did not tolerate prozac as expected but then i must address here the fact that you only tried the drug for 2-3 days which is too short a period for this drug or any other psychotropic medication to produce any benefits ,in fact it is too short a period to experience any major side effect , this i say because for any drug to produce any significant good or bad affect on the body it should have had at least 5 plasma half lives which amounts to many more doses of the same drug than 2-3 doses that you have been taking.
So the mood disturbances that you had experienced each time that you took prozac they probably were precipitated by your pre-existing fear about the side effects this drug may produce or any drug may produce and this inadvertently impinged on your psyche and made you feel some sort of make belief mood disturbances when actually the drug had been insignificantly low in it's levels to produce any such sort of mood changes.
Anyways if you do not want to try prozac then leave it at that but you may try a much improved and effective drug like lexapro which although belongs to the same class of anti depressants like prozac but it is considered much more refined and less associated with side effects.
Another safe alternative for you can be a drug called as Effexor ( venlafaxine ) at dose of 37.5 mg -75 mg / day.
You see if you use and withdraw these drugs as per the protocol then it is quite unlikely that you may have to face either their side effects or withdrawal symptoms and yes they are not going to be used life long and are most likely to be weaned off slowly once your negative symptoms have been managed by them.
So backing my comments with a vast experience of many years i will reiterate that at the moment the most plausible solution to deal with your negative symptoms is to use any one of the above mentioned drugs like lexapro or effexor at the mentioned above safe doses which are within the safe therapeutic range. But i can only present to you some suggestions based on my past experience and expertise of this field , the final decision shall remain with you.
As far as the returning policy for drugs is concerned , it is best to discuss this with the policy makers as they are the ones who can do something about it.
I hope this helps.
Wish you all the best.
Please kindly leave a Positive rating if you are satisfied with the answer.
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