Dear Sir, My daughter, aged 27 years is suffering from schizophrenia for the last 11 years and is under regular treatment at PGI, Chandigarh since September, 2007. She was prescribed various set of medicines during the course of treatment. She is presently taking Skizoril 200 mg and Tryptomer 25 mg daily. As the symptoms persist, doctors say that she would have to take medicines indefinitely. Though my daughter is average in studies, she spends maximum time glued to books (just staring) and often looses cool on the petty issues, if things are not going as per her liking. She is very introvert and has no friends, even girls. She used to go to her educational institution alone and did not have any interaction with her classmates. She is M.A. In English. She does not like watching T.V. Programmes and using mobile (smart phone). She confines herself to her room and did not like sharing meals in dining room in the company of family members. Sometime she speaks with herself. She is self centered and sometimes envies even her siblings, when she observes them to be getting favorable treatment or they are excelling in their studies and other activities. She loves eating fast foods and enjoys travelling in the company of parents but not with others. She enjoys attending social gatherings like wedding parties. She gets irritated often and do not hesitate to speak loudly and makes ungraceful gestures to parents. She is lazy by nature and avoids doing even petty household works like cooking, washing and ironing clothes etc. She is very casual about her appearance and is not fascinated by good dresses. She often suspects her old classmates and others for conspiring against her. She also suspects her mother and thinks that she (mother) is always conspiring against her. Nevertheless, she never forgets to bring gifts for her on her birthday, mother?s day etc. She is a confused lot and her long and prolonged allopathic treatment has not brought any favorable results. Please guide, whether alternative therapies like CBT, ECT, meditation, Homeopathic treatment etc. Could treat her completely or partially. I discussed about these with her doctor (senior consultant of the rank of Associate Professor) at P.G.I. Chandigarh but he said that these are not effective therapies. Clozapine therapy worked very well for few years but now it's effect is getting reduced. My daughter has gained weight and has become dull. She has lost interest in every thing except eating. She had stopped reading newspapers and had lost interest in preparing for competitive exams. Etc. She has become quarrelsome and in fact has become a big problem for family as every one is disturbed by her behavior. Doctor (her consultant) at P.G.I. Chandigarh do not offer any alternative therapy and only advises for increasing the dose of clozapine. I took her to NIMHANS Bangalore for better treatment. She was examined thoroughly by the senior doctors there and I was advised to get her admitted in the ward (one attendant allowed) for 15 days to one month for observations and further tests. The doctor has prescribed clozapine 200 mg and Sizodon 3 mg (my daughter was earlier on Sizodon 15 mg for three years and she developed tardive dyskinesia and as a result she was prescribed clozapine). NIMHANS doctors said that alternative therapies would also be tried once she starts taking treatment from them. I am in a dilemma since Bangalore being a far off place it would not be possible for me to travel to that place frequently for follow up. In the meantime. I also consulted a private psychiatrist at Chandigarh, who after examining her and undertaking psychological tests/blood test (her hydroxyvitamin d was found abysmally low (8.60 ng/mL)(at PGI, this test was never conducted) prescribed sizopin 225 mg, ariphrenz 5 mg, escipra 10 mg and pyrocal d3 (for vitamin d deficiency. Now I am at crossroads and do not have any idea to choose which treatment (institute) to pursue for better recovery of my daughter. Prolonged treatment at PGI Chandigarh has not yielded desired results (PGI doctors have hectic schedule due to heavy rush of patients and obviously the institute follows conventional approach). In view of this kindly guide me which of the above treatments best suits my daughter for optimal results. Thanking you in anticipation.
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You are describing behaviours of a typical paranoid schizophrenia. The NIMHANS visit should have been followed up since they are very thorough. However, I quite understand your plight in terms of distance. Anyway, CBT is a must and must used in tandem with medication. The more a person with this disease with draws, the more internal they become. The internal world of a schizophrenic is a house full of crazy ideas and notions. This must be prevented at any cost. If she likes parties and functions, take her to many of them. Since she is comfortable with the parents, take her to places to visit wilfully to expose her to more social stimulus and thus get her out of her internal world: this is going to be key to recovery. There will be delusions of persecution and suspicion over everyone including family and other trusted ones. Paranoids are specifically tormented by abnormal fear. What they do however is that instead of dealing with that fear, they escalate anger over it and act violent. They are extremely sensitive to rejection or the anticipation of it. Their thinking can be quite illogical and distorted. They imagine everything with suspicion and withdraw into themselves. They must be put on medication and a lot of occupational therapy and intense psychotherapy are needed to mitigate the symptoms. I suspect that your daughter suffers from a severe case of rejection and many of the behaviours are indicative of one suffering the Rejection Issue. Â
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