My brother is 19 years old, had breakup, going to appear for 12th board and need this year. Doc said he is suffering from psychosis, we consulted psychiatrist, we are giving him medicine zisper ls, arip mt 10 mg from almost 1 month some days he is remain ok-ok but some days he behave very abnormally. His gf again started talking for 1-2 days and then blocked him telling she has other bf, he was a very bright student but now he is struggling to pass. Again he has started fearing, and feels everyone wants to harm him, has started hating me, he just keep on saying i'll complete my chapters but he's not able to study even if he's trying. His marks in test has deteriorated from 660 to 190. He even don't know what has happened to him. We give medicine in food. Should we tell him what has happened to him because is not ready to go to doc. Is the medicine right or should we go and see somewhere else? Please help me.

Dr. Saranya DevanathanPsychiatrist51yrs exp

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Dear Lybrate user, please continue your brother with zisper ls and arip mt till you consult again. He may not be willing to consult the doctor. At the appointed time without stopping the medicines, you can meet the doctor without him. Then, both of you can decide on further course of action. Most persons living with psychosis, are not willing for consultations, medicines, follow ups, etc. That does not mean the doctor won't treat him. There are certain procedures to treat un cooperative persons. The medicines are right - but the dose will be altered if you report the progress and side effects. No need to to take him somewhere else. With psychosis, it might repeat with another doctor also. Since he is young and suffering with psychosis, you and your parents need to play active role in his treatment for some time. If possible, include his girl friend also in the treatment.  

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Mr. Saul PereiraPsychologist51yrs exp

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Yes, he needs to know what his problem is. The medication seems to be suitable but it needs to work in the long run. If it is not having a desirable effect, then either consult the same doctor or go to another to review the medication or dosage. He has a serious condition and must accompany medication with psychotherapy. This will take a long time and expect many relapses if he does not cooperate. for cooperation, he must know what his problem is and his involvement in his recovery is very important. He may have to skip this exam this time until he recovers to some extent. It does not help to have a GF who is often breaking up with him. It is better to stop that girl from contacting him until he recovers. He sounds like he is suffering from paranoid schizophrenia and needs immediate help. He will be intelligent no doubt but that could become a cause too. You may have discovered the schizophrenia only now but it is likely he had had some symptoms earlier but it was not diagnosed and he may not have presented major symptoms, either. Because it is a psychotic condition he needs to be made to relate to reality often by confronting the distortion both internally and in his environment. He may be given to delusions, hallucinations, and disordered thinking and speech. He may be emotionally unresponsive, suffering from social withdrawal, extreme apathy, and lack of initiative and drive. If he is allowed to go internal he can strongly relate to his distortions and in fact, believe them to be true. His cooperation with rehabilitation and medical intervention is often not as desirable as it should be, usually. In which case, someone has to monitor him constantly and enforce some compliance. He must be kept functional to get him to be aware of his surroundings and build a steady and trusting relationship with at least one member of the family/community. He will be difficult to handle, and he himself will not find it easy to comply with therapeutic expectations. With someone strong and firm he could be made to follow a tight schedule and do many activities and exercises to prevent him from succumbing to this illness. Because he is young, the prognosis is very good. But you need to do something effective with the help of a therapist and he can get back to a healthy state. Please do not delay. 

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