Hello.
My son just went to a psychiatrist today and was prescribed amblify and lexapro. For the past year he has heard a voice that calls him names and calls people he passes by names. He has also experienced a lot of OCD symptoms like tapping and counting. He goes to school, gets good grades, just got his black belt in karate, and has goals. He doesn’t see things but does experience a bit of paranoia at school. My question is, should he start both medications or is there something else that he can take that’s more natural? He goes to therapy and has never had any aggression or suicidal thoughts. He’s very self aware and we talk all the time about this. I don’t want the medication to hurt him with all the side effects but I also don’t want things to get worse. Can anyone tell me how this might progress as he gets older? She didn’t say it was schizophrenia but she also wanted to admit him to an inpatient program right away. How does all this work and what should we expect moving forward?
Why don’t you get another, and possibly a 3rd opinion? I believe that some psychiatrists specialize in adolescent psychiatry. I just did a search in Find a Doctor | Find a Physician - Healthgrades and looked for Psychiatric Evaluation - Child and Adolescent. The results turned up mostly family medicine people. When I Googled for psychiatrist, adolescent I got a lot of interesting leads.
Melissa, if there is a NAMI support group for parents of children in your area, that would be a good source of information for you. Back when I attended NAMI’s Family to Family class, they stressed to us that children and teenagers were a different matter from adults. A local group would have doctor referrals for you and would have experience with the medicating of youth.
Your son is at the age (late adolescence) when the first symptoms of SZ spectrum disorder can appear, if indeed this is what is going on. It’s called the prodromal stage and with the right treatment he may or may not ever experience psychosis. His brain is still growing rapidly. Psychosis is the main thing to avoid, if at all possible, because it can permanently alter the brain and accelerate the manifestations of the disorder.
I second the recommendations to get other opinions and cautiously entertain the idea of medications, but understanding that it may take time to see which ones work best, always considering the trade-off with side effects.
It sounds like you have a lot of work ahead to understand what is going on and educate yourself on this disorder and his options. There are new meds in the works, therapy often can be very effective, and some people seem to do well on a therapeutic metabolic diet. But careful professional guidance is a must either way. I pray for you that your son will cooperate because untreated SZ is almost always a terrible thing for all concerned.
Please let us know what you find out and how he is doing. This is a very experienced and compassionate community so don’t hesitate to ask questions!
Here is a short definition of the three stages of schizophrenia. For better understanding, Dr E Fuller Torrey’s book “Surviving Schizophrenia A Family Manual” is the best source.
Prodromal - this early stage is often not recognized until after the illness has progressed.
Active - Also known as acute schizophrenia, this phase is the most visible. People will show the telltale symptoms of psychosis, including hallucinations, suspiciousness and delusions.
Residual - this term is used to describe a time much later when the individual’s symptoms have lessened
Step one is a medical examination to rule out any sort of physical condition (such as a brain tumor) causing the issues
Schizophrenia is cyclical in nature which means a person may have periods of time without symptoms.
The doctors want to be proactive. There is a good reason.
Even one psychotic episode can take weeks or months to recover from. Even one psychotic episode can permanently damage your son’s mind. A series of psychotic episodes is more likely to permanently damage your son’s mind.
Your son is doing well in school. He is improving himself with karate. He is getting counseling. He is still self aware; he is aware of his distress and he wants to do something about it.
This means that his mind is still healthy. If his mind is damaged by a psychotic episode, you can expect some of this to erode. The mind can be damaged just like trauma can damage the mind. This is what you want to avoid.
I hope you never find out. I wish you and your son the best of luck. I hope you never see the things I saw.
Doctors always want to push pills. Seroquel has been prescribed for patients that weren’t diagnosed with mental illness. I wouldn’t be happy about it but if your son is indeed in the prodromal stage it might be the lesser of evils. He is doing a lot of stuff that is helping his mind for sure so don’t discount that when making your decision. And if he gets worse then it might be the best thing to do.
I wish you and your son all the best.
What would cause a psychotic episode? What should we be looking for?
You want to watch for signs before a psychotic break.
Deterioration of hygiene is a sure sign that things are getting worse. Your well groomed son will stop caring about his appearance. His clothes might be filthy or he may go for days without bathing. His self awareness might deteriorate and he may become lazy and inconsiderate.
The son you describe sounds like he is well adjusted. The fact that he hears voices does not even mean he’s mentally ill; there are different reasons and it would help if we could figure out why. People with PTSD experience hallucinations. People with grief often experience auditory or visual hallucinations. And don’t forget, drugs can cause hallucinations and drug induced psychosis. I’m sure your doctor has listed other reasons; and if they haven’t, ask.
You’ll know if your son has a psychotic break. He will experience some break with reality and might display bizarre or inappropriate behavior. I certainly hope that never happens.
Best of luck.
The sooner you treat psychosis the better the outcomes. Even though he is still functioning, he is experiencing psychotic symptoms. There are many places in the country that have started early psychosis programs precisely because early treatment is so important. They also do evaluations. Finding the right medications may take time. I dont know of any natural treatments.