Family and Caregiver Schizophrenia Discussion Forum

A few questions about when meds are stopped


#1

Hi

If somebody is taking meds and they are totally, or mostly cured while on the meds, then I have a few questions I’m wondering about:

  1. If they had anosognosia prior to taking medication, then while on meds does this aspect of scz also get cured? i.e. they realize and accept that they were/are ill and had scz? Or do just the other symptoms of scz go away but the anosognoia remains.
  2. If they stop taking meds, approximately how long does it take for symptoms to reappear?
  3. If they stop taking meds, does the reappearance of symptoms start gradually and increase, or can they suddenly just appear out of nowhere?

TIA


#2

Hello, I don’t know about the anosognosia, luckily my son isn’t afflicted with this.

However, we had this experience when he was about 20. A year and a half after his first episode of psychosis, which included some visual hallucinations (black dots in his vision, mostly), delusions of spreading love and a fixation on a particular young woman, he had seemingly completely recovered. He was not using pot because of a probation situation.He was doing so very well that we, with the approval of his psychiatrist, slowly tapered his risperidone until he was off. it It took a couple of months, he was on a low dose.
He was making plans to go to school and had almost completed registration about a month after the last dose. He seemed a little disorganized but denied anything was wrong. About two weeks after he began school registration he began a decline that included dark moods, staring, silence, We recognised it and restarted his medication with the approval of the psych. Three days after that he had a very dark episode of psychosis and badly injured me with a kitchen knife.

I would be very careful of decreasing or stopping meds and of restarting them. Please do so only with the approval and CLOSE supervision of a competent, engaged psychiatrist (ours wasn’t).

Sz is an individual illness. It presents differently in people and the course of it is individual also. In my son’s case he relapsed quickly- I’ve heard of other stories where it took years and months.

Good luck. It’s a bumpy ride any way you look at it.


#3

It doesn’t take me long to relapse when I lower my medication. I haven’t been off anti-psychotics in seven years but I recently reduced my Haldol from 30 mg to 20 mg with the blessing of my pdoc, who wanted to see if I could handle a lower dose and minimize side effects. Took six weeks for me to have three full blown psychotic episodes in a week (and go back up to 30 mg).

Schizophrenia has no cure, it is treated with meds. for most of us, if we go off our meds, we relapse quickly. As has already been said, don’t ever stop taking meds unless you are under the care of a very involved psychiatrist.

I don’t like taking these meds, but I’ve lowered and stopped enough to realize that it is the meds that are responsible for my improvement. I think it’s a lesson most of us sza and sz patients learn by experience.


#4

My adult daughter has been on and off meds three times. She has always had anosognosia, on or off meds. The first two sets of meds didn’t handle many of the symptoms: delusions were still strong as were voices. The last time on meds it was probably a shot, and it almost completely handled all symptoms (except the anosognosia). When the shot wore off, within three weeks all symptoms were back in full force.


#5

@digitalfructose, @Shmookitty is correct. There is no cure for SZ. Meds (and talk therapy) just help manage the symptoms. And some on this site are advocates of certain supplements. It is my understanding that some meds CAN help a person gain insight, but I think this is far from the norm. Some persons with illness gain insight over time (probably a small percent). There are residential treatment programs that can help a person gain insight. Then there is the LEAP strategy that, through gained trust, helps a person stay on meds for reasons that he/she wants, and not because he or she is sick.

Your Questions 2 and 3 are all individual based on the specific med and the person him or herself.


#6

My son has schizoaffective disorder and anosognosia, his first episode of psychosis was 3 years ago. He was on abilify maintaina injections for a year, then oral abilify for another year. He has been off his meds for 10 months and just recently started to show increasing paranoia and delusions about 8 months off medications.

There was some research done in 2018 that found people who were treated with antipsychotic injection for at least a year, preferably two and were symptom-free on medication 50% can come off medications without relapse/psychosis. But the researchers cautioned they do not know how to determine who can come off and remain symptom-free. Still, a lot of work needs to be done before this information can be used clinically.
In the past before my son’s first episode of psychosis when he was on antipsychotics for his mood, he would destabilize quickly (days) after stopping medications. But after the injection he as so stable (probably due to consistently medicated) it was months before symptoms reappeared even his mood-related symptoms took months to re-emerge after the injection for a year.

Important to remember medications effects are very individual as is the diagnosis of schizophrenia so hard to generalize. As other replies have stated reduce or stop medications with close medical supervision. We are not so lucky with that as our son has fired his team and refused medications for the past 10 months. Hope this helps.