Is it okay to stop the medicine prescribed?

Hi all, my brother had his first psychotic episode around 1 year ago and he has been seeing the same psychiatrist since then. Until now, my whole family, including me still don’t know whether his psychotic episode was due to schizophrenia. The psychiatrist has not given us any diagnosis on his psychotic episode. However, when i google searched about his symptoms during and prior to the episode and the medicine prescribed - Olanzapine, they are all pointing to the symptoms of having schizophrenia.

My brother has been having problem sleeping throughout the night for quite a while before his episode. There were few times when my mum woke up in the middle of the night because she heard some noises and when she woke up, she found out that it’s because my brother was awake and he was praying. He has always believed that gods, heavenly beings, ghosts and evil spirits do exist. He also has always believed that people who can connect to the gods/heavenly beings can help to drive away the evil spirits so he has always respected and idolized the people who claim that they have connection with the gods/heavenly beings. While the existence of supernatural beings are not scientifically proven and no one really know if they do exist, I do now wonder whether his belief on supernatural beings are actually the sign of him having schizophrenia.

Few days before his first episode, my parents already sensed something amiss. He went missing for few hours and he was uncontactable almost everyday. There was once my dad managed to find him in a shopping mall after he was missing for few hours. He looked like he lost his way and when my dad approached him, he couldn’t recognize my dad.

When he had his first episode, he locked himself in the toilet for hours. My parents were outside and they were so worried, all they could hear from outside the toilet were him laughing obnoxiously and saying stuff like wanting to leave this fantasy world with his other friends, wanting to teach arrogant people a lesson. My parents asked for help from their friends and that was how we got to know the psychiatrist. He calmed down after the psychiatrist gave her an injection and started prescribing him medicine.

The psychiatrist has never said when the medication will stop but my brother has been wanting to stop the medication on his own after he is able to function in his daily life. He said since he is able to function like how he used to be, this shows that he has already recovered. The medicine makes him feel sleepy all the time and if he stops the medicine, he feels much more energetic.

He has already tried to stop his medication once and around 2 months afterward, he started to go missing and lock himself in a car for hours again… When he locked himself in the car, he also started to talk to himself again…

So i am wondering if there’s anyone here who can share whether my brother is indeed having schizophrenia and whether there are any other alternatives to manage his symptoms other than taking medication? I would appreciate if you can share your own or your loved ones’ experience. To be honest, i have very limited understanding on this illness and i don’t know anyone who can share this with me. Thank you :')

You don’t say how old your brother is. SZ typically starts in a person’s 20s. The diagnosis should have been written on the bill, because that is what is submitted for insurance reimbursement.

It sounds like SZ and if it got better after taking olanzapine, that further supports the diagnosis, but the psychiatrist is the one best able to diagnose. For example, it could be bipolar with psychotic features. If he wasn’t prescribed a mood stabilizer, like lithium, then SZ is more likely.

My son’s psychiatrist prescribes dextroamphetamine-amphetamine (generic Adderall) which counteracts the sleepiness and probably helps with compliance. I don’t like this idea much because of dependency, but it’s between him and his doctor and it probably does help him stay on his meds.

Going on and off APs (antipsychotics) is bad because they tend not to work as well after they are stopped and restarted.

You might not be able to reason with him about seeing the psychiatrist and staying on meds. This book might help: I Am Not Sick, I Don’t Need Help! How to Help Someone Accept Treatment

Thanks for the tips, i probably need to read the book then. My brother is in his early 30s when he had his first psychotic episode. It seems like SZ at his age is quite unusual…

early 30’s are often a time when scz is “discovered” in our family members - my son’s was diagnosed at 31 after an episode at work found us seeking help -

1 Like

Does he also have resistance on his medication?

First hospitalization at 31. Started out as bipolar at 19, I think, and morphed into schizoaffective disorder by late 20s.

1 Like

Hi caregiver 1-
I am Interested to hear how similar this is to my son who was first diagnosed (no voices) at 18 with bipolar 1 and then at 28 (after stopping meds) schizoaffective disorder.
I haven’t read anything about this specifically - that bipolar can worsen to schizoaffective disorder but I know that they share genetic traits and that many people have family with either one or the other diagnoses.
My mother was diagnosed bipolar 1, for example.
To address the thread, I think there really isn’t anything other than medication that can help people who are dealing with these serious brain disruptions. The side effects are no joke, but the meds are a Godsend to anyone dealing with the heartbreaking fallout of this disorder.

My son’s family practice doctor said that he thinks it is fairly typical for the illness to start out as bipolar 1 and then progress to schizoaffective or schizophrenia.