Family and Caregiver Schizophrenia Discussion Forum

Psychotic break while on medication

Hello All,

So, I have previously spoken how I did not believe invega/riserdone were really effective for my mother. Now, she is pretty much experiencing a minor psychotic break. Not as bad as before but what I don’t understand is if the delusions/hallucinations are caused by too much dopamine in the brain, how can a break happen while on on treatment ? I just
Don’t understand it. Her tripital is still working and once it starts kicking in, her mania calms down.

@Javi, my son is on his 3rd or 4th antipsychotic med. In a couple of cases while taking his med he started to have psychosis again, initiated by smoking pot. When he has required hospitalization he is given a different antipsychotic and after discharge usually stays on the one that worked to stabilize him in the hospital. However, he’d been clean for a couple of years and early this year his antipsychotic med just slowly stopped being effective. I hope for the best but figure at some point he may need another med.

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Thank you for sharing… has the doctor ever explained to you why a drug stops working?

My son has been on so many different anti-psychotic meds that I’ve lost count. And, as with Clozapine and others, they slowly stopped working for him. Many of the drugs’ dosages depend on whether or not the person smokes - if so, as many with mental disorders do, the drug either can’t be taken or the dosage has to be adjusted.

Although this dates back to 2012, its pretty much on target with what my son’s doctors and pharmacists have said: https://www.healthyplace.com/blogs/breakingbipolar/2012/05/tolerance-when-psychiatric-drugs-stop-working

Thank you for sharing that article. Her team is finally going to pursue a medication change.

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I think you have some fundamental misunderstandings about medication and AP treatment. First, medication can help manage or lessen symptoms-- it generally does not completely obliterate them. Perhaps this is understandable as the term Antipsychotic implies psychosis might be eliminated or counteracted with these drugs. Remember marketing people name drugs and classes of drugs-- not scientists.

Second drugs are not one size fits all. People with SZ respond differently to specific drugs. I may do very poorly of Risperal, yet very well on Zyprexa for example and it may be the complete opposite for other people. Modern atypical antipsychotics act on multiple receptors not just dopamine. There are also studies that suggest receptors get sensitized or desensitized by antipsychotic and other drug use and thus drugs may have lesser or exaggerated effect over long term use. Unless given in the form of long term injections, compliance and adherence to dosing is always in question. In my opinion none of this is not a good reason to give up on drugs altogether, and underscores why regular psychiatric care with monitoring and dosage or medication adjustments is crucial to long term treatment.

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Yes all very true. Risperdal failed to break her psychosis despite upping the dosage ad adding invega(Max dosage) for the last five months. She has been stable for 30 years and I refuse to believe that this is the best she is ever going to get again without doing some medication changes and attempting new things. No, she won’t ever get cured but she should be able to realize her family isn’t dead instead of living this tortured existence.

Yep, bottom line is there is no cure but hope we can find the best medication to control their issues. A friend of mine’s brother is also SZ and wants a CURE but when genetics and brain injuries are involved, I’m just looking for mood stabilization so he can enjoy life - if possible …

I spent most of today preparing my son for tonight (New Years Eve) - he had an episode earlier today screaming at someone in the garage (who wasn’t there) but there WERE kids playing across the street. I don’t want them to feel that he is a danger to them but that’s what he sounds like when he goes off on a tangent. I explained drunk drivers, fireworks and crazy people on the roadways but what does he do? He takes off on his bicycle after dark and is riding the streets. I found him about three hours ago but he wouldn’t come home.

I just pray that he comes home OK since he has no friends to hang out with. My nerves are shot…

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