Family and Caregiver Schizophrenia Discussion Forum

Schizophrenia 1st episode meds not working

My son has had his 1st epis
ode we assume brought on by smoking weed (skunk). He has been in the hospital for 5 weeks and the meds do not seem to be working apart from calming down the aggression. He is on 20mg now as of this week of Olanzapine. Has anybody else had experience of antipsychotics taking weeks to kick in?

Is he sleeping alot? (That would be good right now.) Is he getting incrementally better? It took my family member weeks and weeks to stabilize on that med, but there were signs of improvement within a month or so. Six weeks is the time of a medication trial according to some researchers.

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Yes he is sleeping from 11pm till 1.30pm so about 14.5 hours a day. He is now on a 20mg dose at 10pm at night. I feel his episodes are getting worse with the paranoia

I would discuss your concerns with his doctor. Ask the doctor when you should see positive results from the med, and what’s the contingency plan if this one does not work.There are many other drugs he can try.

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Hi. Olanzapine (Zyprexa) was not effective for my son. That may be the case for your son too.

My son is now on Invega Sustenna monthly injections. It’s sure as hell not perfect, but it is what it is.

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My son had two episodes of psychosis (no paranoia) and olanzapine was the first drug that he tried after the first one. He went from that to risperidone and then back to 20 mg of olanzapine with two antidepressants added. It took about a month for the first round of olanzapine to start working. He got incrementally better- it took about a year and a half for him to recover his baseline mentation. And now, three years later, he is very stable, although living in the local State hospital right now (after a long ordeal that involved the second episode and involvement of the law).
Give it time. If olanzapine doesn’t work, there are many other drugs that can be prescribed. Behaviors will not often “pass” without meds, you will likely have to figure out ways to learn to live with his illness, as he will have to also. Hopefully he will come to understand he NEEDS treatment- sometimes after one has been on the meds a while, this understanding increases, but not all the time. Is he getting therapy as well as medication?

My sympathies to you for your son taking your house apart. I also have issues with family members not understanding what’s going on with my son or how we are dealing with it. It’s a tough journey. Take care and please keep us posted on how things are going.

Hi @LaineyB My son was dz paranoid sz. He was in psychosis for a few years. I got him on the Invega shot. I had to push for it. They were going to give him resperdol (two week shot) and because of someone else on this forum I asked for Invega and his Medicaid covered. It’s been almost 4 months and he gets more clear the longer he has been on it. I hope he continues. Good luck with your son. I know you are on a rough road. I have been there. Whatever they gave my son in the hospital it did take a few weeks to kick in, really a good month or more to really start to see him get clearer.

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They are now going to decrease the Olanzapine and try Amisulpride. They are taking advise from the pharmacist before changing him to this. They have also said they want to keep hin on Olanzapine for a few more days. But to be honest he seems to be getting worse rather than any better. Yes it has pulled our world apart just knowing his mind is tormented with all these horrible thoughts. He is being very aggressive too.

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Thank you I am so grateful for any support and help right now. It just seems they cannot stabilise him on the treatment.

Well, the sleep is part of olanzapine, so it’s in his system.

I hope this works or something else does. It took my family member about seven months on olanzapine then about six or eight months on Risperdal to stabilize.

My son began psychosis (later diagnosed w schizophrenia) 6 months ago. It was brought on by Adderral abuse. He had severe paranoia and aggressive persecutory auditory hallucinations. Was put on Serequel up to 800 mg per day. This helped w paranoia but not all hallucinations and cognitive issues. He then added Vraylar which brought his negative symptoms closer to baseline. Since he was still hearing voices is doctor agreed to wean off Serequel and is now on Zyprexa 20mg. He also takes Propranolol 40mg daily and 5-9 tablets of Trazadone at night. When needed Ativan is added.

About two weeks ago, he had 4-5 days in remission for the first time. Then auditory came back but less often and unintelligible.

He is 28. I believe that sleep is the key to any level of recovery at least for him. I don’t know if he will ever be in complete remission w meds, but I understand how difficult this is for you. The waiting, worrying and wondering when a change w happen.

Think about how strong your son is to be able to endure this. I always thought I was the strong one, but have realized in our journey that he is the stronger.

Caveat: when the pd added Vraylar the psychosis increased and he had to stop. Three weeks later he wanted to try it again, more slowly and it worked well, but the propranolol was increased to relieve anxiety and Trazadone was increased to induce sleep. Lack of sleep and the resulting anxiety/agitation are triggers for my son.


The encouragement to your son that things are better and asking how he is feeling, thinking is just as important as the meds themselves.
My son was diagnosed PSZ two years ago and is on Invega oral. 3 mg daily. Counseling and therapy are ongoing and this helps also. In short, let him know it’s not just being on meds and all is rosey. It’s learning a life on meds can be “normal” for all of you.

Schz onset has a hard impact, lasting for years on everyone concerned, and can tear apart families. That is my experience. I suggest that you quickly educate yourself through NAMI, Dr. Amador’s book “I’m am Not Sick, I don’t Need Help” and read/post on this site.

My daughter’s schz was not drug related and became obvious in her early 30’s, 2.5 years ago now.

Her first two sets of medicine caused little improvement (one was Zyprexa) the last set (including a shot) produced immediate and almost 95% improvement (Haldol and Trileptal). These were through forced hospitalizations of one week to 3 weeks before release.

She cannot see that she is ill, cannot see when there is improvement, and so she won’t continue with a doctor or meds. My opinion: If your son is under 18 and you can oversee what he takes, I think it is important to find a medicine that works before he turns 18 and can refuse to let you help him.

My son just had his first episode of psychosis back in February. He was hospitalized and the first hospital put him on a low dose of zyprexa and 40 mg of Latuda. They released him after about two weeks but he was not stable as he deteriorated again and this time I took him to Denver Health (a research and teaching hospital). That hospital was much better. The doctor there said he never was on a therapeutic dose of zyprexa. He increased it and it took several weeks to start working. At first I though it wasn’t helping at all. This doctor said that often patients with schizophrenia take higher doses of zyprexa than the FDA max. My son was relatively stable with minimal symptoms at 35 mg. He was home and then after a week some auditory voices came back. The doctor told me we could go as high as 40 mg but not higher. That seemed to work for him for about six weeks although on occasion he would have voices that said nice things but not mean voices. During that time he worked a summer job and did well. The third week of July he started to slip with more negative voices that are mean and it has gotten increasingly worse with voices all day long tormenting him. No real idea why the med worked well for a month and a half and then quit working. He is medication compliant. Anyhow we are in the process of titrating down the zyprexa and titrating up with Saphris. Keeping my fingers crossed that this will work. I feel so bad for him. I know that this could take awhile. Currently he also takes trileptal, propanolol and the last month we added Prozac.

Since you are new to this journey like me if you want to chat more via phone feel free to email me and I’ll send you my number.