[kettlecorn]

Hello!

This is my first time here; I am writing about my mother who was dx'd with paranoid schizophrenia nearly twenty years ago.

For most of that time, she was placed on risperdal (risperidone?) and was on a good maintenance dosage of 3mg morning and night. Paranoia and delusions were essentially non-existent, as least so far as my sister and I heard.

A couple of years ago, the doctor at the county MH clinic thought that she was a candidate for reduction on her dosage, and slowly began to wean her down to 1mg, twice a day. Until about six weeks ago, we saw no real changes, but her paranoia and delusions came back in full force. She's been brought up over the last six weeks to 2mg in the morning and 3mg at night, and we have yet to see any changes.

Although she is not yet back at her previous dosage levels, my sister and I are concerned that we aren't seeing any reduction in her delusions and paranoia at all.

I'm wondering how soon we should start to see improvement, and if there is any hope that returning to the full 3mg morning and night will help her at all.

Barring that, what other medication might we be able to talk about with her doctor? We are concerned because at the last appointment, among other things, our mom mentioned that she often hears gun shots and knows people are trying to shoot her... and that she would welcome it.

Our mom lives in a very safe neighborhood, and her home is less than a 5-minute walk from my sister.

[Sometimes psychotic]

Sometimes after a break whether it occurred on meds or off you need a higher dose than the previous to restabilize....so risperidone is among the atypicals the strongest binder of d2 which is the mechanism....among the atypicals you can only go weaker and usually they are changed based on side effects at that level not effectiveness. The only thing I know that's stronger is haldol which is a typical antipsychotic so it's likelier to cause movement disorders etc. but it is stronger. Finally if everything fails there is clozapine. Clozapine is the weakest d2 binder but it also affects nmda signalling. Clozapine though is a last resort as it requires weekly blood tests to ensure that you don't die due. The severe side effects.

One thing to remember though is that even with an effective treatment dose the delusions can take a couple of months to go away...I would just monitor the hallucinations for effectiveness of a particular dose. Ie so she hears gunshots....is it less that last week etc...it may never be zero....that's not unusual...the meds don't actually change the underlying condition...

[empath301]

In resume they tried reducing your Mom's Risperdol without really giving reasons for wanting to try. She was doing good on the former dose which is a bit higher than her present dose. Why not see to it she is put on the dose she was on before they tried dose reduction? That ought to be an elementary thing to do since they had no qualms with her dose before reducing it. I don't see why the need for something to replace Risperdol from what I read in your post.

Originally Posted by kettlecorn

Hello!

This is my first time here; I am writing about my mother who was dx'd with paranoid schizophrenia nearly twenty years ago.

For most of that time, she was placed on risperdal (risperidone?) and was on a good maintenance dosage of 3mg morning and night. Paranoia and delusions were essentially non-existent, as least so far as my sister and I heard.

A couple of years ago, the doctor at the county MH clinic thought that she was a candidate for reduction on her dosage, and slowly began to wean her down to 1mg, twice a day. Until about six weeks ago, we saw no real changes, but her paranoia and delusions came back in full force. She's been brought up over the last six weeks to 2mg in the morning and 3mg at night, and we have yet to see any changes.

Although she is not yet back at her previous dosage levels, my sister and I are concerned that we aren't seeing any reduction in her delusions and paranoia at all.

I'm wondering how soon we should start to see improvement, and if there is any hope that returning to the full 3mg morning and night will help her at all.

Barring that, what other medication might we be able to talk about with her doctor? We are concerned because at the last appointment, among other things, our mom mentioned that she often hears gun shots and knows people are trying to shoot her... and that she would welcome it.

Our mom lives in a very safe neighborhood, and her home is less than a 5-minute walk from my sister.