![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 37. This is the beginning of the thread.
Posted by mrm12333601 on September 1, 2009, at 14:22:53
Hi.
My wife has had 4 psychiatric hospitalizations and about 3 months before each she stopped taking her medication (she suffers from schizophrenia). Once again, she has stopped taking her medication (Invega) and I'm afraid she'll have another breakdown.
Does anyone have any suggestions as to how I can convince her to take her medications? I've tried to reason with her but she just doesn't listen to me.
Posted by SLS on September 1, 2009, at 15:14:50
In reply to Suggestions re: Someone Who Refuses Medications, posted by mrm12333601 on September 1, 2009, at 14:22:53
> Hi.
>
> My wife has had 4 psychiatric hospitalizations and about 3 months before each she stopped taking her medication (she suffers from schizophrenia). Once again, she has stopped taking her medication (Invega) and I'm afraid she'll have another breakdown.
>
> Does anyone have any suggestions as to how I can convince her to take her medications? I've tried to reason with her but she just doesn't listen to me.What are her reasons for wanting to discontinue her medication?
- Scott
Posted by maxime on September 1, 2009, at 15:45:45
In reply to Suggestions re: Someone Who Refuses Medications, posted by mrm12333601 on September 1, 2009, at 14:22:53
You might be able to get a court order to make her take her medication. Or perhaps she could get it in the form of an injection which lasts one month.
Posted by mrm12333601 on September 1, 2009, at 15:50:47
In reply to Re: Suggestions re: Someone Who Refuses Medications » mrm12333601, posted by maxime on September 1, 2009, at 15:45:45
Thanks for your responses. She's refused to take medications because of her psychiatric hospitalizations. Each was a forced psychiatric hospitalization (I had to call emergency police because on each occasion she threatened to kill herself) and her experiences in the psych units was TERRIBLE.
She also refuses a long acting injection.
Posted by zana on September 1, 2009, at 16:49:29
In reply to Re: Suggestions re: Someone Who Refuses Medications, posted by mrm12333601 on September 1, 2009, at 15:50:47
My heart really goes out to you. What a tough situation. I still don't understand exactly why your wife goes off her meds although I know it is not uncommon for schitzophrenics to stop their meds because they find them so dulling.
A court order might work. I don't know what your states laws are but that's a kind of rotten route to have to go. Still, if it kept her on her meds, that would be great.
It really sounds like a very hard place to be. Does your wife have a therapist? A priest? Anyone she trusts who might take a more active role?
Hope you can make some progress with this. It sounds pretty scarey.
Zana
Posted by SLS on September 1, 2009, at 17:11:41
In reply to Suggestions re: Someone Who Refuses Medications, posted by mrm12333601 on September 1, 2009, at 14:22:53
I think it would be helpful to know what her objections are to taking medication.
- Scott
Posted by maxime on September 1, 2009, at 17:47:27
In reply to Re: Suggestions re: Someone Who Refuses Medications, posted by mrm12333601 on September 1, 2009, at 15:50:47
So she doesn't like to take the meds because she thinks that will lead to a hospitalization? I would go for the court order in that case.
Posted by Phillipa on September 2, 2009, at 0:40:25
In reply to Re: Suggestions re: Someone Who Refuses Medications » mrm12333601, posted by maxime on September 1, 2009, at 17:47:27
What I found when working in psych is that Some have delusions of being poisoned, some voices tell them not to take the meds, some simply are so out of touch with reality that talk does no good. There are many stages some where the patient will and is able to talk and some they are too delusinal to talk. Hence the court order to force the med as horrible as that sounds but it's necessary. A lot of times once the person is stabalized they can then talk about the meds and the whys. Like depression say there are all degrees of this illness also. So many new meds now when last worked clozaril was new and worked very well for many with the testing of WBC's weekly. Long acting injections are very good for those that even when their illness is controlled just hate the meds then month long injections work well. I imagine your wife's hospitalization was very tramatizing for her. Safety of your wife is number one and it's hard to do but sometimes hospitalization is necessary. I'm sorry to say. Good luck to you and if your wife will talk you can babblemail me and I'll talk to her via babblemail. Don't know what good this would do but you sound so in need of help. Love Phillipa
Posted by mrm12333601 on September 2, 2009, at 8:34:28
In reply to Re: Suggestions re: Someone Who Refuses Medications, posted by Phillipa on September 2, 2009, at 0:40:25
Thanks Phillipa.
Posted by bleauberry on September 3, 2009, at 19:14:05
In reply to Suggestions re: Someone Who Refuses Medications, posted by mrm12333601 on September 1, 2009, at 14:22:53
There could be many reasons she refuses meds.
If they make her emotions numb, she may lose sense of her spirit. We are spiritual beings. Strip that away through numbness and we are nothing. For some people, being ill with a live spirit is better than being numbed with a dead spirit.
I know a woman who went on and off her prozac same as your wife. She admitted that her depressed life off prozac was better than her numbed life on it, simply because once in a while she could actually get a few random moments of enjoying her daily morning walks, when on prozac it never happened ever. She looked forward to those few random times and was willing to deal with depression all the other times just to feel it when it happened.
When someone threatens suicide, it is an outward sign that all hope is gone. Psychiatric wards and medicines do not give that needed hope. If anything, they can potentially trap the patient in a more confined world where hope is yet limited even more. If the meds work great, that's a different story. I am assuming in this case they haven't worked great.
Sometimes when people get better on meds, they think they are better and don't need them anymore. When they stop, the slippery slope from well to sick happens in such a deceptive way that they don't see it happening. Somewhere along the way they even lose sight of the obvious clue that the med stoppage is what caused it. Very deceptive blinded slide.
I personally feel, opinion, it is cruel for any human to force any other to take a foreign molecule not of their choosing. Who are we to have such domain and power of someone else's life? Criminal prisoners yes, but a spouse, no.
The suicide threats are a statement of lack of hope. What is missing in her life and the household she lives is something that gives her hope.
If she chooses to refuse meds, then I say, opinion, ask with respect what other protocols can we do? With a heart to heart talk, put it on the table that WE have an enemy here that WE are going to battle together, you and me. For now, let's try it different. Let's not do medicines. If a medicine has helped you, maybe let's do just a small amount of it, not the large doses you had before. Let's not do hospitals. You have enough bad memories already. Let's not add more. We can do this together. We can move forward in a new direction for both of us. We can beat this monster.
Maybe it means going to church. Maybe it is taking up a new hobby such as landscape painting. Maybe it is taking walks together. Doing something new and unique together on a regular daily basis. Both spouses stepping into the world doing something new for both, together. Maybe it means both researching herbs, reading natural healing books. Maybe it means seeing a Naturopath instead of an MD. Maybe it means seeing an Integrative MD and asking what are the biological causes of schizophrenia that we may test for them and treat them instead of the symptoms?
More than likely, it should be all of the above in a unified strategy.
All of these things have one thing in common...they give hope to the person who needs it. They open up a door to a new road where true healing can actually have a chance to happen. A hospital stay cannot do any of those things.
Posted by Phillipa on September 3, 2009, at 21:20:06
In reply to Re: Suggestions re: Someone Who Refuses Medications, posted by bleauberry on September 3, 2009, at 19:14:05
BB this is schizophrenia. Not the same as depression person could be out of reality. Do you know or have you met schizophenics when they stop their meds? One I took care of brought home a possum dead in the road and was cooking it to eat. His Mother also well controlled schizophenic had him admitted and once back on meds he was fine and able to function in the world. His Mother always took her meds. Phillipa
Posted by bleauberry on September 4, 2009, at 15:06:05
In reply to Re: Suggestions re: Someone Who Refuses Medications » bleauberry, posted by Phillipa on September 3, 2009, at 21:20:06
> BB this is schizophrenia.
Yes I saw that part.
>Not the same as depression person could be out of reality.
Could be. The poster didn't say. There are varying degrees of it. We have no clue at this time so I won't venture an assumption either way.
>Do you know or have you met schizophenics when they stop their meds?
Yes several. Spent time in the hospital with ones on and off meds.
>One I took care of brought home a possum dead in the road and was cooking it to eat.
I'm sorry to hear that. Not concerned about the strange choice of meat or taste, but it might have been rotting.
>His Mother also well controlled schizophenic had him admitted and once back on meds he was fine and able to function in the world. His Mother always took her meds.
In your own words, "everyone is different". "Nothing works for everyone."
I think it is a stretch to make these kinds of assumptions on such little information.
It has been shown that schizophrenics can be revived back to functional society without medicines. If she doesn't want medicines then society, family, and friends should utilize every possible strategy to offer her alternative options. That creates hope and ends the suicidal threats.
I don't know her, friend of my mother, but a schizophrenic woman is functioning pretty well off meds. Sure you can tell she isn't normal. But she is fine and safe. Her recovery has been strong support from a counselor, and a lot of love and empathy from her family.
Another woman I do know personally. She sounds like the spouse in this thread. Really bonkers, suicidal, a roller coaster ride with no apparent end in sight, in and out of hospitals, drugged up bigtime, no real gains after doctors had their say. Somewhere along the line she turned to Jesus. She abandoned her meds. She sought help from family and friends, became involved in the Church, and now appears so normal you would never even know her history unless she told you. Jesus and family support were more powerful than all the meds, all the doctors, and all the years, combined.
The moral of the story...medicines are not the answer for everyone. Medicines can have shortcomings. Medicines can themselves make a person's pathological course worse over time than if left alone. Even the worst of schizos can be managed well without meds. I present the possibility that this woman probably deserves a shot at a different choice of treatment. Whether it would work or be suitable in this case, we don't know.
We can make a pretty good assumption of the future based on history however. The history shows a failed path in this particular case.
As I said, however, none of us have enough detail about this case to really offer more than a general opinion on the topic as a whole, which may or may not apply to this particular case.
Phillipa
Posted by Phillipa on September 4, 2009, at 21:23:17
In reply to Re: Suggestions re: Someone Who Refuses Medications » Phillipa, posted by bleauberry on September 4, 2009, at 15:06:05
BB let's agree to disagree okay? Phillipa
Posted by bleauberry on September 5, 2009, at 7:22:53
In reply to Re: Suggestions re: Someone Who Refuses Medications » bleauberry, posted by Phillipa on September 4, 2009, at 21:23:17
> BB let's agree to disagree okay? Phillipa
Schizophrenics from all walks of life can live healthy functional lives without medicines. It happens by the thousands every single day all across the nation.
For some it means specialized approaches. For some it is targeted nutrtional therapy. For some it is a psychotherapy approach. For some it is undergoing scientific detective work to identify the underlying pathology. For some it means choosing to prefer being a street person rather than a social person. For some it means being saved and walking with Jesus. In all cases, it requires special love and support above and beyond a normal healthy loving relationship. That is basic. Without that, it all crumbles...meds, alternatives, everything.
I submit that this woman deserves a chance at a different journey. The very limited confined journey she has been on has fallen so short. Probably because it has not encomppased the whole person, but rather, only an artificial medicine molecule forced into the brain. That is probably in my estimation only about 10% of the bigger picture, so it is no surprise to me that her treatment has resulted in 90% disappointment.
As this is an opinion board and the disclaimer says not to believe everything you see, we are all free to disagree.
Obivously I am all for meds. Just not when they have led to a bad outcome repeatedly and other alternatives have been scoffed without even consideration.
Posted by 49er on September 5, 2009, at 8:19:48
In reply to Re: Suggestions re: Someone Who Refuses Medications, posted by bleauberry on September 5, 2009, at 7:22:53
Bleauberry, thank you so much for what you wrote. I started to respond to this thread several times but just couldn't articulate my opinion very well.
I also feared I would be portrayed as that crazy anti-med zealot and I just didn't want to deal with it. But your post has given me that courage.
Like you, I am not anti-meds even though it may seem like it. For example, I had to admit that for someone I know who has schizophrenia, meds were the right choice initially.
But now, in my opinion, because the side effects are devastating are worse than the cure, they aren't. Another post as I don't want to get sidetracked.
Phillipa, a perfect example of someone who recovered from schizophrenia without meds was John Nash. There is no way in my opinion, he would have been able to accomplish what he did on psychotropic meds.
These are not scientific studies but here is link to several recovery stories from schizophrenia without meds
http://bipolarblast.wordpress.com/recovery-from-extreme-states-psychosis-etc/
Robert Whittaker, who started off his research, believing in the miracle of psych meds (he was not one of those crazy scientologists) provided entensive research in his book, Medication Madness, showing that neuroleptics don't work.
To pick up what Bleauberry said about meds leading to a bad outcome repeatedly, why do people keep insisting on this solution even though over time, it has been shown not to work in particular situations? What is that expression about insanity?
People need to get over their misconceptions that meds are the answer for all mental conditions. They aren't for everyone and to insist otherwise, is very cruel in my opinion. Just like it is cruel to insist that people who benefit from meds stop taking them.
Finally, I want to mention that forcibly committing your wife is a big mistake and will make her fear asking for help. In my state, even people who are definitely pro meds fear mentioning that they are suicidal out of fear they will be forcibily committed due to the toughened state mental health commitment laws.
One more thing - I would encourage your wife to reinstate the last med to the dose that she was last stabilized at and taper it very slowly - 2.5 to 5% of current dose every 3 to 6 weeks.. It is quite clear from the fact that she has been hospitalized from discontinuing these meds that she cold turkeying them or tapering too fast had an adverse effect.
Yes, it will take awhile but tapering slowly will increase her chances of preventing relapses and ending up in the hospital where she will be drugged against her will.
Posted by Phillipa on September 5, 2009, at 20:20:07
In reply to Re: Suggestions re: Someone Who Refuses Medications, posted by 49er on September 5, 2009, at 8:19:48
My biggest concern is that hubby says wife becomes suicidal without her meds. Hence My pro meds responses. Phillipa ps just a piece from another website. I feel the husband knows his wife and he will make a great choice. It's hard to do.
won't take meds
Having read Crayola's comments, let me say that we have been dealing with a seriously paranoid schizophrenic son for going on nine years. The side effects are treatable in most cases, and play second fiddle to the delusional thoughts of a truly schizophrenic person who might otherwise be living on the street. If you are so lucky to be able to talk to them and get them to listen, the illness is far from severe as is the case with our son. Rationalizing with an insane person is generally NOT what a psychologist cares to do, but once in a while you can find one that will be helpful in convincing them that they need to talk to a psychiatrist for medication. Having tried virtually all medications, there are some that work well but have serious side effects with long term use. But, I'd still rather have him with a well mind and sick body, if it means he can have some semblance of a life. Abilify didn't begin to touch my son's mental illness. It's a better mood stabilizer, but if you have luck with it, more power too you. A new atypical med that is out is called Invega. My son refuses all medication right now, and I may have to go down to the court house with my guardianship papers yet again, for about the tenth time, and ask for a court order to have him picked up. Once the judge signs it, I take it to the sheriffs office and they then bring him to the hospital where real professionals medicate him, generally on a 200mg shot of Haloperidol, which shuts down the delusional thoughts immediately. It takes him about two days to stop napping all day, but when he wakes up out of it his mind is as clear as a bell, and he is in a great place to make his own future medication decisions, that is until he decides to stop taking them again. He ran away once and I found him in a county shelter in Long Beach. Generally until they get medicated, they believe that the psychologist is part of the system that's pitted against them, and that we're all passing messages back and forth telepathically. It's far better to get them on meds so they can think clearly, at which point only then can a professional really offer any objective help. Forget about the idea of talking to your mom if she's that psychotic. Get a court order and get her into the hospital, where they can treat her
Posted by 49er on September 5, 2009, at 23:41:04
In reply to Re: Suggestions re: Someone Who Refuses Medications » 49er, posted by Phillipa on September 5, 2009, at 20:20:07
> My biggest concern is that hubby says wife becomes suicidal without her meds. Hence My pro meds responses. Phillipa ps just a piece from another website. I feel the husband knows his wife and he will make a great choice. It's hard to do.
>
Philipa,That is from cold turkeying or tapering off the med too fast. It is a common misconception to confuse withdrawal symptoms with the need to stay on a med forever.
It might be a different story if the person would taper the med very slowly at 2.5 to 5% of current dose every 3 to 6 weeks.
In the links I posted about people with schizophrenia who became med free, they said the meds never stopped the delusions and made their minds feel extremely cognitively dulled. Sure doesn't sound like they clear your mind.
Posted by SLS on September 6, 2009, at 6:04:19
In reply to Re: Suggestions re: Someone Who Refuses Medications, posted by bleauberry on September 5, 2009, at 7:22:53
> Schizophrenics from all walks of life can live healthy functional lives without medicines. It happens by the thousands every single day all across the nation.
What happened to "happy"?
How many paranoid schizophrenics do you know personally? How about those with 24/7 auditory hallucinations? I lived among such people for over 8 years, and I know for sure that these wonderful people were more functional and self-described as being happier with drug treatment rather than being allowed to continue separated from the flow of humanity. You know, there is a dangerous period during the recovery process of some individuals with schizophrenia when they are most apt to commit suicide. It is when they first respond to treatment and try to comprehend the years that they lost in the midst of such an unfair, malignant, and warping alteration of consciousness; the magnitude of which is unfathomable for them - just as it is unfathomable to me. They just can't comprehend how they could have lived with such an illness for so long. They can't accept it, and would rather not remain alive to deal with living in a strange new world so unprepared and inexperienced.
Until Abilify came along, I found myself working with a woman almost every day, trying to comfort her by telling her that there were no such things as witches that were going to kill her before she got home. Another woman was convinced that they were feeding her the flesh of infants in the meals that were prepared for her in her boarding home. It was difficult to have her believe otherwise so that she would eat. Another talked loudly and belligerently with her dead mother all day long as she roamed the halls.
I'm afraid I must take issue with your posture on this issue. I think that it is very unfair to people with schizophrenia that anyone judge the quality of their lives - with or without treatment. I try my best to listen to my brothers and sisters who live with schizophrenia. From speaking with many of them, I am left with the impression that most prefer to be treated medically, and join the brotherhood of man rather than to remain involuted and separated from others by the ravages of a devastating brain disorder.
- Scott
>
> For some it means specialized approaches. For some it is targeted nutrtional therapy. For some it is a psychotherapy approach. For some it is undergoing scientific detective work to identify the underlying pathology. For some it means choosing to prefer being a street person rather than a social person. For some it means being saved and walking with Jesus. In all cases, it requires special love and support above and beyond a normal healthy loving relationship. That is basic. Without that, it all crumbles...meds, alternatives, everything.
>
> I submit that this woman deserves a chance at a different journey. The very limited confined journey she has been on has fallen so short. Probably because it has not encomppased the whole person, but rather, only an artificial medicine molecule forced into the brain. That is probably in my estimation only about 10% of the bigger picture, so it is no surprise to me that her treatment has resulted in 90% disappointment.
>
> As this is an opinion board and the disclaimer says not to believe everything you see, we are all free to disagree.
>
> Obivously I am all for meds. Just not when they have led to a bad outcome repeatedly and other alternatives have been scoffed without even consideration.
Posted by 49er on September 6, 2009, at 8:18:42
In reply to Re: Suggestions re: Someone Who Refuses Medications, posted by SLS on September 6, 2009, at 6:04:19
Scott,
We need to stop making this an either or situation.
If someone with schizophrenia prefers meds, that choice should be respected.
If they don't want meds, that should be respected also.
Some people with BP and schizophrenia will take meds on an emergency basis but once the crisis has passed will discontinue them. That choice should be respected.
There is the hearing voices network which is a support group for people who want help in dealing with their voices. Here is the link to the Yahoo Groups List:
http://health.groups.yahoo.com/group/voice-hearers/
49er
Posted by SLS on September 6, 2009, at 11:35:47
In reply to Re: Suggestions re: Someone Who Refuses Medications, posted by 49er on September 6, 2009, at 8:18:42
> Scott,
>
> We need to stop making this an either or situation.You are entitled to characterize my approach to the this issue any way you like. I don't agree with you that I am somehow trapped in all-or-nothing thinking.
> If someone with schizophrenia prefers meds, that choice should be respected.
> If they don't want meds, that should be respected also.
I never said anything about not respecting the feelings of another human being. It is a difficult line to walk, though, when someone's judgment is affected by an illness of the brain and an alteration of the mind. None of the people I have mentioned is being forced to take medication. That is not to say that it didn't take some coaxing to have them reach a decision that allowed people to treat them.
You just don't ask someone in an altered state a question once and accept the answer you get as an irrevocable decision - at least, not if you really care about their welfare.
People drop in and out of treatment of their own accord. They leave when they feel well enough, often against medical advice. They return after they stop taking their medication and end up homeless.
A very intelligent man who had been in medical school when his schizophrenia hit was not clever enough to adhere to treatment on a daily basis. He came in voluntarily once a month for a Prolixen injection, because he knew during these treatment periods that he could function and maintain an apartment. He would disappear for a few months and wind up in the streets talking nonsense. For the life of me, I don't know what brought him back for treatment periodically. I guess it was a moment of lucidity. Maybe it was the persuasiveness of his case worker. This man's decisions were respected in that no one would force medication down his throat or a needle into his arm.
By the way, these stories come from an adult partial hospitalization program. No one is forced to go. However, if they do not accept treatment, they are often referred to other agencies as they do not benefit from the program.
Do you accept every decision a young child makes? Why not? You can continue to respect the feelings of another while not agreeing with their decisions.
The people on the mailing list you offer are lucid and not terribly ill. I find it irrelevant when dealing with people as seriously ill as are present in the program I attended.
- Scott
Posted by 49er on September 6, 2009, at 11:58:14
In reply to Re: Suggestions re: Someone Who Refuses Medications, posted by SLS on September 6, 2009, at 11:35:47
<<I never said anything about not respecting the feelings of another human being. It is a difficult line to walk, though, when someone's judgment is affected by an illness of the brain and an alteration of the mind.>>
Agreed but a real attempt need to be made.
<<You just don't ask someone in an altered state a question once and accept the answer you get as an irrevocable decision - at least, not if you really care about their welfare.>>
Sorry, I didn't mean to give that impression. At the same time, I hope you would allow people who initially made a decision to take meds to later change their mind.
<<People drop in and out of treatment of their own accord. They leave when they feel well enough, often against medical advice. They return after they stop taking their medication and end up homeless.>>
Unfortunately, if they cold turkey or taper these meds too quickly, that is what is going to happen. If doctors would stop taking an all or nothing approach with meds and counsel patient that if they want to go off meds, they should taper very slowly (2.5% to 5% of current dose every 3 to 6 weeks), this might be prevented.
Instead, alot of them have the attitude that patient needs to be on meds for life which creates this all or nothing approach.
<< Do you accept every decision a young child makes? Why not? You can continue to respect the feelings of another while not agreeing with their decisions.>>
Scott, just because you have mental illness, doesn't mean you are a child and lose all rights to make decisions about your welfare.
<<The people on the mailing list you offer are lucid and not terribly ill. I find it irrelevant when dealing with people as seriously ill as are present in the program I attended.>>
>
How do you know that? Have you ever asked those folks to tell their stories? Just because they can participate in a mailing list doesn't mean their symptoms are mild.49er
Posted by bleauberry on September 6, 2009, at 15:40:58
In reply to Suggestions re: Someone Who Refuses Medications, posted by mrm12333601 on September 1, 2009, at 14:22:53
This has been an extraordinarily productive thread. In the course of strongly held personal opinions as well as documented case studies including famous people, a big picture of schizophrenia has been painted in this thread. Within that picture I see the following summaries. These should be very helpful to the thread author. Very respectable job. It would not have been so without the varying viewpoints or case studies.
1. Schizophrenia displays a wide degree of intensity from patient to patient.
2. Schizophrenia displays considerable variation of intensity at varying patient timepoints.
3. An unknown percentage of patients benefit greatly from their meds and prefer them.
4. An unknown percentage of patients do not benefit from their meds, but their surrounding family members see it as the only option due to lack of awareness of other options.
5. An unknown percentage of patients do not benefit from their meds period.
6. Weaning off powerful meds too quickly can cause a new tragedy to occur.
7. Weaning off powerful meds carefully can result in a benign outcome.
8. Happiness and functionality can be achieved without meds by utilizing a number of other strategies.
9. Schizophrenia is a term to describe a cluster of symptoms, but treatment fails to look at basic environmental causes of those symptoms.
10. Every case is different, and in this case we all made many assumptions and opinions based on a complete lack of case details.One final interesting tidbit to add. As the child of a trauma physician, my father to this day still speaks of the significant increase of mental illness traffic into the emergency room when it was a full moon. It was as predictable as a clock. Perhaps treatment could also take that into account, and provide extra care and attention during those times each month.
Posted by Phillipa on September 6, 2009, at 20:44:16
In reply to Re: Suggestions re: Someone Who Refuses Medications, posted by SLS on September 6, 2009, at 6:04:19
So true have known and cared for many personally on a day to day basis some were terrified of in his words " Jan the Spirtual warfare is going on in my mind again. What can I do I'm so scared". Grownth man frequently admitted. Coaxing he would reluctantly return to his meds. Two weeks later he was happy and no more spititual warfare. These are real people. Back to beginning of thread and BB's comment choice of meat for the other young boy it was Road Kill meaning a squished animal. He could have been severly hurt from eating fly infested road kill. His Mother had him admitted as she as explained before took her meds had a happy marriage and wanted her Son to have same. Billy the patient name thought their was a horse in the unit and dumped the garbage on the tables. Asked him why (one of my favorite patients ever) said to feed the horse. Said I didn't know we had a horse there where does he sleep. He said in the room across the hall. Now could this person make a decision based on reality? But two weeks later he could. As his meds kicked in. A Few examples of my personal experiences. Scott you've also seen the real world of schizophenia. For that I am thankful right now. Some patients ended up chosing the prolixin injections as they knew they would sell their meds on the street for money hence off them again and the process repeats itself. Some were brought in by police in handcuffs as had tried to harm selves or had and were sent from the ER or ICU. I maintain my position and hope the Husband who obviously to me anyway is very concerned about his wifes welfare from her past suicide attempts that he chose to post the thread on getting help in maintaining his wife on meds. Lucky woman to have such a supportive husband. Kudos to you!!!!! Love to you and your wife Phillipa
Posted by SLS on September 7, 2009, at 9:14:54
In reply to Re: Suggestions re: Someone Who Refuses Medications » SLS, posted by 49er on September 6, 2009, at 11:58:14
> <<I never said anything about not respecting the feelings of another human being. It is a difficult line to walk, though, when someone's judgment is affected by an illness of the brain and an alteration of the mind.>>
>
> Agreed but a real attempt need to be made.I'm confused. A real attempt to do what?
> <<You just don't ask someone in an altered state a question once and accept the answer you get as an irrevocable decision - at least, not if you really care about their welfare.>>
> Sorry, I didn't mean to give that impression. At the same time, I hope you would allow people who initially made a decision to take meds to later change their mind.If I were a healthcare worker managing the case of a person with schizophrenia whom did poorly without medication, I would try to pursuade them that they do indeed need to be treated, especially if they are too low functioning to feed themselves while living as an indigent out on the streets. Perhaps you can suggest here how you would treat someone who is always found roaming the streets dirty, dishevelled, and hungry, talking to themselves while wearing a foil hat whenever they discontinue taking medication. Is this the type of schizophrenia you speak of?
> <<People drop in and out of treatment of their own accord. They leave when they feel well enough, often against medical advice. They return after they stop taking their medication and end up homeless.>>
>
> Unfortunately, if they cold turkey or taper these meds too quickly, that is what is going to happen.Are you telling me that it is the rate of taper that determines whether someone eventually relapses or not?
> If doctors would stop taking an all or nothing approach with meds and counsel patient that if they want to go off meds, they should taper very slowly (2.5% to 5% of current dose every 3 to 6 weeks), this might be prevented.
And you have ascertained this "fact" how?
I get it. Doctors need money, so they make sure that a patient have no chance to be well without medication so that they can insure themselves of a repeat business. In fact, such a thing can only be done if it is considered the standard protocol by "the establishment", otherwise, they might lose their licenses. Therefore, it is the establishment that hides from people that the best hope for a low functioning schizophrenic person to get well is really nutritional.
> Instead, alot of them have the attitude that patient needs to be on meds for life which creates this all or nothing approach.
What alternatives are there, in your estimation, to treat the woman who won't eat because they are cooking her meals at her boarding home using the flesh of infants.
> << Do you accept every decision a young child makes? Why not? You can continue to respect the feelings of another while not agreeing with their decisions.>>
> Scott, just because you have mental illness, doesn't mean you are a child and lose all rights to make decisions about your welfare.
I guess you missed the point. Many people with schizophrenia are less capable than a child at making the decisions for themselves that will keep them clean and fed. It's not pretty, I know, but it is no less true.
> <<The people on the mailing list you offer are lucid and not terribly ill. I find it irrelevant when dealing with people as seriously ill as are present in the program I attended.>>
> How do you know that?Oops, I apologize. I was just reading the preamble mission statement on the webpage and thought that it was representative of their membership. That writing in no way resembles a word salad (schizophasia). The author seems to be high functioning, de facto, or he would not write so comprehensively and organize a website. The site is dedicated to those who hear voices, not to schizophrenia per se.
I really don't know how you have arrived at your belief system regarding schizophrenia and its treatment and mistreatment. I find your taper hypothesis very disturbing - stated as if it were a fact that someone suffering from schizophrenia could become free of medication if they would only discontinue their drugs using your taper schedule.
- Scott
Posted by 49er on September 7, 2009, at 10:19:42
In reply to Re: Suggestions re: Someone Who Refuses Medications, posted by SLS on September 7, 2009, at 9:14:54
Scott,
I wanted to try a different approach in our discussion.
Do you feel anyone with schizophrenia can recover without meds? If you don't, then it really is pointless for us to be having this discussion.
Sorry, I should have asked that alot earlier so I am not putting the blame on you.
I did want to discuss the medication issue. Not to do a "you too" but I have found your advice for tapering medication disturbing also. So the feeling is mutual.
Medical professionals I have spoken to on the Internet have said psych meds need to be tapered at a very slow rate. Come on Scott, you know that due to them making neurochemical changes throughout the body, you can't just stop taking the med as doing so, is like putting the car in reverse at 60 miles per hour. This isn't like stopping Tylenol.
I didn't say that tapering slowly off of meds means the person won't relapse in the future. But since withdrawal symptoms produce many rebound symptoms that are quite similar to the original illness, it is common sense that you would taper more slowly and lessen the chance of a relapse.
Why is tapering slowly such a hard concept for you to understand? You seem like a very bright person so I don't understand why you're resisting this concept.
I know it is hard to change entrenched beliefs but this is important. Even if one doesn't want to go off medication, I have seen so many posts on this board of people suffering needlessly transitioning between meds because the taper is too quick. I don't even bother responding because I feel what I say falls on deaf ears.
You won't see studies of this because many medical professionals have the same entrenched beliefs. Not because their intentions are bad or because they are drug whores. It is because of the attitude that we have done it this way for a million years and we're not changing..
If you think I am crazy, when I discussed tapering my psych meds slowly with my psychiatrist, his response was, "it just isn't done that way". Nothing about what I was doing was unsafe.
A compound pharmacist also tried to tell me I was tapering too slowly. Again, I asked him if what I was doing was unsafe and the answer was no. It was because I was bucking medical establishment routines.
My psychiatrist too his credit has cooperated so I don't want to leave you with a total negative impression.
Anyway, back on topic - I will be interested in your response about whether you feel anyone can recover from schizophrenia without meds.
49er
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