Hi doctor,
I would like to brush up on my sister's medical history once again here. Two years ago when she was diagnosed with schizophrenia, she was prescribed tablets Risperidone 1 mg, Parkin 2 mg, and 5 mg Escitalopram for a week and then it was increased to 2 mg Risperidone, Parkin 2 mg, and 5 mg Escitalopram for one month. At that time, she was feeling fine with 1 mg of Risperidone, but when it was hiked to 2 mg, she had the symptoms of drowsiness, forgetfulness, dry mouth, not being able to enjoy any work or any activity like watching her favorite program on television, listening to music, experiencing lack of willpower and having the urge to recover from all of this quickly. She was weeping and had thoughts of suicide mainly because of depression. She used to say that she wanted to quit taking the medicines since the side effects were intolerable for her.
She wants to work and enjoy everything. As a result, she quit taking medicine. Within a period of two to three weeks, hallucinations recurred making her feel uneasy. On my convincing her, she started taking medicines only till the hallucinations vanished. She again stopped the medicines saying that she was alright. At that time, she was unemployed at home. I convinced her a lot to stick to the treatment, but she was reluctant. I pressurized her to go for a job and not sit idly at home. She found a job and started working. She got busy with her job, and it reduced her hallucinations. When she was at home (jobless) she used to have hallucinations all day and at night. But when she started working, she used to have hallucinations only when she reached home and not in the office.
With your suggestion, I started giving her tablet of Risperidone 1 mg and Parkin 2 mg by mixing them in her food due to her poor compliance. I increased the dosage of tablet Risperidone to 2 mg and this time I did not give her tablet Escitalopram. After a period of two months, she started complaining about the side effects mentioned above. I started giving her tablet Escitalopram 10 mg to reduce her symptoms, but she did not recover. Conclusively it appears that the side effects of a hiked dose of tablet Risperidone are intolerable for her. Now when I have lowered the dosage of tablet Risperidone to 1 mg, and I am giving tablets Parkin 2 mg and Escitalopram 10 mg. She is feeling fine like she wants to be. Please suggest another medicine with the least side effects. My sister also has maxillary sinusitis and a middle ear infection (CSOM). She is having pus discharge from both ears since her childhood. Now she is 35 years old. She has left her ear treatment untreated and uses ear drops to control pus discharge. Does her ear condition add to her schizophrenia and medicine non-compliance? Please help.