Q. Suffering from schizophrenia. Doubt regarding Sulpitac dosage.

Hello Doctor,

• My brother (aged 18 years) has schizophrenia since two years. (Note : My father has schizophrenia who is under medication for nearly 25 to 30 years).

• The tablets prescribed by the doctor were Mirtaz 15 and Sulpitac 50. During this period he had an increased appetite and was obese. He was sleeping a lot and was hearing voices (which he told only after changing the doctor and after having the new medicines).

• One year back he was prescribed with tablets Sulpitac 50, Arip 10. He was fine with these tablets as he was not hearing any voices (during his junior college). The doctor also said that sulpitac is a drug to be avoided since there are chances for cardiac problems in future.

• But as his exams were nearing (my observation), he had sleepless nights because of which he was always resisting to go to school and started to hear voices again. So each time we consulted the doctor, he increased the dosage. And these are the tablets that he was taking during his exams --> Sulpitac 200, Arpizol 10, TF-Plus, Zolcalm 10 (started with Zolcalm 5) and Flocetam 400(morning). After 3 or 4 exams got over, he again started to have sleepless nights inspite of taking Zolcalm 10.

• When we visited the doctor mid-way during the exams, the doctor said he had prescribed the maximum dosage beyond which he cannot increase or do anything. So my brother had to cope up to complete all his exams and when his exams were over he did not have any sleep problems after which Zolcalm 10 was gradually stopped.

• Now he has joined a professional degree but still he takes Sulpitac 200, Arpizol 10, TF-Plus and he is in the midway of his first semester. He has started to have sleepless nights now and then. After consulting with the doctor, we have started to give him half tablet of Zolcalm 10 if he continuously has 2 or 3 sleepless nights.

• What should be done as the boy is suffering to cope up with his studies? He says that he lies awake during nights and his body gets too tired to move.He also said if my father or mother calls or speaks to him (assuming him to be awake), he gets irritated as he feels too tired to respond.

• My parents and I are worried about the situation and also about the dosage of Sulpitac which has not been reduced till date. Please help us with this situation.