How can my brother manage his schizophrenia well at 40?

Question

Hello doctor,

My brother, who is 40 years old, has been suffering from Schizophrenia for the last seven years. He is taking medications like Haloperidol, Paliperidone. He is doing ok. However, recently he has developed strange symptoms like sudden unnatural movement of facial muscles, eyelids, and hands. Also, for the last three days, his tongue has started moving unnaturally. As a result, he is having difficulty talking and eating. Please tell me what it is?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

From your description, your brother’s new symptoms, such as

Sudden abnormal facial, eyelid.
Hand and tongue movements.
Speech and eating difficulty

These symptoms are very suggestive of tardive dyskinesia (TD). This is a movement disorder that can develop after long-term use of antipsychotic medications such as Haloperidol (an antipsychotic agent) and Paliperidone (an atypical antipsychotic medication). TD is caused by long-term dopamine receptor changes in the brain and may persist or worsen even if the offending drug is reduced or stopped.

You can inform his psychiatrist promptly so they can confirm the diagnosis and decide whether to adjust his current medications. In some cases, switching to a newer antipsychotic with a lower TD risk may help.

Specific medicines called VMAT (vesicular monoamine transporter) 2 inhibitors (Valbenazine, Deutetrabenazine) can significantly reduce TD symptoms, but they must be prescribed and monitored by a specialist. Speech and swallowing therapy can help with eating and communication difficulties while the movements are being addressed. Early intervention is important, as the chances of improvement are better when TD is recognized and treated promptly.

I hope this information helps you.

Feel free to ask further queries.

Thank you.