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Mental Health > Schizophrenia Forum > Schizophrenia / Paranoia Where's the Distinguishing Line ?
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Q: Schizophrenia / Paranoia Where's the Distinguishing Line ?
asked by: WorriedSis on June 16th, 2007
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I was hoping to ask a doctor but apparently none are online. I have a sister who is 39 years-old who is receiving inpatient care at the moment from having delusional thoughts that have interfered with her work and home life. She never really spoke of anything "bizarre" just highly unlikely events. She's been on Geodon now for the past few days and now she says she has been hearing voices argue in her head for years (since before her first hospital stay for the same ailment over 5 years ago). She said until a couple of days ago she just considered it "self talk" (her words). Now she says they are really voices. I'm wondering if perhaps antipsychotics can actually cause symptoms like this.

When she went through this same scenario of being admitted for about a week five years ago, she was released on Geodon. It seemed to be a Godsend, then it turned her into a mindless zombie barely able to function. She also had a facial tic where it appeared her lips would roll. She has been seeing several doctors and trying different dosages of Geodon, but honestly I know we'll soon have her back to her zombie state as soon as the first two week initial doses kick in.

She started having her delusions about government/terrorist conspiracies that include her as some pawn at about the age of 33. She looks back over her past life even before that age to incorporate events that took place and twist them to fit her theory. But prior to that age, there was never anything of this nature going on with her.

I'm curious, since I've been reading about Delusional (Paranoid) Disorder and the treatment being primarily anxiety meds, antidepressants and psychotherapy, that if this is indeed what she is suffering from and not schizophrenia that perhaps the use of antipsychotics might be making her symptoms worse or even branching into the more psychotic realm. Could this be plausible?

If so, how do we get through to doctors who seem to insist throwing her on antipsychotics to calm the delusions and now psychosis? We know exactly what this med will do to her and her husband is hoping for some miracle that she won't respond to it like she did years ago.

This is beyond frustrating because she won't be dismissed until she tells them she is no longer delusional or hearing voices, which she admitted after her first episode that she has never stopped believing in, even during the meds.
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Stan
replied on June 16th, 2007
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She should have first been tested for any physical problems with hormones, glands, glucose and such, which I'm sure they didn't do. As far as I know, delusional disorder and schizophrenia are often treated with the same medication depending on how serious the delusions are. It sounds like hers are pretty serious if she had to be inpatient, because most delusional types will be able to generally function normally but will have odd beliefs, though typically paranoid cases don't get as extreme as you seem to state. Usually, delusional disorder will involve believing one's spouse is cheating when it's not true, in fact Maury had several people like this on the other day or so, though they weren't called this, it was one of those lie detector shows. Delusional disorder is typically something odd, but plausible. It's plausible one's spouse is cheating but not plausible the government is singling you out for some grand purpose. Delusional disorder also very rarely includes hallucinations, so it's most likely schizophrenia if any other problems can't be discovered. Unfortunately, as you're seeing, the treatment for it is below standard and terrible. The facial tic is from the medicine and eventually, if they can't give her something less extreme, she will have permanent face contortions and such from the medication. If you've ever gone to a psychiatric hospital and have seen people there, the ones that are all contorted looking and have tics are not experiencing symptoms, they're experiencing the medicine they've been taking for years that ruined them.
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WorriedSis
replied on June 16th, 2007
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Well, from everything I've read about Delusional Disorder, feelings of grandiose are fairly common such as government or even religious theories. I don't think she is really experiencing any voices (I'm assuming that's what you're referring to as hallucinations). I think she used the wrong wording in the wrong place and now she's convinced herself that thinking in words is hearing voices. I may be wishful thinking I know, but I still don't believe this is what's going on especially since it would have been the first time she would have anything even remotely like hallucinations in her life, not prior to the age of 33 anyway.

I will agree without a doubt that she's delusional though. I don't believe her case is that severe. The reason she's inpatient is because by the time we (as a family) confronted her with her delusions it was past midnight and she went to the ER very agitated at us for not believing her and insinuating she was "crazy". At her request they admitted her and are treating her inpatient.

They did change her to Abilify today and are taking her off Geodon, although it's another antipsychotic, and plan to discharge her in the next 36-48 hours.

We're hoping once she starts psychotherapy that she can come to her own peace from counseling and discover whatever is driving her in and out of the mental facility. She's been under an immense amount of pressure for the past 20 years in an emotionally abusive relationship. She's had to deal with things that our whole family has said would drive each of us over the edge.

We're ok with her staying on the medicine until she feels she's "better". Are you even supposed to stay on an antipsychotic forever? I've read up on Abilify and even their website states you shouldn't stay on it for longer than - I believe it said - six months. I might have read that wrong though.

As far as physical problems, she's borderline diabetic (constantly having to check it and occassionally high readings), and she's been having thyroid screenings for problems in that area as well. Her near condition with her blood sugar levels is one of the main concerns I have with Geodon and Abilify. I'm fairly certain her doctors know this though.
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Stan
replied on June 16th, 2007
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Yes, it can have that, but again it depends what these 'voices' are. If she's really hearing things, delusional disorder is doubtful, but then again from what you said it sounds like she was pretty lucid when she was admitted willingly, correct? Schizophrenia pretty much just comes on suddenly, so if that's what it is it's not a surprise really, especially considering the stress you say she's experiencing. However, what worries me is the sugar thing. Has she had any other problems, physical or mental, before this? If so, and if she has a history of symptoms like aching behind her eyes, frequent headaches, flu-like symptoms that are severe but not temperature is present, fainting, as well as a variety of others, her likely problem is glucose. I'm saying this from personal experience and people I've helped. Doctors are supposed to screen people for physical problems before a mental diagnosis is ever settled on, but they rarely do. In my case I had to push for test after test until it was revealed my pancreas was overreacting to food and my blood sugar was dropping 30mg ever half hour or so, which is bad. If she has this problem, it can only be corrected by diet. Not sure about length on abilfy, but unfortunately even though it's to treat stuff like bi-polar disorder, rarely can such people actually get off of the medication without experiencing a relapse.
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