Resolved question:
My name is Yoshiki Mino from Japan. I have questions about my medication.
First, I will explain about my medical history.I am 27 years old and I have been illness of schizophrenia since 17years old.
I had mild delusions at that time so my parents and I decided to go to the doctor. My doctor at that time prescribed Zyprexa.
But it didn't work at all. I was sleeping all day long. So my parents adviced me to go to the doctor of good reputation in the neighborhood.
He told me that I had a mild neurosis and prescribed haloperidol. I doubt about what he was saying. He was always dodged about my illness.
I noticed that my illness as schizophrenia about 6 month after I had been taken my haloperidol as medication.
My trigger of noticing my illness is that I researched about my medication on internet. It was saying that haloperidol is used as treatment of schizophrenia.
About four years I had taken haloperidol as treatment of my illness, but it was tough days. I never skipped my medication but I had strong fear and gaining weight as side effect.
I could not endure my pain any more so my parents and I decided to change doctor. I moved my house and started my new life in Tokyo. But it didn't go that easy.
I had abilify, rouland and haloperidol as my medication. At first it worked. I felt that it cleared my fear and felt very great.
But as time goes by, my doctor took out haloperidol and add abilify, rouland about three times more than I had taken. I felt tired and I could not get up from my bed. Also I had felt impatience very strong.
I told many times to my doctor that I could not live normally. My doctor told me that my body was lacked of vitamin B so he gave me a vitamin B as medication. I had tough days so my parents and I chose to go back home and focusing on treatment.
When I got home, I started to go to the doctor where he was at 1hour from my home by riding the train. He was young and had the gift of gab. I couldn't imagine it started worst nightmare of my life.
When the treatment had moved on. He took off rouland at all and started using abilify as main medication. I still felt tired and also I was impatience very strong.
So my parents and I asked him to do something but he could not listen at all. When my parents asked about medication, he got angry and told us that "You can change a doctor if you have doubt about my medication." My mother cried and asked the doctor what we should do. The doctor told my mother that "I know how it feels like. It is tough" and he just gave us abilify as medication.
About 2 years passed I had abilify as main medication. It was about 6mg a day and I had tough days. I could not sleep well and I was impatience very strong.
My father had to move to Tokyo because of his job. So I decided to move to Tokyo and started finding a new doctor.
I was moving house in Tokyo and home by train for once a week. It was very tough for me because I couldn't find a doctor.
So I was moving Tokyo and home by train to get treatment by doctors that I had already examined before. I could not live normally and suddenly the nightmare shocked me. At that time about four years ago from now, I started hearing voices. It was nightmare.
Since then my parents and I tried everything we can to stop my voice. But it didn't work. I had 9~10mg of risperidon and 24mg of blonanserin a day. Also I tried 12mg of invega and blonanserin a day but it didn't work at all.
I was impatience very strong and I heard voices all day long. So my parents and I researched about medication and figured out that rouland is the best medication that I had taken. So I asked the doctor to prescribed rouland as medication and it worked. I was impatience very strong but my impatience has gone since I had rouland. But I still hear voices. It worked a little since I had rouland. It was nightmare that when I had risperidon and invega as medication because the voices increased day by day.
Now I take 40mg of rouland a day as irregulary because I feel tired if I take more than 4mg each time so I take 10 times of 4mg rouland as medication a day. Also I take 2mg of blonanserin a day. I already meet 5 doctors this months but didn't have an idea to treat my illness so I researched about my illness and medication. I figured out that Abilify worked.
I asked a doctor to add abilify and voice has almost disappeared.
I take 40mg of rouland, 2mg of blonanserin, 4.5mg of abilify(1.5mg+0.75mg+0.75mg+1.5mg) as main medication. I feel that rouland must be (4mg+4mg+4mg and before I sleep I take 8mg) I must add abilify just little bit more (1.5mg+1.5mg+1.5mg+1.5mg), I wonder if I have to take blonanserin or not. I can't take out blonanserin immediately so I will take 2mg a day and decrease it when these medication got well.
I would like to know that this medication goes well for me.
Sincerely,
Yoshiki Mino
Submitted:
4 Days
Category:
Psychiatrist
Hello
Thanks for using Doctor Spring for posting your query.
I have gone through it in details, and I can understand what you are going through.
Schizophrenia is indeed a very difficult illness to treat and ones it becomes resistant then it is all the more difficult. I understand you confusion initially about neurosis and psychosis. Infact many patients of schizophrenia have neurosis initially followed by psychosis as in your case. I could understand all the drugs that you have mentioned except Rouland 40 mg which I could not understand what does it contain. I would appreciate if you can let me know the content of this medicine. Is it Ziprasidone?
Further after going through all your medical history i have certain comments to make
1) The drug of choice for resistant schizophrenia is clozapine and it seems you have not even tried this drug. Its a very nice drug and very effective even in the resistant cases. The only issue with cloazapine is its possibility to cause neutropenia. Hence a weekly CBC while elevating the dose and there after CBC every 15 days should be good.
2) Now that you are stable on these medicines that you are taking you may take the same but there is no use to break abilify in these many doses as the half life of abilify is long and hence ones a day dose of 5 mg or 10 mg should be good.
3) Regarding your third drugs (Rouland) which also you are breaking in these many parts, may not be required as most of the psychiatry medications can be given in ones a day form or at the maximum twice a day, but not more than that.
4) For resistant auditory hallucinations, hearing music from ear phones is a good therapy. That reduces the hallucinations.
5) Keep your self occupied by some work and you need to communicate to people around you. The more you socialize the better it is.
6) Blonanserine is a new drug and many people have not used it as a first line drug. However if you are comfortable with it, you may use it.
Hope this helps,
If you need any further clarifications, i would be more than happy to help you.
Kind regards
Dr. Srikanth Reddy MD (Psychiatry)
Doctor, Srikanth.
Thank you for your great advice. I told my doctors about you and they are very surprised.
My doctor told me that Cloazapine will work well but in Japan we have to go to big hospital where hematology are available. Also my doctor told me that Rouland is used only in Japan. He was little confused about asking an advice from foreign doctor.
I'm not sure about Rouland. I searched about Rouland but it says you may use twice a day. I think more than 8mg a day will be very difficult to spend your daily life. I did not tell you but I used Latuda before. It was terrible. I could not sleep more than 4 days. Depression was so hard and I did not look very well. I feel that almost got killed by this medicine. I started from 80mg a day and reduced for 20mg a day but it did not work at all. I could not move and sleep at all.
The voice(Hallucination) makes me stressed. Also depression and lack of memory(hard to remind things). I have good memory so I don't understand why this is happening to me.
I invest and make money these days. It is hard for me to work normally with these situation. Also it is hard for me to take medical treatment in Japan. Is there any way that I can take normal medical treatment around world?
Best regards,
Yoshiki Mino
Hello Yoshiki,
The treatment patterns vary from country to country. Its unfortunate that in Japan clozapine is started only where hematology facility is available. In US and in India we can start clozapine at home based treatment as well and it is the drug of choice for resistant depression.
Anyway being in japan it would be wise to follow your local treatment guidelines. Seeking treatment from outside country is not advisable as in schizophrenia you need to have regular follow-ups and that is not possible from outside the country.
However if you shift to a new country for a longer duration then the treatment will be possible. Many Indian hospitals cater to foreign tourists for the medical interests.
Hope that helps,
If you need any further help I would be glad to help you.
Dr, Srikanth.
Thank you for your great advice.
I think I have to think another option. I can not take normal medical treatment in Japan. I move around Japan and seeking for doctors.
I asked many times that I want to get normal medical treatment but my voice(hallucination) are hearing all day long and medication has changed for ten years.(since when I was 17) I used almost every medication that doctor can use. I had met more than 20 doctors including big hospitals and university hospitals. I had met the Japanese professor of university (Kobe university, Harvard university, Seimarianna University) But they had done nothing.
Will you write letter of introduction? So that I can get normal medical treatment. I have never been to India so it has risks of getting medical treatment in India. I have friend in India. It feels comfortable for me. But it has risks.
I think US sounds great to me. I have lived US for two years since when I was Junior high school student.
Thank you for your great support.
Best regards,
Yoshiki Mino
Hello,
Thanks for the follow-up information. Sincere apologies for this but without personally and physically examining you I wont be able to provide you a letter of introduction.
If you want to take your treatment away from Japan, you can take it and its your choice. Regarding the option of India, I don't think there is any significant risks involved. There are plenty of corporate hospitals in India which provide excellent care. I can provide you a list of such hospitals if you can specify which city you want to select. I my self practice in Indore in Madhya Pradesh.
Regarding the US, option is not bad but the treatment without social security will be very costly. The cost will be atleast 10-20 times more as compared to India.
Practically speaking, India would certainly be a better option.
Regards
Dr. Srikanth Reddy MD
Dr, Srikanth.
Thank you for your great advice. I'm feeling better by your message. I think India is one of the best option. I don't know about India but I think Education and Medical care is one of the top level in the world. I know many intelligent people who are from India making world better place.
Is it possible to take medical treatment without visa in India? Is there medical care visa in India?
What should I do for taking medical care from you or other doctor in India?
I took TOEFL test a week ago and waiting for my score. I think it is possible for me to become college student in India or I will just wait for the treatment gets well and do my own business in India.
There are many options if my medical treatment gets well.
I think the best option is to get medical treatment from you.
Thank you for your advice. I deeply appreciate it.
Best regards,
Yoshiki Mino
Hello
Thanks for your follow up information.
Yes you need a visa to travel to India and there is a provision of medical visa as well. You may contact your travel agent for the details.
If you need any further help you may contact me in future through doctor spring.
Regards
Dr. Srikanth Reddy