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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Danielson on February 8, 2000, at 8:23:59
Has anyone experienced a schizophrenic patient so refractory to treatment that you want to throw your arms up in the air and give up?
We have a schizophrenic pt,that has gone thu several ECT treatments , and is currently on Zyprexa 40mg and Clozapine treatment.
Nothing seems to touch this patient.
Any suggestions????
Posted by Noa on February 8, 2000, at 21:32:27
In reply to schizophrenic refractory pts. treatment, posted by Danielson on February 8, 2000, at 8:23:59
Most of us are patients, not docs. And WE feel like throwing our hands up and giving up a lot.
But, is your patient in hospital or outpatient? If outpatient, are you sure of med compliance?
Also, if you stick around here, you might here some info from folks with relatives who have schizophrenia. Good luck.
Posted by JohnL on February 9, 2000, at 3:20:00
In reply to schizophrenic refractory pts. treatment, posted by Danielson on February 8, 2000, at 8:23:59
> Has anyone experienced a schizophrenic patient so refractory to treatment that you want to throw your arms up in the air and give up?
> We have a schizophrenic pt,that has gone thu several ECT treatments , and is currently on Zyprexa 40mg and Clozapine treatment.
> Nothing seems to touch this patient.
> Any suggestions????More detailed description of the patient's symptoms and past medication reactions might be helpful. For example, is the patient predominantly experiencing negative symptoms? Positive symptoms? What other meds have been tried and what were the results (no effect? adverse effect? what kind of adverse effect? partial benefit?) Thanks.
Posted by Cam W. on February 9, 2000, at 23:05:07
In reply to schizophrenic refractory pts. treatment, posted by Danielson on February 8, 2000, at 8:23:59
> Has anyone experienced a schizophrenic patient so refractory to treatment that you want to throw your arms up in the air and give up?
> We have a schizophrenic pt,that has gone thu several ECT treatments , and is currently on Zyprexa 40mg and Clozapine treatment.
> Nothing seems to touch this patient.
> Any suggestions????Danielson - This probably won't help either, but some psychiatrists have said that adding low dose loxapine (5-50mg) can help. Loxapine acts as an atypical at these doses. Don't know if it will help, but may not hurt. I have never seen it added to that combination, but have seen some success in treatment-resistant cases using loxapine with the Zyprexa. By the way, as a caveat, I just heard Herbert Meltzer, the clozapine guru, talk on antipsychotic polypharmacy and he says that adding a traditional to an atypical or even combining two atypicals may saturate D2 too much leading to ESP.
Sorry I cannot offer anymore. Good Luck - Cam W.
Posted by Sam on February 16, 2000, at 23:37:58
In reply to Re: schizophrenic refractory pts. treatment, posted by Cam W. on February 9, 2000, at 23:05:07
> > Has anyone experienced a schizophrenic patient so refractory to treatment that you want to throw your arms up in the air and give up?
> > We have a schizophrenic pt,that has gone thu several ECT treatments , and is currently on Zyprexa 40mg and Clozapine treatment.
> > Nothing seems to touch this patient.
> > Any suggestions????
>
> Danielson - This probably won't help either, but some psychiatrists have said that adding low dose loxapine (5-50mg) can help. Loxapine acts as an atypical at these doses. Don't know if it will help, but may not hurt. I have never seen it added to that combination, but have seen some success in treatment-resistant cases using loxapine with the Zyprexa. By the way, as a caveat, I just heard Herbert Meltzer, the clozapine guru, talk on antipsychotic polypharmacy and he says that adding a traditional to an atypical or even combining two atypicals may saturate D2 too much leading to ESP.
> Sorry I cannot offer anymore. Good Luck - Cam W.How about a gram of Thorazine or 30-40mg Haldol?
This is the end of the thread.
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