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Thursday, May 29, 2008 Diane Olsen, Community Member, asks

Q: What is best medication for paranoid schizophrenia

My son was diagnoised with paranoid schizophrenia approx 7 years ago, he will be 26 next month. He has had two physcotic breaks in the last three years, the drugs don't appear to be working what do you recommend? 

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Answers (10)
Christina Bruni, Health Guide
5/30/08 3:00pm

Hello Diane Olsen,


Though your son has had a couple breaks in the last three years, there is hope and that doesn't mean he will always have breaks throughout his life.


Hopefully your son has a good psychiatrist who is willing to explore drug options if the one your son is on truly isn't working.  Because if the drug isn't working, your son [your SON] has to communicate this to his psychiatrist.


At a NAMI convention in Washington, D.C. three years ago I attended an Ask the Doctor session where the psychiatrist suggested that partial compliance or non-compliance is indeed the case in the majority of instances where the drugs aren't working.  Because even if someone is having symptoms, he or she could have effective coping techniques for dealing with the symptoms, and these techniques could make the difference in the patient's life quality and functionality, so that the patient can cope better while his or her doctor works at the same time to find the drug or combination of drugs that will work.


Read Robin Cunningham's SharePosts here about his Coping Skills, which are up to skill number 11.  He has talked about the fact that for the first 10 years he didn't get relief from his positive symptoms, even though he was on medication.  His psychiatrist tried every new drug as it came out, until the ultimate drug was found to take away Robin's symptoms.


The truth is, the medication might not be working, that's also a possibility; however, to give up on treatment isn't the solution.  Your son has his whole life ahead of him, and new drugs are being researched every year, so if he works with his psychiatrist, takes the meds he's on now every day as prescribed and develops coping skills, he will be able to ride out the time spent exploring new drug options.


There is hope.  Recovery isn't quick or easy; however, it is possible.


Best wishes,


nita, Community Member
6/16/11 5:19pm

i have an boyfrd that has been taking Haldol/Haloperidol for paranoid schizophrenia since he was 19 yrd old and he is now 35 yrs and i been there when he is having outbreak with yelling, talking very rude or ugly. but the family knows nothing of such becasue he only vents to me and when i say something to his family they just say he'll be all right just ignore it. but i can't. can you help me i have just started to go to support groups to understand schizophrenia and i have going thru this for almost three years. what are the triggers or what symotoms are show when they are about to act out. please help

DrBehavior, Community Member
5/30/08 4:40am

Hello Diane,

I believe the first thing that you have to ascertain absolutely is whether or not your son is taking the medication and if so - is he taking it as prescribed?  Unless you're in the priviledged position of being allowed to stand beside your son while he takes his meds then you cannot absolutely know for certain whether or not he's being compliant.  Schizophrenics are absolutely magnificent at manipulating their caregivers and drug taking is one instance at which they excel.

It seems rather strange to me that someone whose taking their meds is showing little if any affective change.  By definition, the medication is a strong drug and it's 'not working' is not amongst the litany of options available.  That is, the drug may not be achieving the intended or desired result; however, it must be doing something. 

I'd suggest that you strike a deal with your son (one that he'll balk at if I'm correct) asking him for permission for ten days to be by his side each and every time he takes his medication.  If he does agree to this deal you'll still have to ascertain whether or not he's 'tonguing' his meds or 'cheeking' them.  Those are the two most common methods of hiding medication from an onlooker until it's time to spit them out.  Once you've determined that your son is taking the medication as prescribed and then concluded that there is zero change - it's time to discuss dose and efficacy of the drug with your son's provider. 

The only way I know of gaining this sort of trust to a) be by his side while he takes his meds; and b) be allowed to speak with his provider with you present is to be truthful.  By that I mean you'd be well advised to communicate to your son how much you love and care for him and how concerned you are that his medication might not be doing what it's supposed to be doing.  If, you could suggest that he allow you to help him by your being present when he takes his meds (not because you don't trust him but rather that you're very suspect as to why the drug you're paying for is not working as prescribed) and, if that is the case - you'd like to join him in speaking with the provider about the efficacy of the dose and/or the usefulness of that particular medication.  I hope this serves as a reasonable starting point for you and your son and I sincerely hope that he cooperates with you.  Best wishes and good luck.

heather, Community Member
2/22/10 5:09pm

my son 24 took a physcotic episode last year. he still hasnt been diagnosed. could u tell me how long it took for your son to be diag. also my son was on tablets too and a never knew if he took them, he now gets a jag every 2wks that way they knw he gettin al his medication but too me its made him bad in a lota ways and a cant get no one 2 help me any sugestions

David, Community Member
8/18/08 9:39pm

The best drugs for paranoia are clozaril, zyprexa, risperdal and loxitane.  Zyprexa and risperdal are superior at preventing a relapse...probably because they are stronger with psychosis.

Darlene Correll, Community Member
9/23/09 2:34pm

My 34 year old son has Schizophrenia. When he has a relapse, he thinks i am breathing hard. This upsets him so much that he cannot be around me, he goes into another room and closes the door. Why is it always me,(in his mind),  who seems to be the one that is trying to harm him.? I can barely function anymore. Any answers for me? He is now in another room thinking i am breathing heavy!!



MegH, Community Member
6/24/09 6:00pm

I just read an excellent book by Xavier Amador on how to work with your loved one around taking meds.  The book is intended to help family members dealing with loved ones who have poor insight into their illness--even think they are not ill at all, and don't need medication.  It is an excellent book.  It features the LEAP method and is called I'm not sick and I don't need help.


Holly Flood, Community Member
6/16/10 4:54pm

Clozaril (clozapine) is the best. My son took this medication for years. Unfortunately, he experienced the side-effect known as agranulocytosis-his white blood cell count plummeted-and he had to stop the medicine. He is now taking inferior medicines and has never been the same. I wish someone could tell us how to ease his pain.

ambein., Community Member
3/ 6/12 6:48pm

Look into ambien.


Momsense, Community Member
1/21/11 11:47pm

My son tried several meds before one was found that worked for him.  There is a new test through Mayo clinic which tests your genetic makeup and shows which drugs you can metabolize into its effective form.  The test is called pharmacogenetics.  Two of the meds my son was taking were actually harmful to him.  We're still trying to get the best combination, but Cymbalta is helping with the depression and haldol continues to be the best antipsychotic for him.  Risperdal, abilify, zyprexa and seroquel did not help control the delusional thoughts. Abilify actually worsened his symptoms.  If the meds your son is on aren't working, it is very possible they aren't the right fit for his metabolism.

maxine, Community Member
2/ 9/12 1:19am

Can you please advise as to how to go about getting into the Mayo Clinic for this test called pharmacogenetics.  My son is 35 and has been on risperdal injections for several years.  I am beginning to think it isn't helping his delusional thoughts.  Abilify  was horrible for him as was zyprexa and seroquel.  My son is on Medicare and does not have other health insurance, how expensive is this test and is there anywhere else that it is being done.  Thank you for any advice. 


Momsense, Community Member
2/16/12 9:08pm

My son's psychiatrist did the test in his office -- a very simple mouth swab.  He then sent the swab to Mayo and they sent a list of effective and non-effective medications for my son's gene type.  If you contact Mayo's psychiatric department, perhaps they could tell you who offers the test in your area.  It was expensive -- around $1500, but maybe the cost has come down by now.  Best to you -- this is a hard road to walk with our children.  My son is doing better, but still struggles with being around people much.


maxine, Community Member
2/16/12 9:41pm

Thank you for the information.  I'm going to do some research on it.  You are quite right about it being a rough road.   I worry a great deal about how my son will do if something happens to me.  He depends on me for so much.  I am doing everything in my power to make him independent.  He lives on his own, but calls me many times a day.  He lives in a downtown area that is near to gyms, and a University.  He paints, and is now learning to play guitar.  He also works out several times a week.  It seems that when he can focus his mind on learning things that he does better.  He struggles with being around people as well yet gets lonely.  I keep looking for a support group with people he can relate to - so far no luck. He spends most of his time smoking like a fiend and gets paranoid and delusional.  I will see what I can learn about the swab test because the voices bother him a great deal and the Respirdol doesn't seem to be helping with that. 


bob straight, Community Member
4/26/11 12:35pm

My son has been battling this terrible illness for 10 years now. He has been on risperdahl, zyprexa,geodon,haldol and they are now going to try clozapine. All these medications are dangerous. I know he has taken the meds as they have given him shots that last several weeks to a month. He is on disability and receives about $700 a month to live on. Of course I help him as much as possible financially and emotionally but unlike many of the other positive commments this is one tough road to travel. He has no friends and few interest, the only "friends" he does have are delusions that he won't accept aren't real. If it wasn't for me he would probably fall throught the cracks at some point and become a street person. These poor people suffering from this illness can't defend themselves and are minimized by state and federal goverments in most states. When's the last time a high public official of any stripe made helping the mentally ill a cornerstone of their work while in office. Shame on them all!!!

nita, Community Member
8/ 1/11 11:34am

Hi Bob my boyfriend has been taking Haldol for over 15yrs and now he is drinking and smoking heavy with it. he is listen to negative things from his bad influned friends and not hearing me at all. he is mad for the things he has not recevided all of his life like a truck, getting out of his parents house for the last 35 yrs. i have offered for him to come live with me since he did proposed last spring but someone in his family told him his life would be miserable and he took it back. how can i help him with not listening to negative people about our relationship when i am the only one that is taking care of him. I dont get a check his mother gets it i dont want it.

help. his friend and family are all jealous that i am doing good things for him and that his life would be better with me, but they are helping him in no kind of way.

bob, Community Member
8/ 1/11 3:24pm

Don't forget to take care of yourself. Your boyfriend is very fortunate to have a friend who trys to help with this illness. This illness can pull you down as there is no cure and even finding a way to keep the illness in check is difficult. You must give your boyfriend lilitations to the treatment you will accept from him. People with schitzophrenia value things just like you and I do so don't give him a free pass to be a jerk. You don't deserve that!!

nita, Community Member
8/ 1/11 4:10pm

Yep. ur right. He got mad at God because he got laid off from a trp job when i had already told him that when u work a temp job there is a large chance that when work becomes slow to no work, you will be sent home until futher notice and when it happen two weeks later, he was mad at God and me. so he acted so bad and his the street and started to drink and hang out. He said that everytime he gets a chance to leave from his parents house something happen but he only treats me wrong and not them. yesterday was the first time he had call me in a month, other than me dong all the calling and text with a response.

gjl, Community Member
8/24/11 8:21pm

you need to not make yourself so available as he is taking it for granted that you will always be there and he thi nks he can do no wrong in your eyes. i know as I have a friend with the same illness and every once in a while he needs to be reminded that I HAVE FEELINGS TOO!  Be strong honey. You BOTH need that!

maxine, Community Member
2/ 9/12 1:22am

I feel your pain.  My story is much the same.  It is painful and very exhausting to be the only caregiver.


Don Fraser, Community Member
8/ 2/11 2:37am

I thought I'd put in my two cents, for what it's worth.        I have had schizophrenia for 34 years.      I have been in recovery for 8 years.      My family went through hell and back trying to find the right meds for me.


     It ended 8 years ago when I saw a specialist in Vancouver who prescribed two anti-psychotics for me.    I now take Zyprexa, Serequel along with a mood stabilizer and an anticonvulsant.         Quite a handful, but I take them 4 times /day, I have no symptoms or delusions and I lead an independent, pretty normal life.

   The great key for me was simply to realize that I had the illness and to take a proactive role in the treatment of it.


Have a good day,


Don Fraser

maxine, Community Member
2/ 9/12 1:28am

Don - thank you.  Can you please explain how the various drug dosages were figured out?  My son is aware of his illness.  He is getting the Risperdol shots every other week.  He is still having delusions.  Congratulations on the recovery.

grace, Community Member
9/20/11 2:30am

I heard from friends that are familiar with the disorder that clozaril is the best, but every person is different, what may be good for one may not be good for another person, sometimes u need to try diffrent meds until they find the one that suits u daugther has schizophrenia too and really bad, at this moment she is lock up for being violent against me, the phychiatrist is going to recomend the court to admit her to the hospital for 1 really sad for her...i guess i have no other choice...Frown

ambein., Community Member
3/ 6/12 6:50pm

If you take 20mg ambien on a empty stomach should nearly destroy all schizophrenia for 5-6 hours. it's amazing. It does make you a bit dizzy off, but after 2 weeks of this use, the "dizzyness" should go away and just take away symptoms. Get on ambien.

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By Diane Olsen, Community Member— Last Modified: 06/16/14, First Published: 05/29/08