Hello doctor, My daughter is 12 years old, and she always showed a great deal of anxiety started having a lot of school refusal during 5th grade, so we took her to see a psychiatrist who ultimately diagnosed her with high functioning autism and started her on a Lexapro. School refusal continued, but we managed the school year. When she started 6th grade, she admitted to her school psychologist that she had been hearing voices for about a year. The voices were a group of teens about her age, and they were all very negative. We sought treatment again with another doctor who put her on Risperidone, which failed to control the voices, so she was switched to Seroquel, which also failed after a month. We had a move to another state, so we had to change doctors. The move did not go well with our doctor, and she ended up with a suicide attempt and four acute hospital stays and one long term stay. Her hallucinations are now fully engulfing her days, and they are tactile, visual, olfactory, and audio. She also admitted to an early suicide attempt while she was 10. Her new doctor has tried Abilify, Latuda, high dose Seroquel, and high dose Zyprexa. All have failed. She had also tried depression medications like Trintellix, Wellbutrin, Lexapro, Cymbalta, and Zoloft. Nothing has worked for more than two months. Her current doctor is not willing to try another medication and is telling her to live with her hallucinations. My daughter is 13 and has very little quality of life. In our place, there are minimal resources here, even being well insured and willing to pay out of pocket. I am looking for advice on what to do next. Do I travel out of state, do I visit another type of doctor? It is also important to say that she has been diagnosed with schizophrenia. My husband nor I have any family history of schizophrenia going back about five generations, although I do have mental illness frequently on mine (depression and bipolar). I had a completely healthy pregnancy, and she was born on her due date without complications. She was big at 8lbs 9ounce and 21inches.
Hello. It is common for adolescents with high functioning autism (HFA) to experience high levels of anxiety, especially when they are pushed outside their comfort zone. Many go on to develop hallucinatory experiences like hearing critical voices at this stage when they struggle socially. I presume your daughter had all the relevant investigations like scans and blood tests to rule out any physical causes for her hallucinations. Your daughter has been tried on so many different medications, and you report limited efficacy. In addition to drugs, has she been getting any structured psychological therapy during this period? Modified CBT can help manage voices and other hallucinatory experiences. Try to discuss with your doctor and explore the availability of any skilled therapist with experience of working with HFA kids. CBT can be beneficial but needs patience and may take time. If your daughter is very unwell, she may not be ready but better to discuss with your doctor or therapist to know what is possible? It is paramount that your daughter does not get more isolated. Try to get her doing some educational activity (homework, online classrooms, etc. ). If she likes going online, provide an opportunity to browse with appropriate parental locks and control to prevent her from accessing any inappropriate content. Recovery can be gradual in these conditions. You can contact again if any further advice is needed.