Hi doctor, My brother is under medication for schizophrenia since eight years. He is well responded to medicines. But, since two months he has not been taking tablets at night (Arpizol 10 mg). The reason is that unknowingly he is masturbating in sleep. He was in spiritual path where the act is considered as a sin. So, he is refusing to consume tablets at night. I tried to convince him a lot, but he is not listening to the doctor's words too. The situation is getting worse. He is getting inferiority complex and becoming violent. Also, he is not ready to get treated by the doctor. He said that he does not want to stay at home and absconded once. He returned home after a day. All the people in office are laughing at him with his abnormal behavior; I cannot admit him in the hospital forcefully as he will become violent. Kindly help me in this case. His current medication includes Prodep 20 mg in the morning and Arpizol 10 mg at night. Is the problem being due to the tablets? If it so, can we change the medicine?
Hi. I have read your query with keen interest and understand your concerns. Presence of aggressive behavior, not taking medicines and feeling that people are laughing at him along with the history of wandering tendency clearly indicates that he is slowly developing symptoms of schizophrenia, which is probably due to medicine discontinuation. It will be wrong to say that it is due to medication, but it is right to say that such behavior was prevented for last few years with the use of medication.  This is also possible that 10 mg of Aripiprazole was not enough to control his symptoms. I understand his aggression, but it is better to start his treatment even in a covert manner if necessary. In addition, these days lots of depot preparation is available. It can be administered at the interval of two to four weeks, thus increasing compliance to treatment and response of the patient. For further information consult a psychiatrist online -->