Can we include Risperidone in current regimen to treat schizo depressive disorder?

Question

Hi doctor, Before three years, my mother was diagnosed with schizo depressive disorder, when she lost her husband. She is having irritable bowel syndrome and diabetes mellitus. Now at present, she is taking Nexito 10 mg (Escitalopram), Hexinor 2 mg (Trihexyphenidyl Hydrochloride) both taken during day and night and also taking Quetiapine 100 mg only at night for two weeks. Now, she is entirely unresponsive, does not answer the questions correctly, pretty unaware of her behavior, hallucinations, and there is a loss of memory (difficulties to remember at present). Before these medicines, she has been given Risperidone 4 mg (day and night), Procyclidine 5 mg (day and night) and Quetiapine 100 mg (at night). When she was taking these medicines, she felt panic, depressed. There was difficulty in sleeping. Then the doctor changed the medication. But with the current medicines also, the problems have raised. What can we do now, should we include Risperidone with the current drugs to alleviate the symptoms?

Answer 1

Hi,

Welcome to icliniq.com.

She is not getting enough antipsychotic medications. If she has hallucinations and a cognitive problem, then she needs an adequate amount of antipsychotic for a long time. She is on Quetiapine 100 mg which is not a full dose to her, or it is also not responding. So, either you should increase the dosage of Quetiapine or add other antipsychotic medicine. If she had responded well with Risperidone in the past, then you can start it again. If she is restless (akathesia) due to Risperidone, then give her Propranolol or Benzodiazepine. Thank you.