A 26-year-old man is referred to the OPD. The patient has turned the house upside down as he is convinced that there is a microphone taping his family conversations. He has not slept for 3 days and has been talking to himself. He was diagnosed with schizophrenia at the age of 20 and was under the care for 3 years. Medication history He was treated with risperidone and seemed to have responded well. However, he stopped taking his medication and had a relapse 2 years ago.
Risperidone was re-commenced but he continued to remain quite paranoid and suspicious. There was concern about the possibility of him missing medication, and he was switched to risperidone long-acting depot. This was continued for over 12 months but without a significant response. Risperidone was replaced with olanzapine, but this also did not produce a significant response and was associated with weight gain. Olanzapine…
