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Abstract: Schizophrenia is a group of chronic disorders of unknown etiology, mostly with slow or subacute onset in young adults. The patient presented to the hospital due to sudden onset of garbled speech, fear and fear, and self-talk more than 5 months ago. It was indicated that the hallucinations and self-talk were partially improved after having used antipsychotic drugs. After examination, it was considered that the treatment was inadequate, so the patient’s discomfort disappeared and the schizophrenia was effectively relieved after 4 weeks of treatment by increasing the drug dose and combining with other antipsychotic drugs.
[Basic information] Female, 16 years old
Type of disease】Schizophrenia
Hospital】Hefei Psychiatric Hospital
Date of Consultation】April 2022
Treatment plan】Medication (aripiprazole tablets + haloperidol tablets + benzhexol hydrochloride tablets + propranolol hydrochloride tablets) + psychological counseling
[Treatment period] 4 weeks of home treatment, 1 month of outpatient follow-up
Effectiveness of treatment】Symptoms related to schizophrenia disappeared
I. Initial consultation
The family indicated that the patient suddenly babbled for no reason more than 5 months ago, spoke in a way that others could not understand, talked to himself, laughed out loud when he talked about something funny, was afraid and scared, thought that many people were harming him, and obviously affected his studies. fidgeting and dizziness, able to eat, and weight gain. Psychiatric examination results: the presence of delusions of victimization, hallucinations, fear of emotional activity, no abnormalities were found in the routine examination, psychological testing revealed psychotic symptoms, and the diagnosis of schizophrenia was clear.
II. Treatment history
The patient’s parents were informed that the patient had obvious symptoms of delusions and hallucinations, which seriously affected the patient’s mood and behavior, appeared to talk to himself, laugh at himself, had fear, and affected his learning ability. Initially, treatment at a non-specialized hospital had some effects, and symptoms reached partial improvement. Olanzapine and aripiprazole tablets are often used in psychiatry and are very effective in relieving psychotic symptoms. However, the course of treatment was inadequate and the dosage of the drugs was low, so it resulted in only partial improvement of symptoms. In addition, the treatment process also led to the side effects of fidgeting, and the patient was instructed to stop using olanzapine tablets, increase the therapeutic dose of aripiprazole tablets, combine haloperidol tablets, and add benzhexol hydrochloride tablets and propranolol hydrochloride tablets to counteract the side effects of the treatment, and give psychological relief.
III. Treatment effect
At the outpatient review at 4 weeks of medication, the family indicated that after 2 weeks of treatment by adjusting the treatment regimen, the patient’s fidgeting, dizziness and other discomfort improved significantly, and the psychotic symptoms that appeared in the patient completely disappeared as of the review date, and the patient was instructed to come back to the outpatient review after 1 month. Propranolol hydrochloride tablets and benzhexol hydrochloride tablets can alleviate the extrapyramidal side effects caused by antipsychotic drugs, such as fidgeting and increased muscle tone. Haloperidol tablets were added to the treatment to strengthen the therapeutic effect of antipsychotic drugs, and these symptoms of delusions of victimization and hallucinations disappeared.
IV. Notes
We are glad that after 4 weeks of treatment, the patient’s symptoms of schizophrenia disappeared, and there were no delusions of victimization, no hallucinations or hallucinations, indicating that the clinical treatment effect was relatively good, and there were no obvious side effects, including fidgeting, changes in muscle tone, and uncoordinated movements. The patient’s compliance with treatment was enhanced. During the course of treatment, patients were advised to take medication according to the dosage and to arrange their work and rest time reasonably, and to visit the hospital regularly during the treatment process, including liver and kidney function and electrocardiogram, to closely monitor whether the medication causes damage to the organs.
V. Personal insight
1. Delusions of victimization are common symptoms of schizophrenia, and there are other abnormalities in mental activity at the onset of schizophrenia. Hallucinations can occur in perception, most commonly hallucinatory symptoms, changes in thinking, including abnormalities in thought structure and thought content, and there can be gibberish and various delusions, such as delusions of victimization, delusions of jealousy, and delusions of relationship. Dominated by these psychotic symptoms, corresponding emotional changes may occur, and corresponding behavioral symptoms, leading to a decrease in the patient’s cognitive ability.
2. these symptoms should be seen in a specialist hospital as soon as possible and receive treatment as soon as possible, and the need to trust science.
3. Closely observe the side effects of medications and changes in psychiatric symptoms during the treatment process, and adjust the treatment plan in a timely manner in order to completely control the symptoms and restore the patient’s ability to learn, live, and engage in social activities.