Let’s take a look at how a schizophrenia second opinion changed the life of a psychiatry patient.
A few months back Mr. RGV’s (not the original name) brother approached me through BestDoctor.com for a second opinion. He stated that his brother is undergoing treatment for depression for the past 1 year and lately he is not doing well. He had stated that Mr. RGV was a 37-year-old male, a Civil Engineer by occupation and was running his own firm before the illness struck him. He was a non-diabetic and non-hypertensive male with good physical health and no past major medical history. Initially, 1 year back, Mr. RGV started being sad for the most part of the day and appeared disinterested. He would talk less and spend most of the time in his bedroom watching TV, lost in his own thoughts. Gradually he developed suspiciousness, fearfulness, hearing of voices which others cannot, irritability and aggression. As his wife got concerned, they took him to a local psychiatrist who diagnosed him as a case of schizophrenia. He was started on antipsychotics(olanzapine) and some sleeping pills for the next 2 weeks and was asked to follow-up after 2 weeks. There was some improvement as well and later Mr. RGV was transferred to Bangalore.
The family kept continuing the medicines as they felt that they have been prescribed by a specialist. After a year of continuing the medicines by self, Mr. RGV was doing well and the family posted a query with BestDoctor.com to know about the future course of action. The family was planning to discontinue the medicines all together as he was doing well. The psychiatrist informed the family that anti-psychotics like olanzapine have their own side effects that need to be monitored during regular follow-ups. Unfortunately, the family had missed out on those critical follow-ups. The psychiatrist suggested them to get some blood tests like Fasting Sugar and Lipid profile done. The patient got the investigations done and found out that the values of Lipid profile were within normal range but his fasting glucose was 110mg% which was grossly abnormal. The patient was advised to immediately stop olanzapine and consult a psychiatrist to discuss starting another antipsychotic Aripiprazole – which is safe in patients of raised blood sugars. The patient’s family was explained that raised blood sugar was a known complication with the use of olanzapine and hence psychiatrists mostly insist on regular follow-ups so that the side-effects of the medicines can be monitored. Unfortunately as the patient, in this case, had moved out of the city where his psychiatrist was living and continued taking the medicines on his own, this problem has arisen.
Had it not been the second opinion on BestDoctor, Mr. RGV would have landed with Diabetes Mellitus. Another advantage this patient had with the second medical opinion was, had it not been taken, the patient would have certainly stopped taking the medicines and would have risked getting a relapse which at times is difficult to manage. The psychiatrist insisted that he should continue the management in order to reduce the risk of relapse and also his suggestions to modify the drug would keep the patient safe.
Mr. RGV is not the only person who faces such situations. These days, where most of the people are employed by various companies and firms, they get frequent transfers and this leads to treatment discontinuation. As there are plenty of other priorities, people generally postpone getting attached to a new doctor in the new city and tend to neglect their health requirements. In such situations, in a new city, having a specialist medical opinion at your fingertips is what somebody would want. Mr. RGV was helped from trouble and so are plenty of people like Mr. RGV.
Dr.Srikanth Reddy (MBBS, MD) is a well known Psychiatrist in Indore. He holds special expertise in Neuro-Psychiatry, De-addiction and Sexology along with other psychiatry disorders.
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