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PARNOID, SCHIZOPHRENIA symptoms with DEPRESSION on MIRTAZAPINE, CITALOPRAM.

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Natasha currently takes Citalopram 40mg tablets 1 a day.  Mirtazapine 15mg tablets 1 a night, Propranolol 40mg tablets 1 up to 3 times a day, depending how bad her panic attacks are.

Could this be Paranoid/Schizophrenia or is it just part of her major depressive disorder, or is both?
My partner was Sexually abused/Raped from age 11 to nearly 16 years old, she never got any justice for what she went through, because she was not yet turned 16 at the time & the decision went by her mother, who did not want to press charges, he admitted touching only & escaped with just a caution.
Natasha is on medication for Major Depressive Disorder & Severe Anxieties.
Natasha keeps going on about seeing things, like faces appearing of her Stepdad, who Sexually Abused, Raped her as a Child for years & Natasha also sees faces of people she has never seen before, reporting to see a Devil like creature/human sitting under a table, seeing two red eyes in the house, floating hands that try to touch her, a rocking horse floating upwards, such bizarre things! Natasha always feels like something is following her or watching her, or something is hiding behind doors, peaking at her, Natasha cannot stand the dark at all, it's a nightmare & has been for years.
Natasha can't stand it all happening to her, she also keeps mentioning recently about hearing voices, telling her "You are to blame", "help me", the sound of Crying children, hearing her own name being called, a message saying "You're not listening to me" Other voices she can't understand what is being said to her etc. Natasha also mentions constantly, that the Police, who let her down, for not giving her any justice, for what she has been through & because of previous experiences with Doctors, she feels they are against her too, She feels nearly everyone is against her & are not here to help her & just ruin her life, so she has lost trust in everyone, apart from myself.
Natasha also gets very upset, when she hears stories about children being abused or hurt in any kind of way, or bad mothers or fathers, it really affects her, she gets very tearful, because she is affected from what she has been through.
Also our Curtains & Blinds have to all be shut Day & Night, as Natasha feels people are spying on her, she will never answer the door to anyone, I answer the door only, when i know we are expecting someone, i also had to remove the Door Bell, as it made her jump, it made her have severe panic attacks, because she always feels that Paedophile, will get her or her family will get her. The recent smashed kitchen Window has made her feel a lot worse now, we even have to have CCTV Cameras now & Warning stickers around our home, to make her feel a little safe!

Category: Psychiatrist

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Hello
Thanks for your query at DoctorSpring.com
I have gone through your question in detail and I can understand what you are going through.
The medications she is is on doesn't have any anti-psychotics and probably the doctor treated her doesn't feel it is schizophrenia. In fact after going through all the symptoms that you have mentioned, it doesn't appear to be psychosis. Instead, it appears to be a neurotic disorder like depression or post-traumatic stress disorder. There are different types of medicines effective for her and if citalopram and mirtazapine is not helping her, then other medicines like venlafaxine or desvenlafaxine or sertraline may also help her. Also using cognitive behavioural therapy can also help her. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help her with her illness.
Hope this helps,
In case, if you have any further query, do let me know.
Kind regards
Dr. Srikanth Reddy


Patient replied :

Hello, Thanks for reply back, Natasha's GP was not aware all of all the symptoms i have described, The GP was mainly only aware of Natasha's low moods & anxiety & a recent attempt of suicide, so do you think if Natasha disclosed the other symptoms she has been experiencing, of seeing things & also hearing voices in her head, do you think her GP would say this is part of her depression or could it be that she has schizophrenia aswell, Natasha has tried therapy & unfortunately it did not work for her.
Please reply back, as i thought i would hear back within 24 hours.


Hello
Seeing things and hearing voices are common in sever depression and PTSD as well. Its not that all people who hear and see things are schizophrenic. She can inform all the details to her GP who may inquire further details about the nature of hallucinations she is having. Based on that face to face interview, a decision will be made. Antipsychotics like quetiapine can always be added to her regime.
Regards


Patient replied :

My partner Natasha suffers with Major depression disorder that has been on going for 15+ years, she also experiences severe panic attacks, social phobias & flash backs, blackouts, hallucinations & hearing voices in her head, which are from her past, where she was sexually abused by her stepdad & neglected by mother, from the age of 11 up to nearly 16 years old. She also suffers with Agoraphobia, she has never left the house alone with me in over 15 years, she has no social life at all, all her family turned there back on Natasha, when the police found out in 1999, Natasha was refused justice, because she wasn't turned 16 at the time of the police interview, they listened to Natasha mother back then, who did not want to press charges, so the abuser walks the streets today, which is why Natasha has so much fear & due to the fact, we recently had our kitchen window smashed in, which we know was something to do with Natasha's family & the abuser, as he had made death threats years ago, but we moved house & eventually they managed to track Natasha down again. Natasha also has bladder problems with incontinence, as well as bowel problems with incontinence. Are you able to give me a medical report, as Natasha doesn't like to leave her house, we need some proof of her illness & how it is affecting her daily life, Natasha is on a lot of medications daily, that cause her to feel very tired, drowsy, poor awareness & because Natasha has terrible sleeping problems, it also causes her to have these symptoms, she experiences strong headaches daily. After giving this information, are you able to write a medical report on how Natasha's conditions would affect her, I can include a snapshot of Natasha prescription list, GP letters from her medical records, about past suicide thoughts & attempts, which also state her medical conditions as well. Please let me know if you can do this, As I am Natasha full time carer. Thank You Glen.


Hello,
Thanks for the add on query.
I understand that Natashas condition is very severe and she definetly requires good psychiatric care. The medical report that you are talking about is a medicolegal document and this has to be furnished after a thorough face to face interview and examination and has to be signed by a doctor who is licensed to practice in your country of residence. Doctor Spring is a worldwide forum and it functions all over the world to provide a second opinion and clarify the health issues. We dont have authority to provide medico legal reports and prescriptions without physically examining the patient.
Kind regards,
Dr. Srikanth Reddy
Consultant Psychiatrist


Dr. Srikanth Reddy
Category: Sexologist
Experience: 
Doctor of Medicine (MD), Psychiatry Residency Program,2001 – 2012
M.B.B.S,Mahatma Gandhi Institute Of Medical Sciences, Sevagram

Certificate Course in sex Therapy and Counselling, Sexology and Counselling, A
Sexology,Medikon Sexual Sciences, Mumbai

Training in Advanced Neurology at a leading corporate hospital (CARE hospital) in Hyderabad

Child Psychiatry Training in National Institute of Mental Health and Neuro-Sciences, Bangalore

Sex Therapy and Counsellingat MEDIKON Sexual Sciences, Mumbai.
Dr. Srikanth Reddy and 4 other Medical Specialists are ready to help you

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