You have been treating, Blake (25 years old) who has been diagnosed with paranoid schizophrenia several years ago, for over a year now. He has experienced three episodes of psychoses in the past three-years and was prescribed 5mg of olanzapine daily after his first episode. His last episode occurred six-months ago, during this time Blake was preoccupied with thoughts that he was being spied on. He lost his job and several of his familial relationships were strained as he feared that they would betray him to the spies.
After this last episode, his dosage was increased from 10 mg to 15 mg of olanzapine daily. Since then, Blake has not experienced any delusions. He has also developed a good understanding of the diagnosis. He has been able to manage his symptoms well and is currently on the 15 mg of olanzapine daily to prevent another relapse. He maintains regular contact with his prescribing psychiatrist, his strained relationships with his family members have started to improve, and he has obtained another job.
Today in session he stated that he wants to stop taking his 15mg of olanzapine because he has been symptom free for over a month. He expressed having extreme concerns and has been feeling a bit down regarding a 20-pound weight gain since the increase of his medication. He expressed concerns that his mother has been diagnosed with a medical condition, Type II Diabetes, and is worried that he will get it as well. He stated that he recently had blood work done and all his results were in normal range.
Please respond to the following:
Given Blakes concern, what would you recommend regarding his olanzapine (keep in mind
your legal and ethical standards?
What are the potential advantages of switching to the alternative antipsychotic drug?
Are there other options for Blake that are not traditional medication? (Can be holistic or non-traditional),