Paranoid schizophrenia with mild EPs/ 42 years male

A person have on medication of paranoid schizophrenia to do work properly in his office but physically as like zombie type posture. Less talk , hypoactive , burden like posture , aloofness face. Walking as like lazy person. Chief Complaints Palpitations, gabharaman History Tablet Trifluphenazine 5 mg Aripriprazole 5 mg Clozapine 50 mg Duloxetine 10 mg Etizolam 5 mg Trihexyphendyl 2 mg All are BD per day Clonazepam 0.5 mg HS. For sleep. Vitals Normal Physical Examination Normal motor reflex..No Diabetes, hypertension Investigations MRI Brain normal THS normal Diagnosis Paranoid schizophrenia with !? EpS. Management What to do next.,?

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Add tab Pacetane 1 bd Rest continue Same treatment

All ready was taken to him... trihexyphendyl 2 mg BD.
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@Dr. Anil Tabiyar Patient is on three different antipsychotics, and all three are in suboptimal doses. Instead reduce it to only one medication in max effective dose. CLOZAPINE should be reserved only for treatment resistance cases. So 100 mg is not effective dose. U can stop it. And Maintain only with Trinicalm plus which is a combination of Trifluperazine and bezhexol, give it BD. Continue Aripiprazole 10 mg OD, u can increase it upto 30 mg gradually. Stop Clozapine, Duloxetine. Trihexyphenidyl u can give 2 mg once becoz trinicalm plus has anticholinergic med in it. Instead of multi drug therapy, one or two drugs in max effective doses work better.

This patient have taken medicine for long time history,,,last his was complains about his behaviour.. thanks for your opinion on base it ur is clearly written by deeply thinking.
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Etizolam 5 mg Sizol .10mg Clonazepam 0.5 mg Vit B12 Special diet(recommended by clinical dietician) Check the patient's glucose level too And these kinds of patients should live in lights they shouldn't even get a bit of darkness As you've mentioned that patient is posture like zombie then the patient must've been having the hallucinations of zombie. Remember that the how the patient is acting and how the patient is looking is exactly the same he is seeing in hallucinations and he's copying the hallucination Mostly all this is the play of our brains glucose level and SSR

Thank you doctor
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Can this be an undifferentiated schizophrenia Amisulpiride is supposedly better for prominent negative syndrome and add escitalopram instead of duloxetine)if it has been tried for more than 6 weeks) And behavioural therapy

Thank you doctor
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