San,
I share your disappointment and your concerns.
The new psych should have transfered her file from the previous psych. This disruption may cost your friend progress. Was there no way that the old psych could continue her prescribing Olanzapine?
Some psychs allow medication visits/phone consultations when the medication therapy is effective. When there is an issue or for regular upkeep, there is a scheduled time to catch up and resolve an issue.
Lowering her dose and eventually removing her from the Olanzapine can cause a setback. It is not often that the first therapy given works so well. On average patients go through several different medications to find a tailored combination or single medication that works for them.
This doctor (assuming) was told by her that she has schizophrenia along with paranoia/delusions? And he still insisted on lowering her dose. I feel this is very irresponsible on his part and someone should express this directly to him. If he says that he cannot discuss her treatment with you, make sure you mention that this woman likely cannot make a clear decision and may require help from family/friends with regards to her treatment.
You ask about her generalised anxiety. Chances are if she did not exhibit avoidance behaviour prior to the medication, then the medication itself may have been the source for encouraging the anxiety.
This is not to say the medication was ineffective, but possibly carried a side effect that would have evaporated eventually.
Agoraphobia is treatable, and more so when caught in its early stages. The avoidance behaviour begins with the place where an attack occurred. The attack being an anxiety or full scale panic attack.
Not long after, when attacks surface while the patient is in other places, the avoidance behaviour continues until the patient is restricted in their home from fear of having an attack outside of the house.
The sooner the treatment, with cognitive therapy, the quicker the behaviour can be corrected.
In her case, her anxiety is compounded by her medication - and psychologically, anyone branded as schizophrenic becomes fearful too. It is that constant worry that leads the patient to wonder if they are making the right decisions. They do not seek the comfort of their family and friends, but rather retreat for fear of embarassment. It becomes a "what if I say this or do this" sort of scenario.
If at all possible, ask her to tell her new psych that she would like her old records faxed/mailed over for review. There are release forms she can sign to get this accomplished.
I appreciate that you posted to me as you have. I do hope you will keep me posted. I will check this board often to look for you.
Best,
Anai Rhoads
