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My daughter is schizophrenic. None of the new medicines help her, so she is on Haldol. Why is this? Also, why can she not make the simplest decision?

Houston, Texas

Answered by John Hsiao, M.D.:
The new, "atypical" antipsychotics have generated a great deal of excitement because they appear to be as effective as the older drugs (e.g., Haldol®) but with fewer side effects (particularly movement disorders). However, there could be any number of reasons why your daughter isn't taking one of the new drugs, and only her psychiatrist can answer this question for you. Whatever the reason, your daughter's situation is not unique. The older drugs still command some 30-40% of the antipsychotic marketplace.

As to your daughter's difficulty with decisions: ambivalence and apathy are all too common in people with schizophrenia, and are examples of "negative", or deficit symptoms. Because many patients do not have a full response to even the best available medications, it is important to continue the search for more effective treatments, particularly for negative symptoms and cognitive impairment.

John Hsiao, M.D.

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