Should i seek independent advice for medication aside from youth mental health service

Ive been on ~200-225mg of quetiapine a day since Nov. (150mg extended release plus 2x25 mg immediate release during the day)

I still have periods where i behave irrationally and inappropriately to the situation, experience delusions (like believing I’m a political revolutionary), and experience hallucinations (like smelling intense cigarette smoke indoors, bug on my face, rain on my arm, etc.) and other things like speaking in only phrases at a time with incorrect grammar (i dont notice right in the moment but i notice afterwards)

I kept asking the youth mental health service who i’m with, several times since Nov if i can have increased dose, e.g. like 200mg at night plus extra PRN during day. Idk but they keep refusing, saying that they want to be able to observe

Is this because it’s only been 3 months since ive been in their service and they want to wait until 6 months in case of sz? I don’t know but it’s just frustrating because sometimes the 200mg a day is not enough. Should i ask my gp to refer me to separate psychiatrist or is this normal for them to wait for full 6 months before increasing dose? Or is it normal to still experience these symptoms even on higher dose?

My gp also thinks maybe because i have too much insight, that it’s masking some things. I did do a WAIS test a few years back as part of autism/psychological assessment report where it said my full scale IQ was 133 which is ““very superior”” (i don’t like this term) and performance above 99% of age-related peers. I saw a study on high IQ people with SZ where it says they tend to have more insight. I worry that because i might seem to have more insight, they think that the current dose is working. I don’t know. They have this report, but I’m not sure if they look at it closely.

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It can take years to find the best possible med combination. You have to trust the process and keep communicating whatever you’re experiencing.

I have a prn that I take when I feel I can’t cope. I find it useful, so you could keep asking for that.

But be prepared for the process to be lengthy. Life is a marathon not a sprint.

When I was depressed I had to complain for example for a year before my pdoc put me on an antidepressant.

I also have insight and it can be useful. Use it for your advantage in your journey.

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Yes, try to articulate and emphasize the symptoms you experience. They will know more from the symptoms you reveal, than from observing you.

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Wow. I could have written this. Same struggles. Condolences.

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Sounds like they just want to take things slow. I’m pretty sure you need 6 months of dysfunction but you only need to experience positive symptoms during 1 out of all 6.

When I got put on quetiapine they started me at 50mg XR and bumped my dose by 50mg weekly until 250mg. Then to 300mg maybe a month after that. I think the latter increase only took longer because they plain out forgot lol

Not sure why exactly wait, but you could complain and ask them directly. Are the side effects bad to the point they might wait?

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I do think high it affects diagnosis and treatment but not forever. I too have a high IQ and am educated.

My therapist says she thinks the only thing wrong with me is my self esteem. She said she has to look up words I use and that I could do any job I wanted

Meanwhile, I can’t go to work because Navy SEALs are monitoring and recording me. They think I’m an agent for another country. When I go places they follow me or send others to follow me. They watch everything i do.

When I have worked they came into my work and created problems for me.

I also struggle with learning new things and I have a terrible memory unlike when I was younger. My meds make me sleep 12+ hours a day.

So yeah, having a high iq affects diagnosis and treatment

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6 months is normal and before then you will have schizophreniform as informal diagnosis.

Since each episode of psychosis makes it worse it make sense to dosage enough to try and cut out all positive symptoms in the inital stage.

It is the case that services help people who don’t want help and that when you do want help that shows that you recognise you are unwell and therefore to a degree this demonstrates wellness. It is often the case that they will force support upon you. This is a problem with how service delivery targets users as well as the intake process and biases. The people who want help and know their needs are the one who will benefit the most from support.

It is common place for services not to react in a timely manner to patients request and there to be a power imbalance in these dynamics. You should alway feel free and able to get a second opinion. It is the case that there are many paths to the same result and that sometimes all you need is a solution. Different doctors will prescribe different medications and give different diganoses since the DSM is based around clinical interview as the gold standard of practice. This means it is open to the interpretation and opinion of the treating Psychiatrist and while however well trained purely qualitative in process.

Psychiatrists often don’t like seeing a patient who has two treating doctors for the reason that they are colleagues, in most cases have differing opinions, which put them in a precarious position if you see both and play one opinion against the other. Also legally.

By the same token that services don’t help people who are well enough to realise they need help. If your orgainse your own supports then this demonstrate to services that you have self efficacy and that you no longer need their support and they will discharge you. Unless your under legal order to work with that particular service.

If you don’t feel that are working for you, taking your needs into account and working collaborative with them I would encourage you to seek a second opinion. I would encourage anyone to do this if they are feeling embattled, slow walked or like their current service provider does not have their best interests at heart. As I would encourage anyone to work at building rapport and towards forstering a collaborative relationship with their treating team like they would a job. Nothing is more important then your health.

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