Nephew has Schizophrenia

Q:  I am a chinese man, I have a nephew(boy) who get the schizophrenia on his 16 years old
(1998), after that he always use the risperidone for more than two years, Should he change to
use Olanzapine ? and what is the difference between Olanzapine and Risperidone ? which is
suitable for the boy who is 18 years old now ?

thank you very much 

Dear Mr. F' -- 
I wish I could help you with this.  You have done well to understand as much as you already do.  If the risperidone is not working well, there are several choices.  Olanzapine is one of them.  Seroquel is another.  There is a brand new one that just came out in America called ziprasidone that people are excited about, but we don't know very much about it yet (two patients I know who did not respond fully to several of these medications did much better on ziprasidone, in a research study; they liked it so much better they would fly 500 miles every 6 months to stay on the medication from the research center. 

But what really matters is why the risperidone is not working well enough.  Sometimes that's because the person has an illness that is more like "bipolar disorder" than "schizophrenia".  It is very difficult to tell the two apart, especially when someone is young.  Bipolar disorder should always be considered.  The medications for that are different than these "antipsychotics" named above, as you probably know.  

Good luck with your education and your attempts to help your nephew. 

Dr. Phelps

Published March, 2001