Expert: Ivan Goldberg, M.D. - 9/15/2006

Question
Hello there, how are you going? My name is Christina and I live in Australia. Thank you very much for taking the time to read my question. My Mum has got schitzophrenia, and she has been on tofranil for 35 years, as well as valium. But then one day her doctor decided to take her off tofranil, as he said it can cause heart problems, and he put her on a new medication called seroquel. She was on 6 tofranils a day, and he cut them all out over 1 and a half months. Since she got off all the tofranils, she has been acting very weird, and I was wondering if you might know why. Her personality has changed very much, and she laughs all day from morning till night, and she says she is on top of the world and she wants to do all these magnificant things like become a doctor or a vet, or get up in front of 1000 peple and give them all a lecture, as she feels like she is on top of the world. This is very different for her, because for the last 35 years since I was born she has hardly wanted to do much of anything. Then, the next day, she cries all day and wants to kill herself, and punch her doctor and she shouts at us, and then the next day she id laughing all day from morning till night. But it's not normal laughing- it's like someone who is drunk or high on drugs. It doesn't stop all day. When we go out she goes up to complete stragers in the street or in a cafe or anywhere and just joins them and starts talking and laughing with them and she says silly things to them like she's drunk. My Dad and I are very worried about her. All these changes only happened when the doctor took her off tofranil, and put her on seroquel instead. She still takes valium. She seems to have lost control of her good mind, as she used to be normal. Would you happen to know why my Mum is acting like this, and what we can do to help her. Will I ever get my old Mum back, or will she always be acting weird now? We took her to the doctor, but she yelled at him, because she was trying to teach him about economics, and he wouldn't listen. She hasn't been to school to learn anything like that but, she's been a housewife. So he is making her go to the psychitrist again next week. She sometimes goes to see a psychiatrist, but she's just been weird since her medication change. Thank you so very much for taking the time to answer my question, I do appreciate it very much. Warm Regards, from Christina in Australia

Answer
Hi . . .

It is impossible to make a diagnosis by way of email. When I have seen patients with stories similar to that of your mother it has often turned out that the original diagnosis of schizophrnenia was incorrect and that the person actually had bipolar (manic-depressive) disorder.

I think your mother should have a reevaluation regarding bother her diagnosis and treatment.

Best regards . . .

Ivan
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