Jovan

• Jovan is a 31-year-old man diagnosed with schizophrenia at age 15.

• He received numerous trials of oral antipsychotic medications over the years, with limited success.​

​

Psychiatric History

• Symptom Onset and Progression: Jovan’s symptoms began in adolescence with auditory hallucinations, disorganization, and anxiety. These early symptoms did not significantly affect his functioning.

• Recent Worsening: Within the past year, he developed worsening auditory hallucinations along with paranoid delusions, leading to episodes of aggression and self-harm risks. He also developed apathy, anhedonia, and asociality.

• Functional Impact: These symptoms severely impaired his ability to maintain self-care and social relationships.

• Hospitalizations: Despite numerous trials of oral medications, Jovan was hospitalized 15 times over the past year due to worsening symptoms and relapses.

• Medication Compliance: Occasional non-adherence, driven by hallucinations, often required his parents’ intervention to ensure he took his oral medications.

​​

Social History

• Jovan lives in a group home but maintains a close relationship with his parents, who actively support his treatment.

​​

Comorbidities

• Generalized anxiety disorder

• Major depressive disorder

• Partial deletion of chromosome 9 (mild intellectual disability)

 

Current Medications

• LAI antipsychotic

• Haloperidol 5 mg daily, being progressively weaned as symptoms stabilize  

• Risperidone 2 mg three times daily, being tapered alongside haloperidol to transition to LAI monotherapy

• Sertraline 100 mg daily (anxiety)

• Propranolol 20 mg twice daily (medication-induced tremors)

• Omega-3 fatty acids, 1 capsule 3 times daily (dyslipidemia)