Dr. Beck's Blog

Paranoia and Hearing Voices
6th October 2008

Today I saw Susie (not her real name) aged 42 for the fourth time and was able to properly able to come to grips with her problems. In previous consultations she had been intoxicated or not willing to discuss the real nature of her problems, and her treatment was confined to ineffective benzodiazepines which she requested. Today we were able to do the Mini Discomforts/Dysfunctions Checklist (DDC) with her. She had a total score of 721, indicating serious discomforts and dysfunctions. Her biggest problem was paranoia and hearing voices for which she had never been properly treated, and which cause her to drink heavily or use heroin in attempts to get relief from her paranoia and anxiety. She also had fairly significant depression, anxiety, sleep disorder and ADD.

I gave her small amounts of Seroquel and Solian to try for the paranoia and voices. She had previously had high doses of Seroquel and Largactil but these had caused muscle spasm and restless legs. We will keep trying different antipsychotics in low doses until we get relief for her symptoms without side effects.

I also prescribed Lexapro, which is very effective both for anxiety and depression.

I am very hopeful that we will get her total score down below 250 for the first time since she was 11 years old, when her troubles began. She has never been previously properly assessed or accurately treated. She will also be attending our counsellor on a weekly basis. Everyday we see people you have never been properly assessed or properly treated and our DDC helps us rapidly do both.


Case History: Alcohol and NaltrexoLite
30th August 2008

H.B was a middle aged very intelligent, conscientious mother and grandmother whose life was being progressively ruined by alcohol. Whatever she tried she was unable to stop drinking a bottle of wine each evening, resulting in embarrassing social incidents and mishaps. The problem had been going on for 25 years and was getting worse.
   
Her biggest underlying predisposing problem was Depressive Sleep Disorder, but she also had Generalized Anxiety, Social Phobia, Inattentive and Overfocused ADD, and Low Self Confidence/Self Esteem. There had been multiple bereavements and family divorces in the previous few years. There was a family history of a daughter who was alcoholic, an autistic granddaughter and another granddaughter with ADD.
   
I put her on NaltrexoLite Plus Daytime capsules, one twice a day and doxepin 25mgm at bed time. When last spoken to 3 months later she had not had a single drink of alcohol since the first NaltrexoLite capsule. She was very happy and was planning an extended holiday overseas which had previously been impossible because of her weakness for alcohol.