There is no easy solution to this problem. Unfortunately, your brother, who is not thinking clearly, has decided the manner in which he wants to treat his illness and it is making his situation worse. Most likely because of his decision to take Ritalin, he is decompensating. Decompensation is a clinical term that essentially means that an individual is psychologically deteriorating. In addition, he is not receptive to anyone’s input. He was not willing to listen to his doctor or his family.
The signs and symptoms you have described are worrisome. He is having delusions. He believes that demons are attempting to harm the horses. Other troublesome symptoms include difficulty communicating, despondency and irritability. You have also described instances of what seem like staring spells or immobility. I’m not certain if this is related to the Ritalin or if it is indicative of catatonia. Individuals displaying catatonic behavior may remain motionless in an odd or rigid position sometimes for hours.
You asked about how you can convince your brother to stop taking the Ritalin and how to get a new doctor in an attempt to stabilize him. I’m not certain if that is possible. Since the episode seems to have already begun it may be difficult to stop it without emergency intervention from mental health professionals.
Given the situation, below are my recommendations for you.
Call his prescribing physician. HIPPA (privacy) laws may prevent his doctor from giving you specific information about his case but there is no law preventing you from calling and detailing your concerns. His prescribing physician needs to be aware of his current symptoms and your concerns. Also, his doctor may be unaware of his psychiatric history. You can and should provide that information.
My second recommendation is that you and your mother be vigilant. At this point it seems as though your brother is actively psychotic. He may still be in the early phase of a psychotic episode but I cannot tell with certainty because the nature of psychotic episodes can vary from individual to individual. Why should you be vigilant? Because individuals who are experiencing psychosis and paranoia may be at risk for harming themselves or others. For instance, if your brother believed that demons were attempting to harm him or the horses then he may do something to protect himself against the perceived threat that may endanger himself or the horses.
It’s also important to monitor whether he is caring for himself appropriately. Is he eating or drinking fluids? Is he bathing? If you see a change in this type of behavior then it may mean that he should be admitted to a hospital. In some states, individuals who are not able to care for themselves (eating, bathing, etc.) would be eligible for inpatient hospitalization.
Another complication in this matter is that it is unclear what has caused this psychotic episode. It may have been the Ritalin in combination with another drug. Maybe there was a negative drug interaction. Perhaps he takes the Ritalin on an irregular basis, not as prescribed (i.e. takes too much at once or doesn’t take it when supposed to). It may also be that he suddenly stopped taking the Ritalin and that has caused his symptoms. In some cases, an abrupt discontinuation of medication can cause a relapse. Those are some possible triggers for a relapse. There may be many others but at this point it’s too difficult to tell what exactly is causing your brother symptoms. All that you may be able to discern with any certainty at this time is that his behavior seems to indicate that a psychotic episode has begun and emergency intervention in the near future is likely going to be necessary.
As indicated above, vigilance is important at this time. If the decompensation continues then please strongly consider taking him to an emergency room or calling a local mental health crisis team. Be certain to call his prescribing physician and ask for his or her advice.
I wish that I could give you an easier answer about how to deal with this difficult situation. The fact is that dealing with schizophrenia and other related psychotic disorders can be very difficult, especially for the family. If you have any further questions, please do not hesitate to ask. Thank you for your question. I wish you and your family the best of luck.