Back when he was at Eastern State the doctors had him on Invega.
Invega is for the treatment of schizophrenia. It caused him to not produce semen so he was changed over to Abilify.
Abilify is also used to treat schizophrenia. When he was released from the mental hospital in 2018 he was to stay on the Abilify and he was also taking Lithium. I think due to all the past comments here about Lucas and also his mother saying he is schizo he started saying his diagnosis was just Bipolar I.
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Lucas could have schizophrenia, it is entirely within the realm of plausibility. Outside of having invasive access to medical records or actually conducting assessments with him, we’ll never be able to confirm it or rule it out based on the findings of Wernology. Personally I like that, the speculation is fun.
That said, I don’t think Lucas suffers from schizophrenia and I’ll lay out some of my reasons why I think that. Let’s start with your comments about medication.
Paliperidone is often used to treat bi-polar mania for the same reasons aripiprazole is, it is why his providers switched the scripts when he complained of side effects. Atypical antipsychotics have a wide variety of applications, especially with mood and anxiety disorders. Simply being prescribed atypical antipsychotics isn’t much of an indicator that a person is being treated for a delusional disorder like schizophrenia.
Now we know Lucas has got the beetus and it has begun to seriously impact his life, like the chronic non-healing wounds on his feet. Despite this fact, he is still being kept on aripiprazole which only aggravates the insulin resistance. Why is Lucas still being kept on that medication?
My best guess is that a cost/benefit analysis was done and controlling Lucas’ impulsive behavior and obsessive thinking was given priority. Being stuck at Mallon Place with little to no money helps curb poor eating habits and with staff making sure his medical needs are being met, the diabetes has a better chance of being successfully managed than his mental health without the use of atypical antipsychotics.
If Lucas was being given paliperidone and then aripiprazole for schizophrenia, then there are a lot of first generation antipsychotics that can curb delusions and hallucinations that play a lot nicer with diabetes. I think that if Lucas had a diagnosis of schizophrenia in conjunction with type 2 diabetes, he would have promptly been put on an older generation of antipsychotics. I think his providers didn’t do so, because the older antipsychotics don’t really help with mood or anxiety disorders, only the newer atypicals do.
There are other reasons worth mentioning as well. Schizophrenics typically have a much flatter affect than Lucas and his emotional range is more consistent with the ol’ manic depression. The nature of delusional thinking doesn’t fit with schizophrenia either, there is no talk about thought control or external entities forcefully communicating when he doesn’t want to comply, etc. His speech and writing lack things common with schizophrenics, his ability to stay on topic and complete thoughts on an antagonistic interview is something a lot of schizophrenics wouldn’t be capable of doing either.
I think when Lucas was younger, schizophrenia was seriously considered and probably discussed with his mother, but as time went on, the diagnosis was shifted to Bi-polar. When someone is balls deep into mania, they are going to act and sound like schizophrenics suffering from a crisis induced psychosis.