Summary for Spanish psychiatrist
Patient profile
35‑year‑old Swedish man, functioning well in daily life, with good insight and high motivation for treatment.
Diagnoses
Autism spectrum (Asperger’s)
ADHD, combined type
Previous schizophrenia diagnosis now under review
No somatic contraindications; blood pressure and heart rate within normal range.
Medications (July 2025)
Aripiprazole 300 mg depot every 4 weeks — patient is tapering in a controlled manner to oral 10 mg/day
Venlafaxine 37.5 mg/day
Methylphenidate 27 mg/day (administered only when toxicology screens are negative)
As needed: quetiapine 150 mg, zolpidem 10 mg, alimemazine 20–40 mg, propranolol 20 mg
Behaviour and functioning
Consistently described as polite and cooperative, with no violent incidents
No documented psychosis during 2024–2025; cognitively clear with sound reality testing
EQ‑5D indicates quality of life above the age‑group average
Substance use
~80 % of 20 urine tests negative; isolated findings: THC (Nov 2024), anabolic steroids (Mar–May 2025), benzodiazepines during hospital stay (May 2025), and two indeterminate samples in July 2025
No amphetamine, cocaine, or opioid abuse; alcohol not problematic
Critical events
May 2025: voluntary admission for anxiety/suicidal thoughts after abrupt cessation of steroids; stabilised without psychosis
Since June 2025: stable in outpatient care, no recurrence of self‑harm or violence
Assessment before move to Spain (Aug 2025)
Stability: six weeks without acute symptoms; good treatment adherence
Risk level: low risk of violence and psychosis; suicide risk judged low after steroid episode
Treatment goals in Spain
Continue structured tapering of aripiprazole with psychiatric oversight
Maintain methylphenidate therapy (clearly beneficial for ADHD) with regular toxicology checks
Psychotherapy/coaching for executive‑function challenges and life adjustment during the move
Other: The patient is frustrated by slow dose adjustments in Sweden and stresses the need for faster, shared decision‑making on medication optimisation.
Overall clinical impression
A cooperative, largely substance‑free, non‑violent man with no current psychotic symptoms, good self‑insight, and clear goals for maintaining function and quality of life. He requires ongoing combined pharmacological and psychosocial follow‑up but is currently well stabilised for relocation and treatment in Spain.