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Clinical Overview (Sep 2024 – 18 Jul 2025)

Diagnoses
Autism spectrum, ADD/ADHD, previous schizophrenia diagnosis under re‑evaluation. The neurocognitive profile points to attention/executive difficulties rather than an ongoing psychosis.

Medications

  • Aripiprazole depot 300 mg every 4 weeks (controlled taper under way)

  • Methylphenidate 27 mg/day (dispensed only after clean urine screens)

  • Venlafaxine 37.5 mg/day

  • PRN: quetiapine, zolpidem, alimemazine, propranolol
    Good adherence to oral medication; patient has refused further depot injections since late June.

Treatment adherence

  • Last depot accepted on 24 Jun 2025 (aripiprazole 300 mg)

  • Patient initiated a self‑designed 10–12‑week taper plan and informed the team; remains active, structured, and transparent in medication planning.

Urine toxicology (24 months)
≈ 20 samples; ~80 % negative. Isolated findings:

  • THC (Nov 2024)

  • Anabolic steroids (Mar–May 2025)

  • Benzodiazepines during inpatient stay (31 May 2025)

  • Two borderline results in Jul 2025
    Overall, 99 % drug‑free in the past year; no amphetamine, cocaine, or opioid use documented.

Mental status in outpatient care
Repeated assessments (e.g., 28 Apr 2025, 24 Jun 2025) describe “neutral baseline mood, good rapport, no psychotic or suicidal signs.” Affect and reality testing remain stable.

Functioning level
EQ‑5D index 0.85, VAS 85/100 — above the age‑group average, indicating objectively good health‑related quality of life.

Critical events
Only admission: 22 May – 2 Jun 2025 for anxiety and suicidal thoughts after abrupt steroid cessation; stabilised, no psychosis at discharge. No readmissions since.

Upcoming move to Spain
Planned 8 Aug 2025 – 7 Aug 2026. Outpatient physician emphasises need for local psychiatric contact in Spain and a dose plan before departure. Care team informed; patient requests a summary and prescriptions to take along.

Overall Assessment Before Spain

  • Stability: Six weeks with no acute symptoms or admissions; outpatient notes consistently show good clinical status and high insight.

  • Substance risk: Objectively low; positive samples were isolated and linked to inpatient care or an older THC episode.

  • Safety: No violence or suicide history in the past year; mother serves as primary support person.

Pharmacological focus, Q3 2025
Continue controlled aripiprazole taper under medical supervision and resume individual methylphenidate optimisation (higher doses possible once urine screens are clean) to improve concentration and zest for life.

Recommended pre‑departure plan

  • Issue a 12‑month Schengen medication certificate and provide contact details for the current care unit.

  • Secure first appointment with a Spanish psychiatrist within 2 weeks of arrival (translated summary attached).

  • Agree on a crisis plan (contact list plus suicide/relapse warning signs).

  • Maintain regular urine toxicology every 4–6 weeks in Spain.

Brief for Spanish Colleague (“Elevator Pitch”)

35‑year‑old Swedish man with autism & ADHD; previous schizophrenia diagnosis under review. Brief anabolic‑steroid use in spring, now in sustained remission with only sporadic benzodiazepine findings during inpatient stay. Takes venlafaxine daily, tapering aripiprazole depot 300 mg → oral 10 mg, and tolerates methylphenidate 27 mg (wishes to increase to 54–72 mg). No current psychotic or suicidal symptoms; EQ‑5D indicates good quality of life. Goals: maintain symptom control, boost cognitive energy, and pursue work/study in Spain. Regular tox screens and close follow‑up are recommended.

Feel free to contact me for detailed lab values or a complete medication list—everything is compiled and ready.