Psychiatrymiddle twist
A 27-year-old man with schizophrenia remains persistently deluded and hears voices for most of each day. He has completed eight weeks of risperidone 6 mg daily and then ten weeks of olanzapine 20 mg daily; his community nurse supervised every dose. He does not use alcohol, cannabis or amphetamines, and a urine drug screen is negative. He has no extrapyramidal signs and has gained 6 kg. He remains distressed by the voices, is not working, and his family are asking what happens now. Which one of the following changes to his antipsychotic treatment is now indicated?