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Drug induced psychosis

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Hello Dr,

I had an episode of drug induced psychosis in March of this year, was put on resperidone in June and fully came out of psychosis in August. I'm completely back to reality and no longer entertain any of the bizarre ideas I held.

After my initial psychosis, I became depressed. I was put on citalopram in July, and I came out of depression in November of this year. I don't know if I am completely out of depression because I will feel some of a lack of motivation, but it's really not as bad as it was and I feel largely normal. I have had one relapse of auditory hallucinations when I took a legal high, but the symptoms subsided after a week.

I'm currently stable, but I've had problems with these medications for some time now. For months I've been unable to think straight. My concentration is bad. My short term memory is affected. I can't think fluidly when writing essays. I'm in my final year of my undergrad in political science and I am unable to think properly, can't contribute in class, and can't do my work properly. I spoke to my psychiatrist and we decided it was time to take me off 3mg resperidone and put me on 10mg abilify instead. I think my mind will become clearer as the resperidone leaves my system, but I just wanted your opinion. Will my mind return to its former clarity? Can I get my concentration back? Is there anything I can do to make me mentally sharp again? I am desperate to get my brain back!

Thanks for reading this rather long email, I hope you are well.

Regards, Rav

Category: Psychiatrist

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Dr. Srikanth Reddy
Category: Sexologist
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Expert:  Dr. Srikanth Reddy
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Hello,
Thanks for using DoctorSpring for posting your query. I have gone through your question in detail and I can understand what you are going through.

Depression causes nerochemistry imbalance and changes in the brain leading to reduced attention and concentration. The deficit in the cognition that you are having suggest that the brain changes have not yet reverted.

Your psychiatrists opinion that change of risperidon to abilify may improve the cognitive functions doesn't suit me. The cognition will improve with the remission of symptoms. Meanwhile if you need to improve attention then methylphenidate will help in improving the symptoms.

Do regular aerobic exercise and eat healthy. Have adequate sleep and keep away from alcohol.

Hope that helps, please feel free to get back with more queries.
Regards
Dr. Srikanth Reddy MD


Patient replied :

Thank you for the response Dr. I have done some research on the use of buproprion for normalising cognitive deficits, I was wondering whether you would recommend this for improving my brain function? It seems as though the citalopram I take has healed my mood, but it does nothing for the cognitive deficits.


Expert:  Dr. Srikanth Reddy
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Hello
Thanks for the add on information.
Citaloram also helps in cognition by curing depression. But yes, you are right that bupropion has some extra edge over other antidepressants when comparing their effect on cognition. Its effect on the nor adrenaline helps in improving cognition.

You may certainly consider shifting yourself on bupropion or you may augment your current therapy with bupropion.

Hope that helps, please feel free to discuss further.

Regards.
Dr. Srikanth Reddy


Patient replied :

Thank you doctor. I spoke to a psychiatrist today and as I am in the UK, the use of buproprion is not commonplace so I am unable to augment my treatment in this way. However, one option open to me may be the augmentation of citalopram with modafinil. Would this option be a good one to take? Thank you.


Expert:  Dr. Srikanth Reddy
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Hello
Yes , this would be a good option. Its a new drug and effective stimulant and cogntive enhancer.
Regards.
Dr. Srikanth Reddy

Dr. Srikanth Reddy
Category: Sexologist
Experience: 
Doctor of Medicine (MD), Psychiatry Residency Program,2001 – 2012
M.B.B.S,Mahatma Gandhi Institute Of Medical Sciences, Sevagram

Certificate Course in sex Therapy and Counselling, Sexology and Counselling, A
Sexology,Medikon Sexual Sciences, Mumbai

Training in Advanced Neurology at a leading corporate hospital (CARE hospital) in Hyderabad

Child Psychiatry Training in National Institute of Mental Health and Neuro-Sciences, Bangalore

Sex Therapy and Counsellingat MEDIKON Sexual Sciences, Mumbai.
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