Hello.
Thanks for using DoctorSpring.com for posting your query.
I have gone through your question in detail and I can understand what you are going through.
Well, it wont be right to make a diagnosis without seeing the patient, but most certainly considering the facts that she is a young lady with continuous symptoms since 1 year, with disorganized speech and behaviour, the most likely diagnosis for her should be Schizophrenia.
However, its unfortunate that inspite of so many medicines available for this illness, she is still not responding well. Considering that she has weight issues, the best antipsychotic for her should be Aripiprazole. Aripiprazole is weight neutral and is a good antipsychotic as well. It may even reduce the weight to some extent.
The other option for resistant psychosis is an electro convulsive therapy (ECT). If used properly, ECT will be very effective and safe. And I would suggest that you should consider ECT for this lady. Do discuss all these issues with her treating psychiatrist.
If you have any further query, do let me know.
Kind regards,
Dr. Srikanth Reddy MD.
Patient replied :
Hi,
Your advice was very helpful , little ray of hope has arised . pls suggest more in this regard.
She is presently consuming Arirpizole arip MT 15 and Asenapine maleate 10 mg sun company i.e chewable.
Ariripizole arip MT 15 started just a week ago and taking one in evening and other Asenapine maleate 10 mg , a month ago , taking once in morning and evening resp.but it seems that that ariripizole not that effective.
We want such a medicine that should shed the deep and negative thoughts of her nd weight should not increase and all other organs should not be effected, as through all medicines , weight is increasing and moreover neck was affected with one medicine and also female problems started.
Also we want to know that whether we shoulg give depression tablets , pysche tablets or else. What exacltly is this?
Her reports
Vitamin D - 4 gm
HB - 10
Liver fatty
Weight 102 kg
Calcium less
Thyroid nil
Sugar 110
If you need any other information regarding the case pls let us know.. or if possible you can see the patient on skype , or some place ..
Hello.
Thanks for the additional information.
A week's course of Aripiprazole is too short to comment on its efficacy. It may take at least 3 weeks to show whether it is effective or not.
Aripiprazole will also reduce weight over time while solving the period problems as well. However, all this will take time so please be a bit patient. And please consider my option of ECT as it will be very effective without any significant side effect.
Antidepressants will not help in such cases.
Doctor spring only has the email consultation facility which we are already communicating with. And as you have suggested to meet personally, I am working in Indore and if it suits you it would be a pleasure to attend to you personally as well. Her reports are mostly alright.
Regards,
Dr. Srikanth Reddy MD.
Patient replied :
Hi,
Please elaborate our few queries as that will be helpful for patient.
We want to ask that whether it is a neuro problem , psycho , depression or else , so that we will take her to the right person for treatment. And the medicine Asenapine maleate 10 mg sun company i.e chewable which she is consuming once in morning and evening resp. should be continued or not and for what purpose this medicine is for ??
And if this is not that effective , so should she take any other medicine with Arirpizole arip MT 15 or should she only increase the dosage of Arirpizole arip MT 15 as presently she is taking Arirpizole arip MT 15 once in morning .
We will soon go for ECT but other than that if any medicine or test is fruitful please let us know . Presently , she has again started screaming out loud the names of some person , some of them she know , some of them she don't know. We wantt her to be alright fully.
Suggest in this regard.
Hello.
The patient is having psychiatric problem and she will require treatment from a psychiatrist. Asenapine is an antipsychotic and may be continued as of now. The dose of aripiprazole will have to be increased gradually.
Do consider ECT ( electro-convulsive therapy ) soon.
Hope this helps,
Regards.