Dr. Saraswat Kumarshri Shriniwas
Psychiatry
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Patient's Query
Hi doctor,
My wife looks highly irritated the whole day. She screams loudly at the top of her voice the whole day, even for a small issue. She keeps criticizing and nagging people. She is 65 years old. She has asthma and in menopause.
Hello,
Welcome to icliniq.com.
The description of excessive irritability, shouting and grumbling is suggestive of mood disorder and most likely a mixed mood episode. There are a few more details required for proper diagnosis and treatment. Is it a first episode? Please give the history of previous episodes, if any. What is the duration of current symptoms? What are the weight and height of the patient? Does she take any medicine for asthma? Is there any family history of mental illness? Did you observe any change or disturbance in her sleep, appetite and paranoid symptoms or odd beliefs?
Patient's Query
Thank you doctor,
She keeps irritating members of the family at home and in front of others continuously. She will bang stuffs in anger. This is her nature, but it is increasing day by day. The problems increased after her retirement and menopause. Her weight is 99 pounds and height is 5'3". She takes Theoasthalin tablet, Deriphyllin injection (rarely) along with homeopathy asthma treatment and Thyronorm tablet for thyroid. She gets less, disturbed and unsatisfied sleep since last 30 to 40 years. Kindly suggest medicine with no side effects. Thank you.
Hello,
Welcome to icliniq.com.
There is no medicine as such without side effects. There are medicines that are less likely to cause side effects and the side effects are expected to be minor. Considering her history of asthma and thyroid issues, I would recommend physical evaluation by a doctor to know the general status, such as blood pressure, pulse rate, etc., and any symptoms and signs of acute asthma. A routine blood check up including complete hemogram, thyroid function tests and blood sugar would be advisable. After confirming that she is physically fit and her thyroid hormone levels after supplementation are normal, you could start her on medicines for her mental illness. I would suggest tablet Trinicalm plus (Trifluoperazine) one tablet at night for two days and then one tablet in the morning and one at night for 10 days. It is a frequently prescribed antipsychotic with good tolerability. Because of her low body weight and other medical issues (thyroid /asthma), it is suggested to start low and go slow when initiating and titrating medicines. Consult her doctor, discuss with him or her and take the medicine with consent.
Investigations to be done
Differential diagnosis
Probable diagnosis
Treatment plan
Patient's Query
Thank you very much doctor.
Hi,
Welcome back to icliniq.com.
You are always welcome. Please feel free to ask any further doubts.
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Psychiatry
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