HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Suggest Treatment For Delusional Thoughts In A Person With Bipolar Disorder

default
Posted on Thu, 19 Mar 2015
Question: I am seeking a second opinion. My 20 yo son was diagnosed with possible bipolar disorder after having some delusional thoughts last August. He has been struggling with medications, side effects and not getting better.
doctor
Answered by Dr. Shubham Mehta (52 minutes later)
Brief Answer:
need some more details.

Detailed Answer:
Hello
Welcome to HCM.
I can understand your concerns for your son.

Kindly give some details so that I can guide you better:
1. Details about his symptoms like duration of his illness, his mood, sleep, energy levels, talks, suspicion and delusions?
2. What medications he is taking at present? Past drug history and response?
3. What side effects he is facing?

The more details you would include in follow-up about his illness, the better I would be able to guide you.

Hope to hear from you soon.

Thanks.
Dr. Shubham Mehta, MD(Psychiatry).
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Shubham Mehta (22 minutes later)
Hello, He has suffered from anxiety and some depression in high school. he had a weight lifting injury when he was 17 and suffered neck pain for the next 3 years. he began smoking pot casually around age 16. he went away to college at age 19 and got mono a few months in and he was very fatigued for months. he passed his fall semester, but dropped out the spring semester because he became depressed about being sick and failing classes. he came home in April and by August, he started having delusional thoughts about ghosts visiting his room at night and getting into his spine and causing him a lot of pain and fear. we went to see a psychiatrist who started him on seroquel xr. he slept 15-20 hours daily so he was switched to immediate release. he still slept for about 12-14 hours a day but he continued to take it bc he did feel better. (he started an ssri during high school and was switched to Effexor at some point. he continues to take Effexor 75 mg). he functioned ok during the 3 months On seroquel but then started having conspiracy theory thoughts and serious fears that overwhelmed him. we saw his doctor and he wanted to increase the seroquel but we opted for a new med bc of fear or increasing sleep. he ended on about 200 mg of seroquel at night. my son started a new med risperidone, which gave him sweats, heart palps and dizziness. he switched to latuda and he had problems with the inner shakiness and weird inner restlessness. he could not sit still or tolerate it. so last night he started on zyprexa 5 mg and now today he is very down and wishes he could kill himself without hurting his family. I told him not to yake it again until we talk to his doctor tomorrow morning. I am very concerned with the harshness of these antipsychotic meds and want him to take a mood stabilizer instead but his psych doc does not think it will be strong enough to help him. Thank you very much.
doctor
Answered by Dr. Shubham Mehta (47 minutes later)
Brief Answer:
continue zyprexa; mood stabilisers not needed.

Detailed Answer:
Thanks for the details.
I have gone through it thoroughly.

First, the description which you have here suggests that your son does not suffer from 'Bipolar Disorder'. None of the symptoms point towards bipolar disorder.

The delusions about ghosts entering his spine and conspiracy theory suggests that it would rather be a psychotic spectrum disorder (probably schizophrenia) or 'Depression with psychotic symptoms'.

Now regarding the drugs:
1. He took SSRIs earlier and then switched to effexor 75. Both the optiobs are fine.

2. Regarding antipsychotics, he has not tolerated seroquel, risperidone, latuda. Now he has been prescribed zyprexa. Zyprexa is a good drug in the sense that it multiple actions. It acts as antipsychotic, mood stabiliser, anti-anxiety, sedative and calming drug. If he tolerates this, this drug would be a good option.
Other good antipsychotic drugs for him could be aripiprazole or amisulpride.

3. Regarding mood stabilisers, these are ggod for bipolar disorder but not effective for psychosis. I dont think they would prove useful for your son. Even these drugs also have side effects of gastritis, weight gain, vomiting, hair loss. So there can be tolerability issues with these drugs too.

And another important thing is to keep him away from any drug of abuse.

Hope this answers your queries satisfactorily.

Feel free to discuss further.

Kindly close the discussion if you have no more queries and give your valuable feedback.

I wish for speedy recovery of your son.

Thanks.
Dr. Shubham Mehta, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Shubham Mehta (16 hours later)
Thank you so much
doctor
Answered by Dr. Shubham Mehta (7 minutes later)
Brief Answer:
happy to help

Detailed Answer:
Happy to help.

Kindly close the discussion if you have no more queries and give your valuable feedback.

I wish good health for your son.

Thanks.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shubham Mehta

Psychiatrist

Practicing since :2008

Answered : 2145 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Suggest Treatment For Delusional Thoughts In A Person With Bipolar Disorder

Brief Answer: need some more details. Detailed Answer: Hello Welcome to HCM. I can understand your concerns for your son. Kindly give some details so that I can guide you better: 1. Details about his symptoms like duration of his illness, his mood, sleep, energy levels, talks, suspicion and delusions? 2. What medications he is taking at present? Past drug history and response? 3. What side effects he is facing? The more details you would include in follow-up about his illness, the better I would be able to guide you. Hope to hear from you soon. Thanks. Dr. Shubham Mehta, MD(Psychiatry).