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Shout and mutter during sleeping time. Taking olimelt. Don't get proper sleep

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Practicing since : 2009
Answered : 66 Questions
XXXXXXX XXXXXXX F Age 86 Weight about 45 kg height 4’10”

1 Shouts and Mutters during the NIGHT and also DAY when dozing or sleeping

2. Fear Psychosis

3.Does not get proper sleep at night

4 Keeps repeating same thing / subject over and over again

5. Very Very possessive about her possessions or family member

6 Has BP but has not taken any tab for last 15 days (will resume asap)

Giving OLIMELT 2.5 (1 at night) prescribed by Psychiatrist for last 10 days no noticeable effect

Your suggestions pl?

Posted Wed, 6 Nov 2013 in Mental Health
Answered by Dr. Sourav Das 56 minutes later
Brief Answer:
Psychosis to be confirmed, Olimelt may be hiked

Detailed Answer:
Dear XXXX,

Thank you for your query. From your history it appears that the patient is having an episode of Psychosis. It however, is not clear for how long is she suffering from these symptoms. Also, if there is preceding history of forgetfulness, difficulty in remembering etc., then it may also be possible that there is underlying dementia with psychosis superimposed on it. If it is of sudden onset, there may be some underlying vascular abnormality like stroke etc.

If a patient would have come to me with your complaint, I would have advised her for a brain imaging (like MRI ), besides doing a detailed workup to confirm the diagnosis. IF psychosis would have been confirmed, I would have escalated the dose of Olanzapine (Olimelt) to 5mg per day, besides adding a benzodiazepine (like lorazepam, clonazepam etc.) for anxiolysis and sedation. It is of note, however, that Olanzapine (and other antipsychotics) when given in adequate doses, require atleast 2 weeks to show its effect.

I would suggest you to consult a Psychiatrist urgently for proper evaluation and management of the condition.

hope I've been able to satisfy your query. If there are no further queries, please close the discussion and rate the same.

Best wishes,
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