Brief Answer:
probably depression with psychotic symptoms.

Detailed Answer:
Hello
Welcome to HCM.
I have read your query and understand your concerns.
Kindly allow me to give you some details so that we can reach to a proper conclusion.

Hearing words or sentences which have never happened or which others cannot hear are auditory hallucinations.
These are a psychotic symptom. These symptoms can commonly occur in schizophrenia, bipolar disorder and also co-morbidly with depression.

The proper diagnosis depends on the other symptoms as well.
If you can revert back with more details, I can help you to reach to a appropriate diagnosis.
1. How has the mood, energy levels, sleep and appetite of your wife been in last 1-2 months?
2. Since when she is hearing such voices?
3. Is there a history of some mental illness in her family? I mean parents, siblings?
4. Any kind of aggression, suspiciousness, overactivity?

The details will help in deciding proper treatment.

Anyhow, Your wife has been prescribed psychotropic drugs namely Oleanz, Nexito and Zolfresh.

Oleanz contains olanzapine which is an antipsychotic. It has common side effects of sedation, weight gain, hypotension, constipation.

Nexito contains escitalopram which is antidepressant. The common side effects are insomnia, diarrhea, vomiting, gastritis, dizziness.

Zolfresh contains zolpidem which is a sedative drug. It is used to treat insomnia. The side effects are drowsiness, decreased concentration and memory.

These psychotropics are usually prescribed for long durations, usually 6-9 months. However, the duration may vary from person to person depending on illness severity.

This prescription of your local psychiatrist suggest that his diagnosis for your wife should be 'Depression with Psychotic Symptoms'.

Hope you find these details helpful.

Kindly revert back with replies to above questions. Or you can discuss the above issues with your psychiatrist.

Thanks.

Dr. Shubham Mehta, MD(Psychiatry).

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Brief Answer:
prodromal psychosis; only oleanz needed.

Detailed Answer:
Thanks for the follow-up details.

Keeping these details in mind, I think she is most probably in the prodromal phase of psychosis. The reason for this is that she is having voices talking against her (that is persecutory auditory hallucinations).

In my opinion, only oleanz 2.5-5mg would have been sufficient. I say so because oleanz has multiple actions like controlling psychosis, mood regulation, improving sleep and reducing anxiety.
The dose can be regulated depending on the response.

In addition, zolfresh 5mg on SOS basis for sleep problem would have been sufficient.

I donot think there is any need of such high dose of nexito or any need of nexito at all.

I follow the principle of treating my patients on minimum possible drugs. Most of the standard treatment guidelines recommend this.

You should discuss this with your psychiatrist.

Hope this helps.

Feel free to ask further.
Kindly close the discussion if you have no more queries and give your valuable feedback.

You can also ask a direct query at your convenience.

Thanks.
Dr. Shubham Mehta, MD (Psychiatry).

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