Hello Dr Raghavendra, I thank you very much for taking out your valuable time and providing your valuable inputs about my mother's issue.

My mother is going thru psychological trauma for almost 15 now. Now, my mother's age would be close to 62. Here is the brief about history of my mother's case :
First time(15 years before from now), we had one neighbour who use to work in Police Department and off-late he use to get his official gun to home while returning from duty and my happen to see that gun in their house once. Suddenly one day my mother had complained my dad “The neighbor had threatened me of shooting you with his gun”. It was a shock to my dad when he heard about it from such good neighbors. Actually, they have been very good neighbours to us and we knew them for almost 5 years by then. In fact, their kids use to come to my for taking tuitions from my sister. In fact the neighbour policeman is a very good friend of my dad. So out of that relationship, my dad could not directly ask his friend about this issue directly. So my dad generally discussed the problem with his spouse about this issue of threat from her husband to my dad. Even she was equally shocked to know that and she was apologizing my dad though her husband didn’t threaten anything of that kind. Even then my mom had continued to complain about it to my dad. That’s when we all started closely observing my mom and got to know she had not been sleeping properly and unnecessarily imagining in her mind about farce. We have even noticed that she had been just whispering some or the other aspects while doing her kitchen work. She even started putting incorrect quantity of salt in the curries. It has reached to a stage where she had gone out of control and stopped noticing what is happening around her. She even use to forget to lock her door when she goes to toilet. Within very few days, she had even got deprived of not recognizing her children(ourselves). I can’t just tell you what we all 3 kids have been going thru our lives. We were not knowing what to do. So my dad knew a medical druggist who had been a very good friend of him. Fortunately, after discussing my mother’s problem with him, my dad got to know even the druggist’s mother had also been going thru the similar kind of problem. The druggist told my dad that these kind of issues arise in women after mensus pause and it is very rare to happen. In fact we got to know that his mother’s situation is more worse than my mom. His mother had been running on roads without control shouting at people in her own imaginations. The druggist tried her mother to so many psychiatrists and doctors but the result was in vain. After lot of trials, he had realized that dose of few tablets(Serenace 0.25, Depsolforte, Cynofer, Espazineplus, Alzolam 0.25, Polybion(multi vitamin tablets) helped in subsiding the intensity of her mother’s issue.
However, the medical druggist had visited my home and confirmed my mother’s case and he had found almost all the symptoms what he had found in his mother. He had suggested similar dosage of medicines for my mom and my mom had recovered in very quick succession of 2 months. We have shifted our stay from that house to some other place which is altogether new and very far away from the previous place of stay. However, the druggist had asked us to continue the medicines for atleast 3 years continuously and accordingly we did that. After that, we stopped giving medicines to my mom. There were no symptoms for 5 years after that. However, after that slowly my mom again started with the earlier symptoms. We have also noticed that she was not sleeping properly in the night just with her unnecessary imaginations. Also she had been watching television channels which he cannot understand also. She is an illiterate lady and speaks and understand only Telugu. But she use to watch English, Hindi and Tamil channels also for hours together. Though she use to sit in front of television her thought and mind use to waver somewhere. So we have again quickly started the dose of the above tablets and she had again recovered from the issue in couple of months. So now we have been these medicines dosage once in a while. Very recently, she had a complaint of gallbladder stones and urinary bladder stones and she had got hospitalized. After recovery, she had complained that it is all bcoz of these medicines she got hospitalized and we have trying to kill her by giving some poisonous medicines which again is an illusion within her. Actually, she had never been hospitalized for any big issues except normal fever and headache. As we know about it and we have again started giving those medicines but she refused to take the medicines thinking that they are poisonous tablets. Somehow, we have managed to convince her and again started to give her the old dosage of tablets and she is again normal now.
What we all are worried is that the long dosage of these psychic medicines should not harm her health in other way while we were trying to control her mental condition. So I am trying to find a solution thru which she can get rid of this issue permanently without any medicines as this is purely a psychological issues (as we have been thinking) post mensus pause.

Thank you for all the patience reading of my mother’s case.

I sincerely request you to suggest/recommend us a good alternate solution to avoid these alopathetic medicines and help my mother to rid of this ailment for which I would be grateful to you.

It would also be great if you can provide your appointment to get in touch with you.

Warm regards
LTRR

Hi LTRR,

Serenace=Haoperidol......an older generation antipsychotic
espazine plus..........another older generation antypsychotic
depsolforte............another old generation antypsychotic chlorpromazine and sedative Diazepam (Benzodiazapine)
Alzolam.........alprazolam.....another benzodiazapine sedative
cynofer.........iron tonic
polybion.........multivitamin tablet



I am sorry to say what your respected druggist is doing is usually called a "shot gun therapy"....give all kinds of medicines (in this case 3 antipsychotics, that too older generation antypsychotics but in very low doses) and iron tonic and multi vitamin tablets............hoping that something amongst so many things will hit the bulls eye.

Let me assure you of something..........your mother problems have NOTHING TO DO WITH MENOPAUSE.

she seems to be having a psychotic illness (going by your description of the symptoms and the response to the antypsychotics.) There are many reasons for psychotic illnesses......physical causes like parkinson's disease, dementia in people of your mother age, pure psychotic illnesses like schizophrenia in people of any age, psychois in mood disorder like depression or bipolar disease etc etc etc

Though useful as they help with any psychosis, the problem with using the older antypsychotics is that they cause many "IRREVERSIBLE" movement problems, memory problems etc if used for long time and hence we normally prescribe newer antypsychotics which do not have these problems but yes , the newer ones are costlier.

The problem with 3 years or such long usage of sedatives like alprazolam and diazepam are that they also cause memory problems, particularly in the elderly people, the body gets used to them fairly quickly (within a month or two) so that she does not get benifit form them and continues to have the side effects from them if used for more than few months and finally get addicted to them...these are really ADDICTIVE drugs....to be used only very carefully and for short time only



my advice for your mother is as follows

1. Please consult a psychiatrist immediately.

I work in UK and hence it would be ethically wrong for me to treat your mother without seeing her and hence I will not treat her. But I can recommend psychiatrists who can take care of her till I come back to India for good-hopefully by June ending of 2011. If you tell me where you live, may be I can help. You say your mother speaks only telugu..so I am guessing you are telugus. Andhrpradeshlone unnattaite ekkada unna meeku psychiatrists refer cheyyagalanu. If you are out of andhrapradesh the only place I can knowingly try and refer some psychiatrists is in Bangalore as that is where my family is currently based.

The only other thing I can do is give a consultation online on this advice but in an advisary capacity (please see the live chat, consult a specialist etc services the forum provides)

2. Please do not treat her without first getting seen by a psychiatrist. There is one kind of dementia where it is almost fatal to treat such patients with antypsychotics (but going by the response your mother has had from the medicines, I would guess ). Also her ECG and some blood tests need to be monitored periodically as well as periodically check for any symptoms of side effects of medicines. ALL OF THESE CAN NOT BE DONE BY THE WELL WISHING DRUGGIST or for that matter on the net.

3. unfortunately, from the recurrent episodes of relapses your mother seems to have, I would think she would need a long time of treatment with "these allopathic medication"

4. I am really sorry but you are asking a wrong person to show an alternative for allopathic treatment as that is my livelihood :-)

jokes apart, the only evidence based treatment for psychosis as far as my knowledge goes is in allopathy. you may try others as well but please do not discontinue the treatment from a psychiatrist.

The irreversable damage to a patient is directly dependant on the duration of untreated psychosis (DUP) research has shown very clearly.


5. finally, these episodes do get worsened or come back again due to stresses in life and these need to be tackled as well......again needs a psychiatrist for this.


6. In UK it is illegal to treat a patient without them knowing that they are being given medicines but in India, I know practitioners do it if the situation worsens to that level, and the family is willing to take care of patient at home rather than hospitalising her etc etc.


I think this should be enough of an advice from an online source :-) and I would not be able to offer any more advice apart from referring psychiatrists, If I can, if you can tell me where the patient lives.

Good luck to your mom and a very happy new year to you and your family.

Hello Dr Raghavendra Garu,

I am thankful to you for your quick and elaborative response and for your valuable advise for my mother's treatment. Memu Kukatpally-Hyderabad lo vuntunnamu. Meeru kanaka mee contact details naaku ichi nattlaithey nenu mee convenient timelo phone chesi meeru India vachina taravaata further treatment gurinchi mimmalni ekkada kalavaloo discuss chestaanandi. My email id is(LTRMED2011@GMAIL.COM).

By the way, thank you very much for your new year wishes. I wish you too and your family a very happy, healthy and prosperous new year ahead.

Hoping to hear from you soon.

Best Regards
LTRR