Brief Answer:
My reply is below.
Detailed Answer:
Hi,
Thank you for posting your query.
Both mania and physical symptoms are related to brain dysfunction. I presume that MRI brain has been done, and it was normal. In this case, the symptoms are because of change in brain chemicals, the
neurotransmitters. Mainly, the levels of serotonin,
acetylcholine and dopamine are altered to give rise to these symptoms.
It is unfortunate that the symptoms have not improved despite using different medications,
For tics, antipsychotics such as
haloperidol and olanzapine are also useful. So, next time, when symptoms appear, these medications may be tried.
Also, divalproex or
oxcarbazepine or
lamotrigine may be used to prevent the recurrence of these symptoms in future.
I hope it helps. Please get back if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad, India