
Having A Suspicious Mind, Feeling Irritable And Making Odd Facial Gestures. Required Treatment?

Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.
Important aspects of your query are:
• 44 year old male
• Known case of hypertension and borderline diabetes
• Complaints of: suspiciousness over fidelity of wife, irritability, odd facial gestures and social/occupational dysfunction.
Your brother case history is interesting and but difficult too. As we do not have any information from his side. I will try to give my best effort to help you in this problem based on current description given by you.
It appear that your brother is psychotic illness called delusion of infidelity. In which person is over-suspicious for character of his wife, which is false, firm, unshakable and do not match social/cultural/educational back ground of the person. Due to that social and occupational complication occur, like in your brother case.
In psychosis insight is absent, so person do not accept that they are ill, due to that they do not accept treatment, which make treatment difficult.
Following are cause and treatment for such disorder:
• Side effect of substance use: like alcohol: so stop alcohol (if use is present).
• Psychotic illness: due to increase dopamine in brain. It is a clinical diagnosis based on history. In such cases anti psychotic medicines (like oleanz/risperidone) are given after evaluation of patient by psychiatrist
• Thyroid related problem: get thyroid hormonal assay done
I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.
Wish you good health.
Regards,

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