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Suffering From Mental Disorder. Addicted To Marijuana. Become Very Violent And Abusive. Suggest Solution?

Posted on Fri, 13 Sep 2013

Question: Hi one of my relative is suffering from some kind of mental disorder where in he has become very paranoid and is addicted to marijuana, he has become very violent and abusive and is very difficult to control, initially we thought it was a case of drug addiction and sent him to a rehab but that did not help. Now he is delusional that some one is trying to harm him and he is not listening to any logic. He is abusive to relatives and lives in his own world. it is very difficult to talk to him some other symptoms are

- He sleeps too long some days and doesn't sleep at all in others.
- He hallucinates hears voices and thinks there are people to hurts him
- He sits for long time doing nothing at strange places, cemetery, temple, garden etc.
- He is very pessimistic and thinks there is no point of living. talks very philosophically which does not make sence
- He constantly wants to be under influence of canabies/ marijuana
- He becomes violent and abusive
- He is very introvert and doesn't socialize at all
- He starts laughing without any reason even in sad news
- He thinks he has knowledge of everything and becomes agitated if someone argues or tries to convince him

Answered by Dr. Susanta Padhy (11 minutes later)

Brief Answer:
regular antipsychotics medication will help

Detailed Answer:
Hi

Thanks for the query

It is either cannabis induced psychosis or independent psychosis because of which he is indulging in regular cannabis consumption

Cannabis consumption will worsen his condition

Antipsychotics like risperidone, olanzapine, if taken regularly, should help in such patients. He needs to be started on these drugs. Additionally, benzodiazepines like clonazepam or Lorazepam should augment the effect of antipsychotics.

After control of acute symptoms, continuing rehabilitation should help further

Past head injury is unlikely to have direct connection with his current condition
Deaddiction centre of NIMHANS, Bangalore can be a better hospital for him to get treated

Hope this helps. Let me know if you need clarifications.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Susanta Padhy (30 minutes later)

Hi Doctor, thanks for your response, Currently my relative is in Mumbai and he is in denial and wont take any medications, he is in XXXXXXX Foundation Mumbai Drug & Alcohol Rehabilitation Center a drug rehab in mumbai. Can you suggest a good rehab facility/ Psychiatrist in Mumbai for him? His condition is very bad now and he just wants to be free from the rehab center, he has become very violent and 4 5 people are needed to control him.
Some other questions:

1) a friend has suggested that he may be a schizophrenic?
2) The drugs you have written are those prescribed drugs or over the counter?
3) Is there an immediate method to calm him down?
4) which is the best facility in india for such treatments?

Answered by Dr. Susanta Padhy (44 minutes later)

Brief Answer:
Answer is elaborative

Detailed Answer:
Thank you

Yes, most likely Schizophrenic. But cannabis induced psychosis can be an alternative possibility. Usually, it is difficult to differentiate the two condition.

The drugs that I have written are to be prescribed, not over the counter(OTC) drugs.

Immediate method to calm down: Injection haloperidol and phenergan, as and when he becomes violent. Response will start in 30 minutes or olanzapine rapitab can be kept over tongue and the effect may start in 30 min.

Dr Subhangini XXXXXXX of Psychiatry department, KEM Hospital may be a good place.

Hope I am clear.

Wish him good luck.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Mohammed Kappan