Question: Hello Dr. C J XXXXXXX My wife is 31 years old, have been diagnosed with Acute Psychosis. She had a very short episode of same 6 years back, it was there for 1-2 months. After that she had the episode again in Jul-2013 and diagnosed with Acute Psychosis. It had been 1 year after she lost her father, she went into depression, the symptoms being: 1. She did not sleep for 5 nights before we went to see a doctor 2. She was having hallucination like her father speaking to her 3. She use to speak unconnected topics 4. Could not understand what is going on in reality She was put on "quetiapine" 200mg for initial 3 months and after that it has been reduced to 100mg. She took medicines till end of Dec-13, she stopped taking the medicine without consulting the doctor. Now, after 1.5 months, she is again showing the signs like: 1. She sits silent, does not talk much 2. She is very lethargic, does not show interest in doing work 3. We are going to visit doctor again this week I would like your valuable guidance in this. I would like to know if she can be treated in Homeopathic. We live in Bangalore, we would like to know if can consult a good homeopathic doctor at Bangalore regarding Psychiatric issues. Thanks in advance

Hello Dr. C J Verghese, Thanks a lot for your quick response. I really appreciate and glad about your comments. I really dont have any issue coming over to Kannur, but my only concern is how often we need to travel to Kannur for the treatment. And moreover if we can have someone at Bangalore also who could support on this case it would be very handy. However, please suggest based on your experience. We are really worried about the future consequences. Please let me know if you have come across some grave cases where people have been completely cured from psychosis and no recurrences in future. Because as per the alopathic treatment, the antipsychotic have side-effects in long run. Hence, please mention about your experience in such cases. Please find the details as requested by you: CASE TAKING / RECEIVING FORMAT (This is only a frame work to help you to develop your case. You can expand your case to any extent. But try to help the physician to understand your genetic dispositions, individuality and constitution in the physical and mental plain. ) I PRELIMINARY DATA 1. Name : XXXXXXX 2. Age: 31 3. Sex : Female 4. Occupation: House Wife 5. Financial Status : Good 6. Social status : Good 7. Religion : Hindu 8. Address: J P Nagar, Bangalore 9. Contact no : 10. Email address 11. Mother tongue: Kannada II PRESENTING /CHIEF COMPLAINTS 1. Since when the complaints started: She had a short episode of a month in 2006. After gap of 7 years, she had the episode again in Jul-2013. From Jul-13 to Dec-13 she was on antipsychotic medication. She had stopped taking medication from Jan-14 onwards. She has started showing the sypmtoms it again from first week of Feb-14. 2. Onset sudden or gradual : Gradual 3. Pain –its duration, how long it remains, how it comes and goes, its character, its extension 4. Side of affection - Left or Right, from left to right or from right to left, upper left and lower right or upper right and lower left 5. Aggravating or ameliorating factors or conditions 6. Supportive investigations and reports, diagnosis, findings… : She is undergoing treatment at NIMHANS. 7. Speed of development of disease - slow 8. Probable or final diagnosis : Final diagnos is Acute Psychosis III ASSOCIATED COMPLAINTS / OTHER DISEASES 1. Since when the complaints started 2. Onset sudden or gradual 3. Pain –its duration, how long it remains, how it comes and goes, its character, its extension 4. Side of affection - Left or Right, from left to right or from right to left, upper left and lower right or upper right and lower left 5. Aggravating or ameliorating factors or conditions 6. Supportive investigations and reports, diagnosis, findings… 7. Speed of development of disease - slow or fast 8. Probable or final diagnosis IV PAST HISTORY ( MAJOR ILLNESSES / SURGERIES / ACCIDENTS) IN THE PAST 1. Never well since like vaccination, pneumonia, typhoid, malaria etc. 2. Any suppressive treatment like ointments for skin, laser therapy for stones, corrective surgery for eye etc. 3. Emotions that precipitate the disease every time Loss of her father, she is really disturbed by that. By nature, whenever she gets emotionally dull, she keeps to herself, never expresses to anybody. Even after asking for hours she does not respond. 4. Emotional conflict happened just prior to the onset of disease that remain unresolved 5. How from lower layers of tissues the disease shifted to more important and higher layers of tissues 6. Chronological journey of disease- how you started with first sickness, next what happened , then what etc. till you developed the present state of illness. V FAMILY HISTORY / HEREDITARY DISEASE TENDENCIES/GENETIC DISEASES ETC. IN THE FAMILY 1. Father 2. Mother 3. Paternal Grand Father 4. Paternal Grand Mother 5. Siblings, in order 6. Paternal uncles and aunts 7. Maternal uncles and aunts VI GYNAECOLOGICAL / OBSTETRICAL HISTORY (FEMALES ONLY) 1. Menses in detail 2. Complaints before, during and after menses 3. Menarche (onset) age, early, late etc. 4. Menopause (stoppage ) normal, early, late, complaints during. 5. Children born, living, dead. 6. Abortions, Miscarriages, delivery normal or surgical VII DRUG / TREATMENT HISTORY 1. Any medication, Allopathic, Ayurvedic or Homoeopatic : She is on antipsychotic drug quetiapine 100 mg 2. Allergic sensitivity to any drug 3. Over use or abuse of drugs 4. Any affection / side effects of taking drugs She has put on weight and also has become kind of short tempered VIII INVESTIGATION REPORTS / RESULTS (ATTACH RELEVANT REPORTS) 1. General health 2. Presenting complaints IX PATIENT AS A PERSON / PHYSICAL / GENERAL 1. Appearance: built, structure, height, weight, complexion, face, skin, warts, moles, discolouration, pigmentation etc. Weight - 61 kgs Height : 5' 2" 2. Speed: of talking, eating, working, walking, Talking - Medium Eating, working, walking - Slow 3. Thermals: Sensitivity to cold or heat, can tolerate heat or cold better, need or fan / ac, need of warm clothes, covers uncovers during sleep, takes warm or cold bath… 4. Appetite: normal, increased or decreased, peculiarities in eating habits, veg/non-ves, desires, cravings and aversions, aggravation and ameliorations, intolerances and ailments from particular tastes and items of food, prefer cold, warm or hot food, 5. Thirst: quantity of water drinking in a day, thirsty during night, drinks by habit or by feeling thirsty, during meals only or drinks in between, throat and mouth getting dry, cold or room temperature, warm or hot water, fruit juices, other drinks Drinks less water 6. Stool: habits, frequency, difficulties, any complaints before, during, and after. Normal 7. Urine: any difficulty, any complaint 8. Sleep: sound/ disturbed, deep comatose or catnap- alert, easily waking, restless, tossing about in bed, position in sleep, salivation during etc. During Jul-13 episode she did not sleep for 4-5 days. But, now she does not have any problem with Sleep. In fact she is sleeping more. She is lethargic and complains about head ache and body ache. 9. Dreams: good/ bad, frightful, repetitive, related to family, work, death, dead bodies, accidents etc. 10. Side: which side is predominantly or frequently affected, 11. Sensitivities: to sun, noise, light, tight clothing, touch, strong or perfume smell, rain, cloudy weather, winds, moon phases etc., how affected and how much… 12. Senses: vision, smell hearing, touch, taste, extra sensory perception etc. 13. Habits: smoking, drinking, chewing etc. X PATIENT AS A PERSON/ MIND/ LIFE SITUATION 1. Family, single, married, staying together, multiple partners, staying with whom, joint family, nuclear family, mutual relationships etc. She is married and we have 5.5 years old son. 2. Job, salary, working conditions, job satisfaction, work site conflicts, She is a house wife 3. Education, diligence for gathering or updating knowledge, eligibility or qualified for the job, laziness to study or to exert mentally, 4. Expressive or non expressive, extrovert or introvert, vivacious or quiet, loquacious or silent, loud talker, sweet talker, self praise, open hearted, foolish talking, lewd or talking about sex, expansive, changing subjects, talking about money, health, religion, talking to himself, jesting etc. She is not at all expressive, she is an introvert and quiet. 5. Communicative, easily starting conversation, easily mixing with strangers, sharing feelings with others, prefers to be in company or solitude She does not mix with strangers that easily and does not share her feelings either. Because of her poor English she generally avoids people from talking. 6. Intellect: studied by self, or pushed by others, how handles work, intellectually sharp or slow, concentration and comprehension easy, reading desires, idiocy or childishness, making mistakes while talking and writing, good and quick or bad and slow in making decisions, indecisive or yielding to the opinion of others, etc. 7. Diligence or non diligence, regular or not in going to school, work , office etc. 8. Morals: respecting rules and morality, sensitive to values 9. Will: good and confident in handling responsibilities alone and in critical situations, or wanting support always, reacting or supporting injustice, strong or weak willed, confident or timid, dependant or courageous, optimistic, persevering and positive or pessimis, bashful or embarrassment. 10. Memory: good or bad, recollecting events of the past, remembering numbers and names, active or weak , any forgetfulness… In general her memory is good. But during this phase she does not remember and recall things fast 11. Nature or disposition: angry or mild, yielding or haughty, weeping, sarcastic, contemptuous, apprehensive, fearful , contented or discontented , quarrelsome, fighter, revolting or indifferent etc. Angry 12. Emotions: when getting angry how reacts, anger expressed or suppressed, expressed even to elders, keep thinking about the issue for long or can forget or forgive easily, sentimental or sensitive, sympathetic to the point of forgetting one’s own needs, involved in XXXXXXX or social service, grieved, affectionate, jealousy, rage etc Anger is always expressed and to elders as well. Yes she does keep thinking about the issue for long time. In fact whatever has happened five years back, she remembers and recalls and gets upset/angry about them. During such situation she goes into silent mood without talking to anybody for hours, sometime more than a day. 13. Sensitivity: to behaviour of others, rudeness, criticism, reproach, contradiction of others, relationship, social position, success or failure, money, admonition, ego, appreciation, injustice, to the surroundings, cleanliness mania, nature, animals, music, religion etc. She is highly particular about cleanliness, when it comes to that she is very strict and gets angry even if a thing is moved around or if my son disturbs the sheet on a sofa etc. 14. Anxiety about conscience, health, children, family, future, salvation, about trifles, for others, apprehension, anticipation, punctuality, 15. Attachment: to career, position, family, friends, name and fame, money, 16. Consolation desires, ameliorates, aggravates, appreciation craves, 17. Fears: any fixed fear XI N.B: You can expand the case to any extent for making the physician understand your life situations and your genetic and constitutional reactions to them so that the physician can very easily understand your individualistic and characteristic features, both physical and mental and thus arrive at your curative remedy, the SIMILIMUM. Here I would like kind of write a story of the entire episode. She comes from a pretty big family, they are total of 8 siblings and all are girls. In May-2012, her father got sick and was bed ridden. We brought her father from Hubli to Bangalore for the treatment. It so happened that, he breathed last in our house. The other coincidense is that he passed away on Jul-12 which also happens to be our son's birthday. After this she was fine for a year. Prior to this, during Oct-2006, before our marriage, she underwent first episode of this. Then her parents went to a doc and she was on pills for not more than 2 weeks. They rather believed this was because of some evil power and took her to many temples. Eventually within 2-3 weeks of time she was completely recovered and no medication was sought afterwards. She was leading a good life for almost 6 years. HOwever, after the marriage, we had tough time in the family wherein she has to adjust to my mother and my family. It was really a rough time, she had to sail through. There are lot of bad instances where she was cornered, this is what she remembers even today and gets angry about it . She did not have a smooth ride when it came to post married life. Because of family pressure, even I did not quite support her during those tough times. This has a lot bearing on her mind for sure. In 2013 she also started interacting with our neighbours in the apartment otherwise she was a -very reserved person, just hi-by kind. Now coming back to Jul-2013. As 12th Jul was nearing (day when her dad passed away) she was slowly drifting towards that agony. Unfortunately I did not observe that it is coming. From 12th Jul 2013 onwards, she went into a depression, she did not sleep for 4-5 days. Following are the observations we made: - She started talking things which are totally irrelevant and talking on different topics one after the other which are not related at all - Suddenly she would look at someone on road and say that this person resembles to a person in her native - She use to get angry a lot - She even started doubting our neighbours, saying that they are ridiculing her. This is because majority of them are from big cities who are well versed with multiple lanaguages. Since, she is not conversant with other languages other than Kannada. She use to feel bad about herself and started feeling left out. This also she expressed many times during the episode - She also said that she does not want to stay in this house , she needs a change - She use to remember things happened in the past and talk about it - She also mentioned that she feels like her dad talks to her, she should take care of her mother - We took her to a psychiatrist working in XXXXXXX XXXXXXX Yoga University, during the counselling she started asking the counsellor if she is from Brahmakumari and has idea about how a soul talks to us and things like that. The psychiatrist could not counsel her properly at all Then XXXXXXX XXXXXXX Yoga guys have referred us to NIMHANS to one Dr. Jagadeesh Teerthahali, after the counselling they have diagnosed her having Acute Psychosis. Following is the prescription we received and medication started from 18th Jul 2013: quetiapine 50 mg --> Day 1 and Day 2 quetiapine 100 mg --> Day 3 and Day 4 quetiapine 150 mg --> Day 5 and Day 6 quetiapine 200 mg --> Till Nov 23rd 2013 quetiapine 100 mg --> 30 Dec 2013 Actually she had been asked to continue the medication till begining of Feb'14, but we stopped by end of Dec'13 when she was feeling better. Now after a gap of 1 month without medication I have started observing that she is having a relapse. But, unlike last time this time it does not look those kind of grave symptoms. These are the symptoms she is having from first week of Feb'14: She is feeling really lethargic, very sleepy always Does not have interest in working on things Not much of concentration Not so confident when she speaks and get angry at times Other than the above mentioned I have not observed any other symptoms In the fear of relapse from 18th Feb 14 onwards we have started medication with dosage of 50mg quetiapine . Please let me know if you need some more details. Thanks and Regards

Hello Dr. C J XXXXXXX The other symptom I missed is, she is very silent now a days, does not talk much. Even if you ask something, you dont get an answer for that. She will just say huh.. Thanks and Regards,

Hello Dr. C J XXXXXXX Thanks a lot for your analysis and response. Sure, I shall go ahead with this, but, before that do you think I should visit you once before starting the medication? If, yes sure I will do that. Also, please answer my query regarding your experience in treating such ailments and curing them. This is more with respect to success rate of Homeopathy with respect to mental illness. Thanks and Regards

Hello Dr. C J XXXXXXX Once again thanks for the candid response. I will go ahead with medication prescribed by you. However, I have one clarification required, what is the ideal duration that I need to look forward to see the effect of homeopathy medicine on her? Based on this I shall make a decision of reducing the dosage of alopathy medicine and also decide when to bring her to you. Thanks and Regards,