Treatment For Depression, Sudden Crying, Hallucinations, Delusions And Paranoia?
I just feel at a complete loss.
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.
Important aspects of your query are:
• 22 year old female
• Known case of Borderline Personality Disorder, Anxiety, Cannabis abuse and paranoia
• Currently on Quetiapine 50mg 3 times a day, but do not take medicine regularly
• Complaints of: depressive/manic symptoms, paranoia, delusions and hallucinations.
In your query you mentioned symptoms of:
Depression like: low mood, crying
Mania like: Increase thought speech, irritability and decrease sleep
Paranoid symptoms and Hallucinations
There is need to rule out bipolar disorder in your case. In Bipolar disorder patient has both manic and depression episode. When a person have symptoms of depression and mania together it is considered as Mixed episode.
Switch from love to hate and black to white thinking is symptom of borderline personality. This tendency increases in presence of depression or mania.
Following medicines are well researched and found to effective for Bipolar disorder: Lithium, Depakote/Epilum (Valproate), Lamictal (Lamotrigine), Carbamazepine and antipsychotics like Quetiapine. These medicines are given for for long term to stabilise mood. They prevent both depressive and manic episode. Even if patient become ill while on medicine, illness is less severe and last for short period.
Out of these medicines patients got stabilised on one or combination of two medicines. Choice of medicine is depend on patient illness state (which can be assessed on interview only), side effect profile of medicine, and duration of illness, weight, age and sex of the patient. Sometime other antimanic agent needs to be added depending on the severity of episode and anti depressants need to be added during depressive episode..
In current condition it is best to restart treatment as advised by your psychiatrist. Quetiapine will help you in sleep, mood and psychotic symptoms. In your condition regular treatment is very helpful, as discontinuation lead to relapse of symptoms.
As you are young and in this age group thyroid hormone imbalance also lead to exacerbation of psychological symptoms. So, it is better to have thyroid function test 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,