Brief Answer: Hi Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. Important aspects of your query are: • 75 year old female • History of multiple depressive episodes with psychotic symptoms • Complaints of: Confusion related to diagnosis. In psychiatric classification, diagnosis are made to help clinician in predicting course and outcome of illness. While treating patient clinical history is more important. Many time in chronic patient it is difficult to explain patient problems with one diagnosis, in such cases differential diagnosis are made. Many time diagnosis can be change after change of course of illness. From your history following are diagnostic possibility in your case in given hierarchy: -Schizoaffective disorder: In this patient frequently have episodes of depression/mania with psychotic symptoms in between. -Bipolar disorder Considering chronic illness, you may need treatment for long term even after improvement, to prevent recurrence of symptoms in future, so never stop medicines. In my opinion Risperdol and Lacmictal combination (as given by your psychiatrist) is better for you, as Risperdol control psychotic symptoms and Lacmictal control bipolar symptoms. 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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