posted in MediSage
A 30 year old man, had an RTA under the influence of alcohol, resulting in a head injury about 2yrs ago, was brought by family with complaints of being irritable, pacing around and restless, having intermittent crying episodes and saying that he has done something wrong, with reduced need for sleep and physical aggression since 6 months. He stopped alcohol but uses cannabis and tobacco, which worsens his behaviour. Diagnosing him with BPAD, mixed episode. What is the first line of treatment??
- #psychiatry
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Dr. Shivaansh
His description of the symptoms suggests depression. He may be having few manic features. He needs inpatient psychiatric management,. After admission and detailed evaluation, basic investigation of blood and urine, he should be treated with sodium valproate 500mg bid, and lurasidone, 40 mg, increase to 80, mg or cariprazine 1.5 to 3 mg. If he does not respond to this in his depression, an antidepressant like sertralline or s- citalopram can be added. ECT is another option.