Suggest treatment for psychotic episode in woman
Patient: I am a psychotherapist.  I work in a crisis clinic.  Recently a 50 year old Mexican National woman had a psychotic episode after her father (99 years old) died of natural causes.  She has no family or personal hx of psychiatric illness and has worked and been basically healthy up to now.  She stopped menstrating 2 months ago. Doctor: Hi, thanks for the query. Considering that you are well aware of the symptoms of psychosis such as reality distortion, delusions, hallucinations, formal thought disorder, behavioral disorganization etc. & presuming that the psychotic episode has occurred in response to stressor (loss of loved one); I would like to enquire whether the lady has fluctuating symptoms varying in intensity & severity over a day to day- hour to hour basis & whether their are predominant affective symptoms like emotional turmoil? I am suspecting this to be acute & transient psychotic disorder & for first episode of Psychosis; Risperidone/Olanzapine shall be my preference presuming there are no contraindications of health, lifestyle. Benzodizepine group drugs like clonazepam, lorazepam etc. can be used as adjuvents to reduce agitation. She should respond as early as within 1 week & may require drug treatment for next 6-8 months or so. Kindly get in touch with a Psychiatrist. Good Luck