Hallucinations, incoherent speech, not aware of surroundings. Taking zolfresh, arip medication. Treatment options?
Patient: Hi.. Need answer to my question very very urgently...My father in law (appox age, 67 yrs) was put under medication 10 days back by a psychiatrist in XXXXX. He is having Arip (20 mg) and Zolfresh (10 mg) daily. for the past couple of days, he has been having hallucinations and talks incoherently and I feel that he is not aware of his surroundings. Today while sitting on the sofa, he urinated and passed stool . He is talking in a very abrupt manner. If asked a particular question, he answers something completely different. Please advice as soon as possible. I am really worried... Please help.. Doctor: HI  neha2000.  THANKS FOR YOUR QUESTION.  FORTUNATELY I AM DOING MD IN PSYCHIATRY NOWADAYS.  FROM THE MEDICATION IT SEEMS THAT YOUR FATHER IS A PSYCHOTIC PATIENT.  FOR LAT FEW DAYS HE BECOME VIOLENT,AGITATED,INCOHERENT TALK CONFUSED,INCREASED HALLUCINATION THIS TYPE OF CLINICAL FEATURE IS SEEN IN DELIRIUM AND AGGRAVATION OF HIS PSYCHOTIC SYMPTOMS.AS DELIRIUM ARE MORE COMMON ,LIFE KILLING CONDITION SO WE TAKE THIS CASE AS DELIRIUM UNTIL PROVE OTHERWISE.SO MY OPINION EITHER STOP OR DECREASE THE DOSE OF ARIP TO 2.5-5 MG,STOP ZOLFRESH AS IT HAVE SIDE EFFECT OF DELIRIUM AND ADD SMALL AMOUNT OF LORAZEPAM IM/SOS. BUT FIRST GO TO YOUR PSYCHIATRIST TELL ALL THE THINGS AND ACCORDING TO HIS SUGGESTION YOU PROCEED.  THANK YOU DR SOURAV GANGULY