instruction: hello doctor my aunt seems to have a psychotic episode she talks nonsense things a few times a day mostly normal sleepless nights for five days while nearing menopause she was prescribed lithium mirtazapine olanzapine and citalopram which she used for three months a year back and stopped them since she started again yesterday as we asked her to what is happening to her is her treatment appropriate
output: hello from your description and prescribed medication it looks like your aunt may have been experiencing psychotic symptoms with an affective disorder additional past history and current assessment will help to clarify the exact diagnosis mood disorders affective disorders can be influenced by menstrual cycle changes usually the cause will be a combination of biological psychological and social factors a complete assessment will help to identify the triggering factors for your aunt illness and help with her recovery it is advisable to consult a psychiatrist to clarify her diagnosis and start medication appropriately lithium is a mood stabilizer olanzapine is an antipsychotic which also acts as a mood stabilizer mirtazapine and citalopram are antidepressants depending on her current symptoms she may need to be started on the most suitable medication at a starting dose and gradually increase it is not advisable to start all the medication at the same time dose needs to be proper as well these medications are helpful but are potent so should be used under medical supervision only so it is safer to consult the doctor who prescribed these medications for review try to be supportive of your aunt avoid any conflicts and arguments as they can make her more unstable at present sleep is important to help in her recovery if possible encourage her to do some exercise at home she will gradually settle down with appropriate support she may need to continue medication for a longer term