instruction: hi doctor my son is 13 years old he is on ritalin la oleanz muzak and lithium I think the doctors do not know what is really wrong and are experimenting on him recently he is telling lies stealing and defiant he does get agitated at times and shows aggression and has become very impatient also he struggles to sleep he was much better before he was put on all these medications what could be wrong
output: hi the medications seem to be for add attention deficit hyperactivity disorder and bipolar disorder with psychotic features he should be managed only by a psychiatrist aggression is a part of add the ritalin methylphenidate hydrochloride can cause sleep difficulties and lithium levels should be monitored very closely I am not sure if all of these steps are being taken please refer to our psychiatrist at icliniq for further recommendations do not discontinue any of these medications abruptly add and bipolar disorder with psychotic features hyperthyearoidism liver function test and blood counts abc should be done when on lithium levels should be monitored for at least every three months continue these medicines for now do not abruptly discontinue them for further doubts consult an internal medicine physician online