instruction: hello doctor this is about a 71 year old male psychiatrist said that a plain it scan and another it scan should be taken with contrast but after four attempts they could not create channel in his veins so contrast it scan of the brain was not done plain it scan of the brain showed cortical sulci sylvia fissure basal cisterns at places and supratentorial ventricles are mildly prominent lacunar infact in right claustrum mild bilateral cerebral cortical atrophy age related background he was unnecessarily fearing that my relatives neighbors and municipality will search and steal his clothes newspapers only one day he had a delusion about dead relatives making a phone call after taking prescribed medicine olanzapine my one tablet per night he is behaving properly he is under medication for one and a half months previously he used to sleep for two hours now he sleeps for four hours
output: hello welcome to icliniq com the symptoms you have described of paranoid ideation suspiciousness restlessness decreased sleep are all indicative of a psychotic type of illness most probably schizophrenia it will require treatment from a psychiatrist with antipsychotic medicines olanzapine is one such medicine this happens because due to elevated levels of certain neurotransmitters such as dopamine in the brain which leads to reduced stress handling capacity of the brain the medicine will get the levels to normal and help with the problem for the first episode of this illness treatment is recommended to be continued for one year and then medicines are stopped for the second recurrence for three years and for the third time of recurrence it is lifelong that is why please complete the course of the medicine as per the doctor advice the lacunar infact in the brain also is one contributory region for this problem and for that I am sure the other general physician or neurologists must have given medicines to take care of the infact and anti clotting medicines if the size is small please continue those and it will reduce along with olanzapine my you can add phenergan 25 my promethazine it will help him sleep better also consider raising the dose to 5 if symptoms of suspiciousness do not reduce