For last few weeks my sister in law is suffering from severe restlessness. Due to this c behaves abnormally, talking to self, and also sometimes suicidal thoughts occurs and then she tries to go here n there .we have shown her to physician first they said us to visit psychiatrist. Now we are taking treatment in cadbams hospital, bangalore.they provided us medicine like nexito 5 mg, tetrafol 7.5 mg, but no any changes, we again shown her to other psychiatrist this time c removed nexito and told to add serta 50 mg. But no any changes. We again shown her to other psychiatrist. This time he recommended tablets etizola 0.5 mg and mirtaz 7.5 mg. We are giving her these medicines but suicidal thoughts ,mood swing, aggressiveness, talking to self and restlessness still there. We are feeling helpless. Pls suggest what to do.

Dr. Saranya DevanathanPsychiatrist51yrs exp

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Dear lybrate-user, nexito, serta and mirtaz are antidepressants that take 2-3 weeks to start their action. They are given in low dose to start with. If you go on changing psychiatrist, you will end up trying antidepressant without any benefit - low dose and not taken for 2-3 weeks. There are no drugs to enter the brain immediately to control restlessness and abnormal behaviour. Neuro modulation like ect (electro convulsive therapy), rtms, etc aims at the brain directly. Since they are given from outside the skull bone, they need to be given repeatedly. Help is there - stick to a psychiatrist nearby, follow the advice, visit frequently, admit her if she can not be managed at home, ect and rtms when adviced try, wait for tablets to work and in consultation like this please give your sister-in-laws details.  

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Dr. Prof Jagadeesan M SPsychiatrist18yrs exp

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The medication seem low and acting slow, many times treatment is based on the severity of symptoms which doesnt seem here so. Kindly get a second opinion. Good luck 

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Dr. Dushad RamPsychiatrist27yrs exp

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Dear lybrate-user the symptoms you described appears to be sever in nature. Medication prescribed appears to be appropriate, but I feel dose is less for severity. Probably they started in this dose to avoid side effect. Though I should not interfere with ongoing treatment, but I feel if you give etizolam twice or thrice than reslessness should reduce. If it is already done than increasing it's dose should help. Mirtaz dose need to be increased based on improvement and side effect. Since patient is suicidal don't leave him alone, keep medication away from him and be watchful for any self injurious behavior. Keep in mind that medication work slowly over weeks. This time I would suggest not to change the doctor, if patient doesn't improve tell the doctor, he/she should go for alternative options.  

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