A 25-year-old man with moderate learning disability comes to the accident and emergency department. It is 10 pm at night. His parents are with him. He is agitated and restless. He is unable to sit in the waiting area. His father explains that he had been on olanzapine for a year after an episode of psychosis where he thought the radio was telling him what to do, and he was hearing the ‘shopkeeper’ next door talking to him and telling him that he was a thief and a ‘bad man’.
His symptoms had abated but he had put large amounts of weight on. His consultant psychiatrist had changed the medication to haloperidol. There had been no recurrence of the hallucinations or delusions, but he had become highly restless 3 days after starting them and this had got worse over the course of the week. This involves him finding it very difficult to sit still and feeling anxious much of the time. Prior to…
