34 yrs male with diagnosis of schizophrenia since 15 yrs on various antipsychotics initially for 1yr and then stabilized on risperidone maintained well for a period of 7 yrs then medication stopped for a yr. He came up with a full blown mania and started on valproate and olanzapine pt was maintaining well then paliperidone was added after which he had akethesia. Psychiatrist misjudged as psychotic agitation and increased the dose of medication.
Later on, it was diagnosed by other doctors and withdrawn all medications and i/v/o past response restarted with risperidone but pt never attained premorbid state and had few depressive episodes of 3-4 days these episodes were not noticed by doctor nor reported by patient. She started on amisulpride and sertaline for social anxiety. The response was tremendous and patient attained premorbid levels and symptom free for last 2 yrs then gradually…
