A 48 year old non-diabetic & non-hypertensive married lady was brought to OPD with a history of mixed affective symptoms ( irritable mood, talkativeness, inflated self-esteem, over-familiarity with occassional low mood and self-deprecatory thoughts and less sleep) that occurred 4 years ago. During that time this particular episode lasted for 3-4 months which was well managed with Divalproex Sodium 1000mg/day & Olanzapine 15-20mg/day and short term BZDs. 3 years before that episode she had a classical manic episode which was also managed with the same medications. Currently she is on DVX 1000mg/day & Olanzapine 15mg/day after the last episode (4 yrs ago) and had no recurrence of her symptoms eversince then.
She gained around 30 Kg weight in last 4-5 years. She came to me for the first time now. At present she is in euthymic affect with no manic/depressive/mixed symptoms. A provisional…
