A 32 year old female presented with frequent mood swings ,more inclined towards sad mood and tearfulness without any possible stressors.The duration of symptoms -5 months. Initially she was given escitalopram 20 mg by another psychiatrist where there was no improvement at all. During the consultation , There were also other complaints including giddiness, palpitations on and off. Investigations: All labs(CBC,RFT,LFT )were normal except hypoglycemia . Further workup showed mildly elevated CRP. Fasting insulin was found to be normal. USG pelvis showed features suggestive of PCOD NOTE:Her menstrual cycles are normal The management was focused on treating PCOD which involved lifestyle changes as a primary focus with no psychiatric medications. She improved significantly during the follow up.Her mood improved as well and recovered now.The symptoms were mainly due to hypoglycemic episodes which were unnoticed. It is always important to rule out the causes especially in women who present with psychiatric symptoms ,rather than treating the symptoms.




Endogenous change form of the symptoms, Change into hormone Balance In progesterone and estrogen, So have patient somatic, anxiety, depression in more common are developed. So I will be suggested that to treat PCOD and can be started tablet olanzepine 2.5 mg to 10 mg and mouth dissolving clonazepam 0.5mg With diet and lifestyle modify. Thyroid hormone levels and rule out stressful situations.

The duration of 5 months with lability of mood and fearfulness without any stressor is noteworthy. PCOD can be one of the causes and treating it would aid the treatment process. Starting the patient with a mood stabilizer is necessary. Had the presentation being repetitive Manic episodes with psychosis and concurrent or prior diagnosis of PCOD. would that change the approach or treatment priority.


Case of Neurosis

Adv CECT brain

Yes it's important to treat the cause rather treating symptoms

Nice posting Doctor thanks

Thank you doctor

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