How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • Go back-and-forth until satisfied
    Rate the answer you receive.
Ask Shahid Karim Your Own Question
Shahid Karim
Shahid Karim, Board Certified MD
Category: Medical
Satisfied Customers: 484
Experience:  MBChB
Type Your Medical Question Here...
Shahid Karim is online now

Dr You spoke with my mother yesterday and advised her to

Customer Question

Dr Karin
You spoke with my mother yesterday and advised her to take a lower dose of her current medication without knowing she’s currently suffering from hypomania. As a result of your advice she has told the neurologist team and mental health team at UCLH and Merton that she will now not take any medication at all.
She is not currently herself and we are doing everything we can to get her back to full health.
It is important that she takes the quetiapine. Please help!
Submitted: 5 days ago.
Category: Medical
Expert:  Shahid Karim replied 5 days ago.

Hi, thank you for getting in touch. I'm very sorry to hear about your mother not being herself and I fully agree regarding Quetiapine. My advice to your mother was that Quetiapine was a very important medication and should likely continue. I mentioned that all medication changes ought to go past the GP before being acted on and that the diazepam and sleeping tablets were probably in part the cause of her tiredness and reducing their doses or considering doing without them may help with the profound tiredness she'd described.

Customer: replied 5 days ago.
She’s stopped the diazepam already. And she’s only having 7.5mg zopiclone at bedtime as she’s not been sleeping for over a month for more than 4 hours due to her mania.
I know you weren’t informed of the whole situation but this has caused huge problems and she’s now refusing care as a result of you telling her she doesn’t need the medication,
Customer: replied 5 days ago.
No I’m not paying more money to switch to a call!
Expert:  Shahid Karim replied 5 days ago.

I'm sorry to hear that, I think your mother took some of the message but not all of what was communicated to her. I never tell anyone to stop any medication without speaking to their GP as I can only get a fraction of the story on here. you can ignore that the site offers calls automatically

Customer: replied 5 days ago.
I need you to confirm that she has to stay on the current increased dose of 50mg quetiapine and listen to her doctors if they increase it as it’s the only way to get her back!
She will now only listen to you.
Expert:  Shahid Karim replied 5 days ago.

I suggested speaking to the GP to see what each one was given for and whether any could be reduced or stopped in time. That doesn't mean they should stop the meds immediately without talking to the doctor.

Expert:  Shahid Karim replied 5 days ago.

Here's exactly what I suggested again (which you can show to mum if needed)

-Quetiapine, very important and should continue.

-Diazepam - may add to drowsiness, may be worth discussing with GP if this exact dose or regimen still needed

-Zopiclone - usual starting dose is 3.75mg at night, may add to daytime tiredness, may be worth speaking to GP if trying 3.75 or trying to go without is an option

Expert:  Shahid Karim replied 5 days ago.

If it helps I can call on my own cost and speak with you both, I'm happy to do that. Otherwise I hope the above helps and mum sees her GP/mental health team to discuss things further.