Does the use of Oxetol by my 23-year-old brother for psychiatric illness increase his suicidal tendencies?

Hi doctor

In last year, my 23-year-old brother was diagnosed with severe depression. He experienced symptoms such as thought broadcasting, suspicion, fearfulness, and a feeling of being followed by someone. He also believed that his mobile phone was hacked, and that the world could hear his thoughts, making him feel guilty for past mistakes. These issues arose when he was living alone in a flat. We also had some problems with relatives related to property matters after our father's passing, which he happened to disclose to a person he trusted but later regretted for no apparent reason. The initial doctor prescribed Oleanz 2.5, Quitipin 25 mg, Lonazep 0.25 mg, Dolo 650, and Kefpod CV for fever. However, after a week of taking these medicines, he attempted suicide and displayed self-harming behavior. We consulted another doctor who prescribed Nexito, Oleanz, and Pacitane. Although he calmed down initially and seemed to be back to normal, after a month, he started experiencing irritability. Another doctor determined that the irritability was due to Nexito and stopped that medication while adding lithium. This change helped him calm down again. However, due to Oleanz 20, my brother's SGPT, SGOT, and cholesterol levels increased. The doctor refused to decrease the dose, suggesting that the elevated levels might be due to hepatitis. We consulted a gastroenterologist who conducted various tests, including a 24-hour urine test, which came back positive with no issues. The gastroenterologist and psychiatrist agreed to stop Oleanz. Seeking another opinion, we consulted a different psychiatrist to discontinue Oleanz. By this time, my brother had been on Oleanz and lithium for seven months, with Pacitane continued as well. During a blood test, we found that the liver function was not improving, and the doctor stopped lithium (which had been taken for six months at that point). All medications were then discontinued, and Oxetol 150 mg was prescribed for five days, followed by 300 mg for 20 days. If there are any sleeping issues, Ativan 1 mg can be taken. This medication was started yesterday. Additionally, my brother is taking Rosuvas 10 to lower cholesterol and Udiliv 300 for liver support. Blood report findings include: total cholesterol 224, HDL-35, non-HDL-189, LDL-154, VLDL-31.2, total cholesterol/ HDL-C ratio 6.4, LDL-C/ HDL-C ratio 4.4, AST 50 U/L, ALT 110 U/L.

Regarding the medication, I read an article stating that Oxetol is not recommended for individuals who have had suicidal thoughts and is primarily used for seizures. Currently, my brother is doing well, working remotely for a company. However, he experiences a brief period of low mood between 6 to 7 PM, lasting around 15 to 30 minutes, during which he is unable to handle negative triggers. Apart from this, he is mostly back to normal. Sometimes, he mentions wanting to leave and stay with his friends. I would like to know if we are on the right track with the medication. Is it safe for his liver? Are there any potential medication interactions? We are concerned about the possibility of suicidal tendencies due to the Oxetol medication, as some reviews suggest it may lead to such thoughts.

Thank you.

Hello doctor,

Thank you for the reply.

Is this completely curable? Will it come back in the future at any time? He does not drink or has not drunk at any time in his life. His dad and brother have similar psychiatric illnesses. I

1. Any past history of a similar condition? No, he was completely fine.
2. Any stress or tension? He is currently experiencing tension, and sometimes he thinks about his disease.
3. Any suspicious or fearful symptoms right now? Not really, but he has fears related to God. He sometimes thinks that we have caused this to him spiritually, but it's only occasional.
4. Are there any mood symptoms, mood swings, or irritability? Yes, his mood fluctuates at times, but he is aware of it and tries to cope with it on his own.

We are worried about sending him out with friends because we do not fully understand what he is going through, and we are concerned about the possibility of suicidal thoughts. Who would be able to help him in such a situation?