### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Sir, My son is Mr. Surya Narayan. Date of birth: 15-01-1992. Because of my younger brother, he learns video games, TV games and mobile and also my son told me that my younger brother do some physical abeyance to his body. Because of that he is not interested to go to school and study, violent, expensable. We are refusing any thing what ever he wants, he starts violent and throw out the cooking items. It started 2007. We have given treatment in Spandhana Hospital, Rajajinagar under treatment given by Mr. Srinivas. We have given to my son computer, mobile. But suddenly he is telling games not suitable this computer or mobile. Please change these things and purchase new one. We have given tablets Zisper Plus 1-0-1, diva od 500 1-0-1, MazorilSR 200 1-0-1, Thyronorm 50 1-0-0, Trancodol dt 10 mg 0-1/2-1/2, Paradise12.5 mg 1 daily. But 40% improvement is there. We are worrying mainly his studying. We have joined him in ramaiah college diploma in electronics and communications. First 4 months regularly gone. After he discontinue himself. 1st Semester exam not attend. Now he is in the house. We are sending him tution for above course not regulary going. Please give your advise about medicines and course studying. Now also some violent is there. Some times he is beating his mother. Many counseling done by Spandana Hospital, Bangalore. The counsel person also told to doctor no use to counsel. Now, he is not completely cure. We refuse to any thing whatever wants he is beating his mother, throw the food items or some other whatever he gets. Now also he is feeling he wants to discontinue college. Another thing he written 1st Semester exam written. 3 subjects failed. Again 2nd Semester he starts going to college. He is not going properly. Against he is feeling to discontinue. Mainly he required games. He told us to buy costly mobile and put games every time. Sir, My email ID is YYYY@YYYY . My house phone no. 080-0000 / (My wife R. Girija is available) My mobile no. 0000 Sir, Please advise to take care of my son strictly sending to college and make study the subjects, if any body is there? Is it useful to us. Now he is in ramaiah college, Mathikere. Regards, N.SIVSUBRAMANIAN My email id: YYYY@YYYY

### output:

Hello thanks for askingYour son of 22 years have complaints of violent abusive behavior, not following commands, demandingness, poor performance in studies, hitting family members. He is currently on Risperidone 4 mg, Sodium valproate 1000, Haloperidol 10, Paradise 12.5 per day. He is not getting much relief and there is only 40% improvement. Furthermore, he is still demanding big games and mobiles. As per my opinion he is suffering from bipolar disorder with manic episode or second possibility is Conduct disorder. He is on right medicines, but the relief is less. Consult his psychiatrist again for reevaluation. Other option is electroconvulsive therapy. This treatment is usually reserved for resistant cases. You can discuss with his doctor for ECT. The therapy is given weekly or every 2 weeks interval, and it has good results as compared to medicines. Thanks, hope this helps you.