examination of his mental status revealed uncooperativeness, irritability, abnormal behavior, decreased volume and pitch of speech, increased reaction time, labiality of mood, impaired attention and concentration, and disorientation to time, place, and person. The diagnosis of delirium was made along with a suspicion of Parkinsonism. The antipsychotic drug, quetiapine, was started at a low dose of 25 mg once daily, and then was gradually increased over 3 days to 50 mg, which showed dramatic improvements within 2 days.

By the 18th day of admission, a decision was made to transfer the patient to the Psychiatry Inpatient Department for further management of his psychiatric manifestation, where he was continued on with the same medications. Consistent mood liability, irritability, fatigability, and features of anxiety were observed; however, features of Parkinsonism wereseen to be improving.

Through a detailed history from his spouse, friends, and other family members, major medical, surgical, and psychiatric illness, and substance abuse were all ruled out. The patient consumed alcohol occasionally, but did not portray patterns of dependency. In addition, the detailed history explored the attempted suicide and saw it as an impulsive act rather than one motivated by depression. The patients' medical history showed mood swings along with suicidal thoughts were persistent. An antidepressant, fluoxetine 20 mg, was started once daily and suicidal precaution was explained to family members. Upon persistent requests from the family, the patient was discharged with the same medication and advised to return for a 2-week follow-up at the Psychiatry Outpatient Department. Gradual improvement in his mood and behavior was seen