I received the report today, it is long and was a hard read, the history of Molly was well documented and my concerns were around the following statements:

1. The constipation is associated to Quetiapine (antipsychotic)

2. Some of her hyper-manic episodes were precipitated by anti depressant prescribing

3. Severe depression episode precipitated by venlofaxine

4. Her mood is further complicated by catatonia

5. Her history supports previous catatonic presentation, for example Mutism and physical health problems which are being dual incontinent

6. She has high anxiety and is demand avoidant (recognised)

7. Autism shutdown has been used previously however this is better conceptualised as that of catatonia

8. Molly has mild EPSE – extrapyramidal side effects associated with antipsychotic medication

ECT Electroconvulsive Therapy to be considered in two months should the lorazepam titration be unsuccessful.

Once I have processed this document I will update you on their recommendations.

Luv C x