Problem:
A 17-year-old boy is brought to the clinic by his mother for a follow-up after discharge from the hospital. The mother worries that he has been acting "strangely" since his release, but he has been taking his medication. Her son sometimes says, "our neighbor is chasing me during the day." She also mentioned that "his appetite is good and sleep is enough during the night." He seems nervous and irritable while his mother is talking to the physician. He explains, "I am under so much stress. Someone has chased me here." He describes his mood as fearful but does not feel depressed. He has no suicidal or homicidal thoughts. He was hospitalized three times during the last two years. He was improved, but shortly after discharge with sodium valproate, risperidone, and benztropine, he stopped taking those due to side effects. The recent one was two months ago. It was due to recurrent symptoms of aggression, being talkative, sleepless, and hearing a voice that commanded him to kill his ex-girlfriend. During that admission, quetiapine was started at 100 mg/day and slowly increased to 400 mg daily. He denies any drug or food allergies. He has a history of attention deficit hyperactivity