What neuropsychiatry covers
Neuropsychiatry addresses psychiatric symptoms that occur with a neurological illness or that are difficult to separate from one. Examples include depression after stroke, anxiety and impulse-control problems in Parkinson's disease, psychosis or mood change in epilepsy, behavioural symptoms in dementia, and emotional difficulties after brain injury.
It also includes functional neurological symptoms, where movement, sensory or cognitive symptoms are genuine but do not reflect structural disease. These presentations are common and distressing, and they need a clear explanation rather than being dismissed as imaginary.
Related: Psychiatry → · Dr. Ruja Shrestha profile → · All conditions →
Common overlaps
Depression is common after stroke and in Parkinson's disease, but it may be mistaken for apathy, fatigue or physical slowing. Anxiety can worsen tremor, freezing and seizure worry. Some Parkinson's medicines can trigger impulse-control behaviours, hallucinations or confusion, which need urgent medication review.
In epilepsy, mood and anxiety disorders are more common than in the general population, and some medicines affect mood or cognition. In dementia, apathy, depression, anxiety, delusions and agitation may be part of the illness or may have another cause such as pain, infection, constipation, dehydration or a drug side effect.
| Neurological condition | Psychiatric symptoms to review |
|---|---|
| Epilepsy | Depression, anxiety, psychosis, memory complaints, medication effects |
| Parkinson's disease | Depression, anxiety, apathy, impulse-control behaviour, hallucinations |
| Stroke | Post-stroke depression, anxiety, emotional lability, cognitive change |
| Dementia | Apathy, agitation, delusions, sleep change, caregiver distress |
Assessment and safety
Assessment reviews the neurological history, medicines, recent imaging and blood tests, sleep, alcohol use, pain and the patient's usual level of function. A family member or caregiver who knows the baseline is often essential, especially when memory or insight is affected.
Sudden confusion, hallucinations, severe agitation or reduced consciousness can be delirium or a medicine reaction and needs same-day medical assessment. Suicidal thoughts, psychosis and unsafe behaviour also need urgent review. This clinic is not an emergency service; use the nearest emergency department when safety is at risk.
Access and booking
Appointments are at Mind Wellness Center, Durbar Marg area, Kathmandu. Call +977-9747736624 or use /book-appointment. Telepsychiatry is available for appropriate follow-up and for patients who cannot attend in person. This is not an emergency service; if there is immediate risk of harm, go to the nearest emergency department.