50 year old brother is learning disabled, diagnosed with hydrocephalus around age 28, shunt inserted and all has been relatively fine. Last week week started having severe delusions with no obvious cause. Only medication is a low dose of depakote for anxiety, ocuvite, vit d and multivitamin. Recently quit metformin after losing 80 lbs and blood sugars returned to normal range.  Curious what course of action to follow next and what kind of specialist to pursue -- neuro?psych?
Hi, Thank you for posting your query. As your brother has had a neurological problem (HY Chat Doctor.  If the shunt is working fine, then, we need to look at alternative causes such as electrolyte imbalance (low sodium, etc.), deranged liver function tests, high creatinine, etc. These can be checked with blood tests. If these are normal, he may be shown to a psychiatrist. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health,