A patient with a 5-year history of bipolar disorder was rece…
A patient with a 5-year history of bipolar disorder was recently discharged from an inpatient hospital stay. She was admitted in a manic episode with a decreased need for sleep, flight of ideas, rapid speech, increased impulsive behavior, and delusional thinking. She was previously stabilized on lithium 900 mg PO at bedtime. Her lithium serum concentration 4 weeks ago was 0.8 mEq/L but was 0.2 mEq/L on admission. During hospitalization, lithium was restarted and olanzapine 10 mg PO at bedtime was added which stabilized her symptoms. Four weeks after discharge, she returns to clinic with a complaint of 30 pound weight gain. Today’s lithium level is 0.9 mEq/L and she has no manic or psychotic symptoms. The psychiatrist would like your opinion regarding her continued drug therapy. What is your most appropriate recommendation?