James was diagnosed with bipolar disorder at age 18.  He is…

James was diagnosed with bipolar disorder at age 18.  He is now 32 years old and has been maintained stable on lithium 900mg daily and lamotrigine (Lamictal) 100mg daily.  He recently had his wisdom teeth removed and has been taking 600mg of ibuprofen 3 times per day.  He suddenly experiences tremors, diarrhea, vomiting, and extreme sedation.  What could be the cause of these side effects?

Your patient, a 22-year-old young man, says he has been feel…

Your patient, a 22-year-old young man, says he has been feeling more energetic, feeling more artistic, skipping meals every day, drinking at least 6 cups of expresso coffee per day, and is now smoking two packs of cigarettes a day.  He has been maintained on Olanzapine (Zyprexa) 10mg daily for several months but it seems it has stopped working and you decide to double his dose of medication to Olanzapine (Zyprexa) 20mg daily.  You base your decision on which of the following statements?

A 28-year-old married woman presents with symptoms of mixed…

A 28-year-old married woman presents with symptoms of mixed episodes of mania and depression.  You are going to initiate treatment with a mood stabilizer.  Although the mood stabilizers should be used with caution with a woman of child-bearing age, which of the mood stabilizers is a known to be teratogenic?

Your patient has been taking 50mg of naltrexone daily for 3…

Your patient has been taking 50mg of naltrexone daily for 3 months and has had great success cutting down on his alcohol use. When he presents for his follow up visit later this week, you know you’ll need to obtain some bloodwork to maintain safe use of naltrexone. Which lab values will you be reviewing?