Problem: WG, a 31-year-old female, has been admitted to your inpatient unit from the ED where she presented unwillingly and accompanied by her husband. She is unable to provide a history right now, but her husband is able to give you the following information: He reports over the past 2 weeks the patient has been uncharacteristically energetic, starting tasks and not finishing them, exhibits hypersexuality, is highly distractible with a speech that is "nonsensical". Her speech has also been rapid and pressured. She only sleeps every second or third night and has abdicated all attempts at self-care such as hygiene or grooming.
The ED diagnosed her with a manic episode.
Substance Hx: There is no documented history of smoking, alcohol, or illicit substance use.
PPH: There is no history of any psychiatric illness in the patient or her family.
Labs: A full workup has been completed and all was normal with the exception of the abnormal findings listed in the table below:
| Lab/Vitals |
Today |
| Blood pressure |
150/90 (H) |
| Sodium |
120 (L) |
Include in your discussion:
1. What do you recommend for treatment (focus on psychopharmacologic treatment) and monitoring of WG's current symptoms?
2. What, if any, considerations should be made?