Mr. BW (male, 37 years old) has a past medical history of bi…

Mr. BW (male, 37 years old) has a past medical history of bipolar disorder and has been stable on valproate semisodium (valproic acid) 1g twice a day for 3 years. He has been admitted to hospital and diagnosed with severe bipolar depression. His psychiatrist deems it appropriate to prescribe lamotrigine in addition and asks you to advise on the starting dose for Mr. BW.   What initial dose would you advise?

Miss HT (female, 27 years old) presents to the GP with her m…

Miss HT (female, 27 years old) presents to the GP with her mother. During the consultation, Miss HT says she is hearing voices and can feel insects crawling in her ears. The GP notes that her speech and thoughts seem disorganised, and her mother is very concerned as this is not usual for Miss HT. Miss HT has no significant medical history. Her blood pressure is 132/85mmHg, temperature 37.1°C, blood glucose 7.5mmol/L, midstream urine (MSU) is negative for nitrites and leucocytes and there is no recent history of head trauma.   Which is the MOST LIKELY working diagnosis?