You have a PMHNP co-worker who is new to practice. She asks…

You have a PMHNP co-worker who is new to practice. She asks if you will consult on one of her patients. She inherited a patient from a psychiatrist in town that has since retired. The patient is a 52-year-old male that has a history of bipolar disorder and is currently taking: depakote ER 1000 mg twice daily, lamotrigine 200 mg daily, abilify 30 mg daily, zyprexa 20 mg daily, seroquel 100 mg daily at night and clonazepam 1 mg three times daily. She notes the patient “looked like he was drooling” during the appointment and was concerned with all the medications that he was on and interactions. When looking at the combination of depakote and lamotrigine what is your best response:

Mary is a 52-year-old female that comes into the clinic as a…

Mary is a 52-year-old female that comes into the clinic as a referral from her PCP. She has been on fluoxetine, sertraline, escitalopram and duloxetine for her anxiety and it made her symptoms worse and more irritable. When talking with her she has had periods in her life where she was on top of the world. Could do anything and felt like she was the best out there. Her thoughts would race, she would be more talkative, did not need to really sleep due to all the ideas that she was having. She has had this last greater than 4 days but no more than 6 days. The symptoms did not greatly impact her life and was able to hold a job but completely noticeable to others. She will then hit a major depression that is debilitating and has had to take off of work due to the depressive episodes. What criteria does she fit best: