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Discussion week#3: Psychotic Disorder

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Discussion week#3: Psychotic Disorder

Hello class. In reviewing the case study about WG, the thirty-one-year-old female who

has been admitted to my inpatient unit from the E.D., the primary treatment that I will

recommend for her presentation and maniac episode diagnosis are mood stabilizers (Stahl, 2021).

To be precise, I will start W.G. on lithium carbonate at 300mg, orally twice a day, and ensure I

closely monitor her serum levels. My rationale for recommending W.G. lithium carbonate is that

it is evidenced to be effective in stabilizing mood, managing acute mania and decreases the

likelihood of recurrent episodes from happening (Stahl, 2021). The other reason I chose lithium

is that it has a faster rapid onset of action, which is efficient to manage W.G.'s present symptoms.

In addition, the monitoring I will do encompasses regularly assessing the serum lithium

levels, thyroid function tests, renal function tests and electrocardiograms because of the side

effects that lithium has on these systems. Based on the study by Gabbard. (2014), for lithium to

be effective and minimize toxicity risks, I have to maintain the lithium level to range between

0.8-1.2 mEq/L (Gabbard, 2014). Also, I will educate W.G. on the vitalness of strictly following

her medication regimen and I will regularly check up on her to ensure she adheres to it.

Furthermore, since W.G. was diagnosed with a manic episode, I will regularly monitor

her elevated blood pressure (150/90 mmHg) to ensure the lithium medication controls it

(Fountoulakis et al.,2022). If I find out that the blood pressure remains high despite prescribing

W.G. lithium carbonate at 300mg orally twice a day, I will prescribe her another medication, an

antihypertensive medication like the low-dose beta-blocker such as propranolol. For the beta-

blocker, I will start W.G. at propranolol 10 mg orally twice daily and then titrate it depending on

how W.G.'s blood pressure responds (Fountoulakis et al.,2022). Lastly, the other thing I will

monitor is the electrolyte. Since W. G.'s sodium level is (120 mEq/L), it will be significant I
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monitor the electrolyte to ensure the lithium I recommended her does not lower the sodium

levels. I will then recommend W.G. stay hydrated to help stabilize the sodium levels. However, if

the sodium levels fail to decrease, I will then adjust the treatment plan.
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References

Fountoulakis, K. N., Tohen, M., & Zarate, C. A., Jr (2022). Lithium treatment of bipolar disorder

in adults: A systematic review of randomized trials and meta-analyses. European

neuropsychopharmacology: The Journal of the European College of

Neuropsychopharmacology, 54, 100–115.

https://doi.org/10.1016/j.euroneuro.2021.10.003

Gabbard, G.O. (2014). Gabbard's treatments of psychiatric disorders (5th ed.). American

Psychiatric Publishing

Stahl, S. M. (2021). Stahl's essential psychopharmacology: Neuroscientific basis and practical

applications (5th ed.). Cambridge University Press.