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Acute Manic Case Study

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A 54-year-old man is brought to the emergency department by police after he was found breaking into a food bank. He reports that he discovered a foolproof way to preserve food indefinitely and just needed to try it out on a larger supply. He states that this is too important to delay because it will end world hunger. He has a history of depression and anxiety. In the emergency department, he is alert and has rapid, pressured speech. He is fidgety and eager to get out of the hospital and to continue testing his product. His temperature is 37.5ºC (98.7°F), blood pressure is 129/84 mmHg, pulse is 98 beats/min, and respirations are 18 breaths/min. In addition to beginning lithium, therapy should be initiated with a medication targeting which …show more content…

The patient’s manic episode with underlying depression is consistent with bipolar disorder. Therapy for acute manic episodes includes initiation of a mood stabilizer like lithium as well as an atypical antipsychotic such as risperidone. Risperidone decreases positive symptoms like mania by inhibiting D2 dopamine receptors. D2 receptors in the mesolimbic pathway are thought to be responsible for psychotic episodes.
Choice "A" is not the best answer. Acetylcholine is a neurotransmitter at the neuromuscular junction and also a neurotransmitter in the autonomic nervous system. Acetylcholine is not affected by risperidone, nor is it related to acute mania.
Choice "C" is not the best answer. Glutamate is the primary excitatory neurotransmitter of the central nervous system, but is not associated with acute mania. Risperidone does not affect glutamate transmission.
Choice "D" is not the best answer. Risperidone has been shown to antagonize α-adrenergic receptors. This is partially responsible for the sedating effects of antipsychotics. However, adrenergic receptors are not responsible for acute manic episodes.
Choice "E" is not the best answer. Serotonin receptors are inactivated by risperidone, but these are not the primary neurotransmitters responsible for acute mania. Serotonin is primarily responsible for mood and is the target of most

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The essay ‘’Bipolar Disorder: The Agony and the Ecstasy” written under the pseudonym Thomas Wheaton focus on the pleasant and the appalling sides of having bipolar disorder such as the medication, the different types of disorders there are, also how others treat people with bipolar disorder. To start off with some of the medications are Depakote, Zoloft, Xanax and Trazodone which a few must be taken daily or whenever needed. However, like every medicine there are side effects including but not limited to organ damage, heat-sensitive, dry mouth, also dizziness. Wheaton says he from his experience he must drink unpleasant amount of water just to avert serious side effects. To continue, the medicine help whoever take it feel stability is more

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D-The patient was placed on HOLD to address her no show for last week. This writer asked the patient if she was okay with tomorrow 's appointment based on her appointment letter. The patient to do the session today since she 's already present and waited for this counselor. This writer agreed to conduct the session. Reports stable on her dose and deny the need for a dose decrease as she denies any cravings/withdrawals.

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In the story “Bipolar Disorder: The agony and the Ecstasy” by Thomas Wheaton, he discusses the treatments, side effects from treatments, and struggles with having Bipolar disorder. In fact, having bipolar disorder requires various versatile treatments. Wheaton actually talks about taking medication, writing in his journal, and talking to a therapist to control the disorder. Taking medication was most important, because missing a dose would make him unsuitable for the public. Of course, when taking medications there comes a range of risky side effects.

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To further exemplify this, “The human body manufactures serotonin, which many researchers believe plays a role in mood balance” (Campbell 1). Antigone takes full accountability for her actions and this is true because of the brain chemicals pushing her to. Additionally, “Serotonin has been labelled the confidence neurochemical. Higher serotonin activity is related to greater feelings of confidence, which in turn gives you the drive to do the things that build self-esteem” (Bishop 11). Serotonin affects the central nervous system and the peripheral nervous system.

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Mania symptoms cause significant impairment in your life and may require hospitalization. b. Bipolar II disorder. You’ve had at least one major depressive episodes lasting at least two weeks and at least one hypomanic episode lasting at least four days, but you’ve never had a manic episode. Major depressive episodes or the unpredictable changes in mood and behavior. c. Cyclothymic disorder.

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Finding might require some serious energy some time might go before the right conclusion is affirmed. Different conditions or diseases which might have concealed indications should be discounted. Treatment DS is a condition that keeps going all through life - it is an incessant condition. Patients with DS need treatment on a constant premise; notwithstanding when indications appear to have left - a period when patients might be slanted to feel that they are fine and require no more offer assistance. Treatment is radically the same for all types of schizophrenia; there are varieties relying upon the seriousness and sorts of indications, the strength of the patient, his/her age, and additionally some different variables.

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According to DSM- 5 (2012) 5th, manic episode’s criteria: A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary) B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree and represent a noticeable change. • Inflated self-esteem or grandiosity • Decreased need for sleep (e.g., feels rested after only 3 hours of sleep) • More talkative than usual or pressure to keep talking • Flight of ideas or subjective experience that thoughts are racing • Distractibility (i.e., attention too easily drawn to unimportant or

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In addition, they having the ability to affect the mood, weight, concentration, sleep might cause unfavorable symptoms. While they balanced in the out of range. Neurotransmitter level might be exhausted in several ways. There are two types of neurotransmitters

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Both nonpharmacological therapy and pharmacological medications must be used to boost the long term outcomes. Nonpharmacological treatments help with pharmacological medicines by guaranteeing that the patient stays on track with their medications. According to the American Psychiatric Association, second-generation (atypical) antipsychotics (SGAs) are the first-line treatment for schizophrenia except for Clozapine. SGAs are the best-liked over typical antipsychotics (FGAs). FGAs are connected with high extrapyramidal symptoms, which are drug-induced movement disorders such as tremors, jerky movements, and the slowness of movements.

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The vast majority with bipolar issue are of the moderate cycling sort — they encounter long stretches of being up ("high" or hyper stage) and of being down ("low" or depressive stage). Specialists don 't yet comprehend why a few people cycle more rapidly than

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is an illness in which schizophrenic and manic symptoms are both prominent in the same occurrence of the disease. The irregularity of mood typically takes the form of euphoria, accompanied by grandiose ideas and joined by increased self-esteem, but sometimes irritability or excitement are more apparent and joined by aggressive or forceful behavior and persecutory thoughts. In both cases, there is impaired concentration, overactivity, increased energy and a loss of normal social self-consciousness. Delusions of reference, persecution or grandeur, may be existing (Perry, Alexander, Liskow, & DeVane,

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Kring & Johnson (2013) note that treatment for schizophrenia most often includes a combination of short-term hospital stays, medication and psychosocial treatment (p. 275). Antipsychotics type of medication would be used for Russell for the Schizoaffective Disorder such as Zyprexa or Seroquel. Russell is currently on the medication Geodon which is used to treat schizophrenia. Preston et al. (2013) note that the antipsychotic medications tend to be effective in the treatment of the psychotic symptoms, regardless of the disorder (p. 233).

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SSRIs work by blocking the reuptake of serotonin in to the brain causing an increase in the serotonin that is being transmitted to the brain cells. The extra serotonin hinders sexual arousal and reduces the capacity of an orgasm. The blocking of the reuptake of serotonin is seen to have a possible effect on sex offender in four different ways: non-specific inhibition of sexual interest; reduction of impulsiveness; decrease of obsessive-compulsive symptoms; and treatment of concurrent depressive symptoms. (Garcia, Delavenne, Assumpcao, Thibaut, 2013) This treatment is a lower level treatment best used with patients who deal with pedophilic thoughts but who do not act on them.

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Antipsychotic medications help regulate the neurotransmitter known as dopamine in the brain, which is responsible for the symptoms experienced by schizophrenics. The physician in charge attempts to find the optimal lowest dose for managing psychotic symptoms. If the individual is also experiencing anxiety and depression, then medications targeting these disorders are also prescribed. Side effects from medications can be a deterrent to a patient’s willingness to abide by dosage requirements. In this case, injections may replace

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CLINICAL SCENARIO AND IDENTIFICATION OF DECISION CHOSEN As part of my exploration to fulfill the requirement of the clinical decision- making analyses, I have identified a scenario in my working environment, which is Penang Hospital in Psychiatric Department. A female patient has been admitted into the female psychiatric ward, which was diagnosed to suffer bipolar mood disorder. In brief, the patient, who is 38-years old, has been further analyzed to undergo auditory hallucination and it could not be controlled due to allergic of anti-psychotic medication (Haloperidol and Clopixol Acuphase). Describing further on her condition due to bipolar mood disorder, she was irritable and restless most of the time.

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