NURS 6521: Case Studies Case1: Jamie, a 38-year-old patient & Xavi a 44-year-old man
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Course
NURS 6521
Institution
NURS 6521
Case1: Jamie, a 38-year-old patient with bipolar disorder
Treatment plan
Jamie's current presentation of acute psychosis necessitates a comprehensive treatment plan with both pharmacological and psychosocial interventions. As stipulated by Volkmann et al. (2020), lithium carbonate serves as the c...
Case1: Jamie, a 38-year-old patient with bipolar disorder
Treatment plan
Jamie's current presentation of acute psychosis necessitates a comprehensive
treatment plan with both pharmacological and psychosocial interventions. As stipulated by
Volkmann et al. (2020), lithium carbonate serves as the cornerstone of treatment due to its
well-established efficacy in mood stabilization for bipolar disorder. Regular therapeutic drug
monitoring is crucial, ensuring serum lithium levels remain within the therapeutic range of
0.6-0.8 mol/L. This will ensure maximization of efficacy while minimizing potential side
effects such as tremors or gastrointestinal upset. To address the immediate psychotic
symptoms, initiating an atypical antipsychotic medication is recommended. Risperidone 1-
2mg daily for a month with a refill can be efficacious in managing acute manic and psychotic
symptoms associated with bipolar disorder with minimal risk of mood destabilization
(Hodkinson et al. 2021).
Psychosocial support is also crucial for this patient. Karrouri et al. (2021) suggest that
psychotherapeutic interventions complement pharmacotherapy optimally. Therapies like
cognitive-behavioral therapy (CBT) can equip Jamie with coping mechanisms to manage
stressors effectively. CBT focuses on identifying and reframing negative thought patterns that
can exacerbate mood swings. Supportive therapy provides a safe space for him to process his
experiences and develop emotional resilience. These interventions can enhance medication
adherence, leading to a more sustainable recovery.
Discontinuation of medications
Even though the recently added amitriptyline has antidepressant properties that could
help this patient, its use in bipolar disorder is concerning. According to Berkol et al. (2019),
amitriptyline has a documented risk of inducing manic episodes or rapid mood cycling in
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