what is the best therapy for Bipolar Disorder?

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Decision Tree for treating Bipolar Disorder using medication options provided giving rational for choosing that medication and expected results/outcome as well as ethical considerations

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The Assignment Examine Case Study: An Asian American Woman With Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes. At each decision point stop to complete the following: • • • Decision #1 o Which decision did you select? o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different? Decision #2 o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different? Decision #3 o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Also include how ethical considerations might impact your treatment plan and communication with clients. In summary: What needs to be in the essay. -Introduction regarding disease state -High-level summary of patient case -Purpose of the essay statement 1, Decision 1 -What options were listed -What option did you choose? -Why did you select that option? -Why didn’t you select the other two options? -What was your goal of treatment -Was the outcome what you expected? Why? 2, Decision 2 -What options were listed -What option did you choose? -Why did you select that option? -Why didn’t you select the other two options? -What was your goal of treatment -Was the outcome what you expected? Why? 3, Decision 3 -What options were listed -What option did you choose? -Why did you select that option? -Why didn’t you select the other two options? What was your goal of treatment -Was the outcome what you expected? Why? -Conclusion with Ethical considerations Resourse : Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press BACKGROUND INFORMATION The client is a 26-year-old woman of Korean descent who presents to her first appointment following a 21-day hospitalization for onset of acute mania. She was diagnosed with bipolar I disorder. Upon arrival in your office, she is quite “busy,” playing with things on your desk and shifting from side to side in her chair. She informs you that “they said I was bipolar, I don’t believe that, do you? I just like to talk, and dance, and sing. Did I tell you that I liked to cook?” She weights 110 lbs. and is 5’ 5” SUBJECTIVE Patient reports “fantastic” mood. Reports that she sleeps about 5 hours/night to which she adds “I hate sleep, it’s no fun.” You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits. You find that the patient had genetic testing in the hospital (specifically GeneSight testing) as none of the medications that they were treating her with seemed to work. Genetic testing reveals that she is positive for CYP2D6*10 allele. Patient confesses that she stopped taking her lithium (which was prescribed in the hospital) since she was discharged two weeks ago. MENTAL STATUS EXAM The patient is alert, oriented to person, place, time, and event. She is dressed quite oddly- wearing what appears to be an evening gown to her appointment. Speech is rapid, pressured, tangential. Self-reported mood is euthymic. Affect broad. Patient denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment is grossly intact, but insight is clearly impaired. She is currently denying suicidal or homicidal ideation. The Young Mania Rating Scale (YMRS) score is 22 Running head: Bipolar Therapy Decision point 1: Begin Risperdal 1mg orally BID Decision point 2: Decrease Risperdal to 1mg at HS Decision point 3: Continue at the same dose of Risperdal and reassess in 4 weeks ...
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Tutor Answer

Proff_White
School: Carnegie Mellon University

Attached.

Running head: TREATMENT OF BIPOLAR 1 DISORDER

Treatment of Bipolar 1 Disorder

Student’s name:
Institutional affiliation:

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TREATMENT OF BIPOLAR 1 DISORDER

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TREATMENT OF BIPOLAR 1 DISORDER
Introduction
The paper will examine the case of a 26 year old Korean woman. A number of Asian
American women face this disorder. Conferring suicide in numerous Asian societies is viewed as
a corrupt and insolent act to one's parents and predecessors. Numerous Asian American women
with despondency will express uninvolved self-destructive musings when addressed delicately.
The Bipolar disorder refers to extreme emotional instability through honest that comes about for
ordinary living of patients and their caregivers (Stahl, 2013). The brain as usual primarily
involves pharmacotherapy and stable treatment.
Regardless, countless shows an inadequate response to treatment and still experience the
evil impacts of unending scenes, symptoms and poor social working. Both psychiatric and
physical issue visits, especially personality issue, substance misuse, cardiovascular diseases, and
diabetes (Stahl, 2013). The multidisciplinary composed exertion of specialists is required to join
all ability with a particular real objective to finish effective consolidated treatment. A couple of
audits have exhibited promising effects of composed treatment programs for patients with
bipolar issue. We also present an ethical consideration to the decision regarding the bipolar
disorder.
1. Decision 1
Decision: Begin Risperdal one mg orally Bis In Die (BID)
Reason
Risperdal, whose logical name is risperidone, is a moment era or atypical antipsychotic
whose utilizations incorporate treatment of the bipolar issue. It attempts to rebalance the
dopamine and serotonin and along these lines enhancing inclination, considering and conduct.

TREATMENT OF BIPOLAR 1 DISORDER
Since the patient was determined to have bipolar disorder, Risperdal is the best alternative
considering its accessible prescriptions. In the past treatment, the patient defaulted on lithium
(Vitiello, 2013). Thus, it may not be a good thought to start lithium 300 mg as chances are the
patient may not go along. Seroquel XR might be a decent alternative yet its reactions may
incorporate weight gain and obstruction. It may not be acknowledged well by the patient who
defaulted in utilizing lithium that is the equal reaction in stoppage.
Goals
For the first four weeks, the patient needs to have the capacity to show progress. The
manifestations should diminish incorporating a change in the state of mind. The patient should
have the ability to begin getting increased rest and getting a charge out of it. Risperdal is a
powerful solution for adjusting mental action that needs to have the capacity to re-establish
logical soundness in the way the patient considers and responds to matters. The self-destructive
practices and tensional response to issues should diminish. Apart from that, anxiety and lack of
calmness should also lessen (Tondo, 2013).
Real and Expected Outcomes
Following four weeks, the patient went to the doctor's facility, and she was calmed and
dormant. Indeed, her mother needed to escort her and help her into the workplace. It accounted
for that these indications ejected following one week of the drug. It is in opposition to the
foreseen consequences of lessened bipolar side effects.
It was standard that the patient would have enhanced the state of mind and appropriate
considering. The distinction in the outcomes is because of the reactions of the medication. A
high measure of Risperdal in the blood prompts sedation. The way that the patient is of Korean

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TREATMENT OF BIPOLAR 1 DISORDER

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plunge and positive for "CYP2D6*10 allele" implies that she might not have quick freedom of
Risperdal from the blood promoting aggregation.
2. Decision 2
Decision: Reduce the Risperdal to one mg at HS
Reason
The second visit does not demonstrate that the Risperdal 1 mg orally BID has neglected
to work; it just gives the reactions. It is important to change the dose to deal with the symptoms
instead of end the medicine for another. Changing Risperdal to 2 mg at HS may, in many cases,
turn out to be a great deal, and the...

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