Bipolar Therapy for a Client of Korean Descent
Name
Institution
BIPOLAR THERAPY FOR A CLIENT OF KOREAN DESCENT 2
Bipolar Therapy for a Client of
... [Show More] Korean Descent
Bipolar disorder is a recurrent, chronic mental health condition that is characterized by
fluctuations in mood, energy levels, activity levels, sleep, and concentration (Vieta, Berk,
Birmaher & Grande, 2016). Bipolar therapy is aimed at managing the condition. However,
several factors can affect the pharmacology and psychosocial strategies that are included in the
therapy, and most of them are client factors. These factors include medical and psychiatric
comorbidities, previous treatment therapies, response and adverse effects on using the medicines,
and the client's willingness to commit to the treatment plan (Vieta, Berk, Birmaher & Grande,
2016).
The purpose of this paper is to examine the management of bipolar 1 disorder in a client
of Korean ancestry using a decision tree.
The Case Study
The client is a 26-year-old woman of Korean ancestry who has been diagnosed with
Bipolar 1 disorder and has been hospitalized for 21 days for onset of acute mania. Genetic testing
has revealed that she is positive for the CYP2D6*10 allele. Her condition was managed using
lithium while she was in the hospital, but has since stopped using the medication after she was
discharged. Mental status examination reveals that she is in a self-reported euthymic mood, she
is dressed oddly, has a rapid and pressured speech, broad affect, and impaired insight. She has a
score of 22 on the Young Mania Rating Scale (YMRS). She is 5.5 and weighs 110lbs.
Decision Tree
Decision Point One
The decisions at this point are to start Lithium 300mg orally BID, Begin Risperdal 1mg orally
BID, or to begin Seroquel XR 100mg orally at HS.
BIPOLAR THERAPY FOR A CLIENT OF KOREAN DESCENT 3
The decision at this point is to begin Lithium 300mg orally BID.
Lithium has been effective in the treatment of bipolar disorders and remains the gold
standard of the treatment and preventing recurrences associated with this condition. It is also
effective in preventing suicidal behaviors that are associated with bipolar disorder (Tondo et al.
2019). The client has previously used lithium, and it was effective in managing her condition.
The recurrence of the symptoms is possibly due to her non-adherence to the medication after
being discharged from the healthcare facility. Initiating lithium is the perfect choice for this
client. However, this time she should be closely monitored with the necessary tests being done as
the use of lithium is associated with lithium toxicity when there is a high dosage is used (Tondo
et al. 2019). Although lithium is an effective medication for the condition, several factors need to
be considered. The client has a history of non-compliance, and she should be educated on the
need to adhere to the prescribed medication and also the need for regular tests, which will be
used to monitoring the effect of lithium use (Stahl, 2017). The client should also be educated on
the dietary restrictions when using lithium, such as the use of caffeinated drinks (Stahl, 2017) as
well consultation, when she will need to use any other medication such as NSAIDs, which
increase the risk of lithium toxicity (St [Show Less]