Patient Encounter Part 4 Outcome Evaluation

Following initial assessment, including evaluation of potential suicidality, support systems, and need for inpatient versus outpatient treatment, MW was hospitalized briefly, then followed in the community on medication along with psychotherapy. She has abstained from illicit substances and has returned to her job. She has responded well to treatment with sustained-release lithium carbonate 900 mg once daily at bedtime with a snack. Steady-state 12-hour serum lithium concentrations have stabilized at 0.9 mEq/L (mmol/L). She now returns to clinic for routine follow-up. She has tolerated the lithium except for a mild tremor and a gain of 3.2 kg (7 lb). She is willing to accept these side effects for now, but asks about how long she must take medication since she is now feeling well.

How would you assess therapeutic and adverse effects of treatment for this patient?

How would you educate the patient regarding the need for continued maintenance treatment?

Use of antidepressant drugs during pregnancy is discussed in the chapter on depression.

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