Assessing and Treating Clients with With Bipolar Disorder 2

Introduction Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental disorder that causes unusual shift in mood, energy, activity levels, concentration, and the ability to carry out day0to0day tasks, (National Institute of Mental Health, 2020). According to Parekh, (2017), “bipolar 1 disorder can cause dramatic mood swings. During a manic episode, people with bipolar 1 disorder may fell high and on top of the world, or uncomfortably irritable and revved up.” Bipolar disorder has a global lifetime prevalence of about 2.4% reported across America, Europe, Asia, Middle East and New Zealand. Researchers have noted a comparatively higher prevalence of bipolar disorder amongst those with Asian ethnicity when compared to the Caucasians, (Subramanian, Sarkar, & Kattimani, 2017). According to American Psychological Association, (2020), Suicide rates among the Asian American are thirty percent high between ages fifteen to twenty-four among Asian females compared to white females of the same age. The purpose of this assignment is to analyze a case study involving an Asian American Woman With Bipolar Disorder and use three decision points to prescribe medications suitable for this patient, taking in to consideration factors that might impact the patient’s pharmacokinetic and pharmacodynamics processes. Decision Point #1 For decision point # 1, I am presented with three options to either start the patient on Lithium 300 mg orally BID, Risperdal 1 mg orally BID, or Seroquel XR 100 mg orally at HS. Based on data presented in the case study, I will start the patient on Risperdal 1 mg orally BID. Risperdal is considered as an “atypical antipsychotic.”According to Stahl, 2013, “when atypical antipsychotics were approved for schizophrenia, it was not surprising that these agents would work for psychotic symptoms associated with mania, since the D2 antagonist actions predict efficacy for psychosis in general.”Mood stabilizers have the ability to “tune” dysfunctional circuits, increasing the efficiency of information processing in symptomatic circuits, thus decreasing symptoms whether manic or depressed. The treatment of bipolar disorder is not only with two or more agents, but with one of those agents being an atypical antipsychotic, (Stahl, 2013). Risperdal is “commonly prescribed for bipolar maintenance (long-acting microspheres intramuscular, monotherapy and adjunct to lithium or valproate,). In adult with psychosis in nonemergent settings, initial dose recommendation is 1 mg/day orally in 2 divided doses (Stahl, 2017). I did not start the patient on Lithium because based on data collected during the patient’s visit, she had stopped taking her previously prescribed Lithium two weeks ago, probably due t