Assessing and Treating Clients with Bipolar Disorder

Assessing and Treating Clients with Bipolar Disorder

Bipolar disorder is an extreme emotional unsteadiness with genuine results for everyday living of patients and their guardians. Mind as usual principally comprises of pharmacotherapy and reliable treatment. In any case, a substantial number of patients demonstrate a defective reaction to treatment and experience the ill effects of incessant scenes, steady inter-episodic side effects, and poor social working. Both psychiatric and physical comorbid issue are visited, particularly identity issue, substance mishandle, cardiovascular maladies and diabetes. The multidisciplinary coordinated effort of experts is expected to join all skill with a specific end goal to accomplish great-incorporated treatment (Fisher et al., 2017). A few reviews have demonstrated likely impacts of coordinated treatment programs for patients with bipolar disorder. In this paper, bipolar therapy is examined with considerations to making the right treatment choices amid ethical considerations.

Decision Point One

Selected Decision

Begin Risperdal 1 mg orally BID

Reason for the Selection

The drug, Risperdal (risperidone), is a second generation or atypical antipsychotic agent whose uses include management of bipolar disorder. Its main action is through rebalancing the dopamine and serotonin and thereby to improve mood, to think, and behavior. Given that the patient was diagnosed with bipolar disorder, Risperdal is the best choice considering the available medications. In the prior treatment, the patient defaulted in lithium, and so it may not be a moral idea to begin lithium 300 mg as the chances are that the patient may not comply (Hamlat, O’Garro-Moore, Alloy, & Nusslock, 2016). Seroquel XR may be a good choice, but its side effects may include weight gaining and constipation. This may not be well received by the patient who defaulted in using lithium which has a similar side effect of constipation.

Expected Results

The patient should be able to improve within the first four weeks. The symptoms should reduce significantly with an improvement in the patient’s mood. The patient should exhibit a good sleeping pattern. Risperdal is an effective medication for balancing mental activity and restore sanity in the way that the patient thinks (Wilson, Crowe, Scott, & Lacey, 2017). The suicidal thoughts should decrease as well as symptoms of anxiety.

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The patient visited the hospital after four weeks, and she was lethargic and sedated. Her mum had to accompany her into the office. It was stated that these symptoms appeared after one week of medication. This was contrary to the anticipated results of reduced the symptoms of bipolar. It was expected that the patient would have improved mood and appropriate thinking. The difference in the results is the side effects of the drug. The high amount of Risperdal in the blood leads to sedation. Given that the patient is of Korean ancestry and positive for CYP2D6*10 allele means that she may not have a swift clearance of Risperdal from the blood leading to accumulation (Demant, Vinberg, Kessing, & Miskowiak, 2015).

Decision Two

Selected Decision

Decrease Risperdal to 1 mg at HS

Reason for Selection

Risperdal 1 mg orally BID did not fail to work during the second visit; it only caused side effects. It is wise to alter the dosage to manage the side effects rather than cease the medication for another. Altering Risperdal to 2 mg at HS may still attest to be a lot, and the side effects may not be sufficiently managed. A choice to switch back to lithium is still not right as the patient still has an attitude towards it (Demant, Vinberg, Kessing, & Miskowiak, 2015). Furthermore, it might confuse the patient on drugs used. Helping her cope with different dosage of the same drug will increase her confidence in drugs and appreciate that it is all about the alteration of the dosage.

Expected Results

As mentioned previously, Risperdal is effective in balancing dopamine and serotonin in the brains and thus managing mood, behavior and thought problems. The adverse effects have been ascribed to the accumulation of Risperdal in the patient’s blood. Lowering the dosage to Risperdal 1 mg at HS will warrant no accumulation of the drug in the patient’s blood as the body will be able to excrete it quite quickly. By altering the dosage, the patient should begin being less sedated and less lethargic. The patient should also begi