A 22-year old college student calls his psychiatrist because he notes that for the past week, after cramming hard for finals, that his thoughts have been racing and he is irritable. The psychiatrist notes that the patient's speech is pressured as well. The patient has been stable for the past 6 months on 500 mg of valproate twice a day. What is the first step the psychiatrist should take in the management of this patient's symptoms?
Sleep deprivation has an antidepressant effect in depressed patients and may trigger a manic episode in bipolar patients. The patient is not ill enough to require hospitalization. The use of a long-acting benzodiazepine will allow the patient to return to a normal sleep pattern and generally will abo the manic episode.
Hospitalize the patient
Increase the valproate by 500 mg/d
Prescribe clonazepam
Sta haloperidol