Question

A 30-year-old man with known bipolar disorder presents with a 2-week history of decreased need for sleep, pressured speech, grandiose ideas and disinhibited behaviour. There is no evidence of substance misuse. What is the most appropriate immediate management?

Accepted Answer

Urgent psychiatric assessment and initiation or optimisation of mood-stabilising treatment such as Lithium or an antipsychotic

Answer

Start an SSRI antidepressant alone

Answer

No treatment; this will resolve spontaneously

Answer

Prescribe hypnotics only for sleep

Answer

Refer for routine outpatient counselling with no medication

Practice question

A 30-year-old man with known bipolar disorder presents with a 2-week history of decreased need for sleep, pressured speech, grandiose ideas and disinhibited behaviour. There is no evidence of substance misuse. What is the most appropriate immediate management?