A 38-year-old woman with bipolar disorder has been stable on lithium for the past two years. She comes to her psychiatrist’s office in tears after a two-week history of a depressed mood, poor concentration, loss of appetite, and passive suicidal ideation. Which of the following is the most appropriate next step in the management of this patient?

a. Start the patient on a second mood stabilizer

b. Start the patient on a long-acting benzodiazepine

c. Stop the lithium and start an antidepressant

d. Start an antidepressant and continue the lithium

e. Stop the lithium and start an antipsychotic

the answer is below…

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