A 22-year-old college student calls his psychiatrist because for the past week, after cramming hard for finals, 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 six 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?

a. Hospitalize the patient

b. Increase the valproate by 500 mg/d

c. Prescribe clonazepam 1 mg qhs

d. Start haloperidol 5 mg qd

e. Tell the patient to begin psychotherapy one time per week

the answer is below…

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