Client seen today at xxxx for first time and was previously followed at xxxx but due to intensive treatment needs, will be followed by XXX and client was initially confused about the change and confirmed understanding after writer's explanation. [pdoc]
She recently was hospitalized at UM 9C 10/1-10/10 for SI [suicidal ideation], mania, psychosis and had zyprexa increased to 10 mg during admission then was at XX 11/12 for SI, psychosis.
Today she denies AH/VH/IOR/paranoia, endorses stable mood without hypomania or mania, low anxiety and depression energy, & appetite normal no wight changes, sleeps 8 hours, memory is variable and low at times.
She has history of mania with psychosis - VH-sees animals. "cat disappearing." AH [audio hallucinations] "someone talking, music playing" referential delusion-"sun giving me messages, I could fly". Grandiose delusions-I was invincible, could walk into traffic and nothing would happen", elevated and irritable mood-"everything is wonderful", agitation- "moving a lot," occasional thoughts of wanting to stab herself "reported this was a chronic issue that did not increase her desire to commit suicide," or inflict self-harm.
Client is not sure why she had episode this fall or last fall because she notes medication adherence and also remarked the last year in November, she had another manic/psychotic period and thinks the fall may be a bad time for her. Per [hospital] admission note during her two weeks prior to hospitalization, client was posting multiple blogs [I just have this one blog.] and writing more, internal restlessness, almost jumping off balcony, increased pressure to talk and stay up past midnight on phone with friends, racing thoughts, low concentration, increased energy, appetite decreased, mildly decreased sleep....
11/26/13
CURRENT SIDE EFFECTS< ADHERENCE ISSUES AND PREVIOUS MEDICATION TRIALS
latuda trial - akathisia, w 20mg dose
fanapt - tachycardia w 4mg dose
depakote - weight gain, worked well
seroquel - itching
nortriptiline
abilify - akathisia
geodon - induced asthma attack
saphris - "internal hallucinations"
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