I made some notes as he was testifying this AM. I may not have all of this correct so please correct me.
7/20/10 Assumed care of patient. Dx: Bipolar I with psychotic tendencies. Meds: Cogentin, Trazadone, Lamictal
7/23/10: PC (phone call) Rx Buspar
8/3/10: Mild depression; decreased appetite. Rx: Lamictal, Cogentin, Clonipin
8/10/10: Slightly worse depression Rx: Lamictal, Cogentin (lower dose), Clonipin, Effexor
8/20/10: PC: Increase Cogentin, Effexor
8/27/10: Wean off Effexor Rx: Lamictal, Clonipin, Cogentin
9/7/10: Mild to moderate depression; lack of energy; Rx: Lamictal, Cogentin, Lithium ER
9/14/10: Mild depression, lack of energy, mild irritability Rx: Lamictal Cogentin, Lithium ER, Clonipin
9/28/10: Mild depression, irritability, Mood: Sad Rx: Lithium ER, decrease Cogentin and Lamictal, Clonopin
10/12/10: After vacation to see a friend, mood better. Rx: Cogentin, Clonopin, Lithium ER, increase Lamictal
10/26/10: Rx: Lamictal 200mg BID, Cogentin, Clonopin, Lithium ER, Celexa
12/3/10: Rx: Cogentin, Clonopin, Lithium ER, Celexa. Told about Rehab.
At some point, Dx of Schizo Affective Disorder was added. Therapy ongoing. Minimal communication between therapist and Psychiatry resident. Blood work to check Lithium level was done in September.
12/10/10: Moderate depression, Vague Suicidal Ideation without specific intent, some helplessness/hopelessness. Mood down. Good hygiene. Moderate risk for suicide. Limited insight and awareness. Baker Act criteria assessed. Patient was in intensive O/P care. HIPAA prevented Dr from communicating with family. JS declined to authorize anyone via HIPAA. JS was negative for Terasoft (threat to harm others).
Clozaril can be used in lieu of Lithium, but it requires intensive monitoring and blood work.