In April 2000, at Psychiatry Grand Rounds, Gary Sachs, MD, discussed
the epidemiology, natural history, diagnosis, and treatment of bipolar disorder.1 Ms G, a 25-year-old woman, exhibited pressured speech,
tangential thinking, and labile affect prior to her 2 psychiatric admissions.
Due to her concern about weight gain with lithium carbonate, she was treated
with divalproex and olanzapine. As an outpatient, Ms G was taking divalproex
(750 mg, twice daily) and bupropion hydrochloride (150 mg, twice daily). She
recognized the ongoing need for medications, but hoped to get off them over
time. She wondered what other treatment modalities might be available to her.
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