Bipolar 1 Mania - Refusing Depakote and lithium, maxed on Zyprexa, thoughts?

I have a 60 something male with history of bipolar 1 disorder. Started on Zyprexa when they came in, is now sleeping and not receiving PRNs anymore. However, still very grandiose (knows several famous people, is writing a new Bible) and paranoid that his family is conspiring against him. Remains pressured and tangential. They are voluntary and up to 20 mg of Zyprexa, but refusing Depakote or lithium. Started Lamictal as they tolerated in the past but I know its not going to be as helpful for... Read more
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Psychiatry Source Type: forums