Question

A 26-year-old woman comes to the physician because of a 3-week history of fatigue, poor concentration, decreased appette, and decreased interest in her usual activities. She sleeps at least 12 hours daily. She has had two similar episodes that resolved on their own after "many weeks and one episode of persistent increased energy that lasted for several weeks when she was a teenager. Her mother and father have both been treated in the hospital for "psychotic highs." Physical examination and laboratory evaluation show no abnormalities this patient is treated with a tricyclic antidepressant, she would be at increased risk for which of the following?

A) Cogwheel rigidity
B) Hypertensive crisis
C) Hypomania
D) Muscle rigidity
E) Myocardial ischemia

Answer 1

The patient presenting with a history of fluctuating mood episodes and a family history of psychotic highs is at increased risk for hypomania if treated with a tricyclic antidepressant.

Step-by-step explanation:

The patient's history of episodes of fatigue, poor concentration, decreased appetite, and decreased interest in usual activities, combined with periods of increased energy and a family history of 'psychotic highs,' suggest a possible mood disorder such as bipolar disorder. If this patient is treated with a tricyclic antidepressant, she would be at increased risk for hypomania (C). This is because tricyclic antidepressants can precipitate manic or hypomanic episodes in patients with bipolar disorder. It is crucial to properly diagnose a patient before prescribing antidepressants, as the risk of inducing a switch into mania or hypomania is an acknowledged concern in bipolar disorder treatment.