Corconsult Rx: Evidence-based Medicine And Pharmacy

Below is the patient case information: 63-year-old white male. Problem List Bipolar II disorder Insomnia Epilepsy (tonic-clonic seizures) Dyslipidemia/hypertriglyceridemia Hypertension Recent weight gain History of hyponatremia  Diabetes type 2(controlled) Medications Clonazepam 2 mg QHS Risperdal 2 mg twice daily Carbamazepine 200 mg twice daily Divalproex DR 500 mg three times daily Levetiracetam 1000 mg twice daily Losartan 100 mg daily HCTZ 25 mg daily Atorvastatin 40 mg daily Fenofibrate 48 mg daily Metformin ER 500 mg twice daily Vitals: Blood pressure is currently 144/86 mmHg Lipids: LDL-C: 98 Triglycerides: 245 (down from 423 4 months ago) CMP: Na+: 133 K+: 4.1 eGFR: 95 All others WNL as well CBC: Hgb: 10:1 g/dL MCV: 73 Ferritin: 17 A1c: 6.9% Current Appointment The patient has seen multiple neuro and psych providers over the last year.  The R­­isperdal and divalproex were for the bipolar II disorder. The patient is experiencing depression symptoms. His family notes that he has also been uncharacteris