A 32-Year-Old Man with a History of Bipolar Disorder Is

A 32-year-old man with a history of bipolar disorder is brought to the emergency department by his wife.  He has been unable to sleep for more than 3 hours a night for the past week.  Over the past several weeks, the patient has been irritable at home and has argued constantly with his wife.  He has racing thoughts and speaks rapidly.  The patient has stopped going to his job as a plumber, having decided to stay home and "unravel the secrets of the universe."  He has been drawing shapes and equations on the walls, and he has accused his wife of working for the police and trying to steal his secrets.  Prior to examination, the patient becomes increasingly agitated and is hospitalized against his will.  He has no other medical conditions.  Vital signs, physical examination, and laboratory findings are normal.  He is prescribed multiple medications to address his symptoms.  Five days later, the patient is calm but has difficulty moving spontaneously or getting out of bed.  He does not respond appropriately to questions and appears newly disoriented and confused.  Temperature is 39.4 C (102.9 F) , blood pressure is 162/98 mm Hg, pulse is 98/min, and respirations are 20/min.  Dysregulation of which of the following neurotransmitters is most likely to be the primary cause of this patient's new symptoms?

A) 5-hydroxytryptamine
B) Dopamine
C) Gamma-aminobutyric acid
D) Glutamate
E) Norepinephrine

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free