A 28-year-old female with a known history of bipolar I disorder is brought to the clinic by her family, who report she has been increasingly irritable, sleeping only 2-3 hours per night, and spending excessive amounts of money. She talks rapidly and is easily distracted. What is the most appropriate initial pharmacologic treatment for her acute manic episode?

The correct answer to the question "A 28-year-old female with a known history of bipolar I disorder is brought to the clinic by her family, who report she has been increasingly irritable, sleeping only 2-3 hours per night, and spending excessive amounts of money. She talks rapidly and is easily distracted. What is the most appropriate initial pharmacologic treatment for her acute manic episode?" is Option B: Lithium.

The other options — A) Sertraline, C) Alprazolam, D) Methylphenidate — are incorrect for this USMLE Exam Prep question. As explained above: The patient is experiencing an acute manic episode. Lithium is a first-line mood stabilizer for acute mania and maintenance treatment in bipolar disorder. Antidepressants (sertraline) are contraindic…