Case Study
Review the case study and then answer the questions that follow.
Case Study

Jeremy Stewart (pronouns he, him, his) is a 44-year-old married father of three who sees you for a psychiatric evaluation. Jeremy is a professor at a local college, where he teaches art. He also has a small art studio close to campus where he paints. As his psychiatric nurse practitioner, you diagnose Jeremy with bipolar I disorder, most recent episode depressed.
Questions
When treating a person for bipolar disorder, you have several medications from which to choose. You decide to start Jeremy on Lamictal (lamotrigine).
Answer Question
- What psychiatric disorders and/or symptoms is Lamictal indicated to treat? What phase of bipolar (manic, mixed, or depressed) is Lamictal most effective in managing? How does Lamictal work and what is the mechanism of action? What is the dosing titration schedule for Lamictal?
- What are the most serious adverse effects you would educate Jeremy to immediately report to you? Identify any important drug-drug, food-drug, substance-drug, or herb-drug interactions with Lamictal. What is Stevens-Johnson syndrome (SJS)? What are the risk factors for SJS? What are the signs and symptoms of a rash due to SJS versus a benign rash?
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