Carrie 1 of 1 Carrie is a 17-year-old girl with a 2-year history of recurrent Manic Episodes. She is now admitted with an acute Manic Episode and accompanying psychotic features. Carrie’s mother has Bipolar Disorder, and the patient has mild cerebral palsy in addition to Bipolar Disorder. Carrie's Manic Episodes have necessitated two previous hospitalizations. During Carrie’s first admission, a “sensitivity" to neuroleptics was noted. The summaries from that admission stated that “catatonia, incoherence, and incontinence" developed when she was treated with chlorpromazine and thiothixene. During Carrie’s second hospitalization for another Manic Episode, she \vas treated daily with 250rng of chlorpromazine and 200 mg of amantadine. Within a few days she developed a fever, tachypnea, labile blood pressure, profound cogwheel rigidity, with hyperreflexia and dystonias, dysphagia, grunting, mutism, and incontinence. Laboratory tests showed elevated creatine phosphokinase (350 U/L) and white blood count (14,100/cumm). Chlorpromazine was discontinued, and diphenhydranline was used for symptomatic
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