Mood disorders: lithium in acute mania onset: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Psychiatry · Mood disorders: lithium in acute mania onset

Sample item

A manic patient on lithium alone is still agitated after four days, with a serum level of 0.8 mEq per litre. The most appropriate next step is

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Add an antipsychotic or benzodiazepine for rapid control

Lithium takes a week or more to act in acute mania, so an antipsychotic or benzodiazepine is added for rapid control while the level is maintained within the therapeutic range. Pushing the level above 1.2 mEq per litre risks toxicity. Antidepressants may worsen mania.

Option by option

  • A. Add an SSRI

    An SSRI could precipitate worsening of mania.

  • B. Stop lithium immediately

    Stopping a drug that has not yet had time to work is not logical.

  • C. Increase lithium to 2.0 mEq per litre

    A level of 2.0 is toxic and dangerous.

  • D. Add an antipsychotic or benzodiazepine for rapid control (correct)

    Correct. Add a rapidly acting agent while lithium takes effect.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Psychiatry questions

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is D, Add an antipsychotic or benzodiazepine for rapid control. Lithium takes a week or more to act in acute mania, so an antipsychotic or benzodiazepine is added for rapid control while the level is maintained within the therapeutic range.

Why is "Add an SSRI" not the answer?

An SSRI could precipitate worsening of mania.

Why is "Stop lithium immediately" not the answer?

Stopping a drug that has not yet had time to work is not logical.

Why is "Increase lithium to 2.0 mEq per litre" not the answer?

A level of 2.0 is toxic and dangerous.

What concept does this question test?

It tests Mood disorders: lithium in acute mania onset in Psychiatry. Pushing the level above 1.2 mEq per litre risks toxicity. Antidepressants may worsen mania.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Mood disorders: lithium in acute mania onset?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.