Topic: BREWER'S HILL INPATIENT CLINIC: WEEK 4

Butcher Ben

Date: 2017-07-07 00:21 EST
Dr. Clifford McDonald

Date of Exam: 4/18/2005 Time of Exam: 3:00:12 PM

Patient Name: O'Connor, Benjamin Patient Number: 10000124965435

History: Mr. O'Connor is a 19 year-old man born and raised in Milwaukee. The chief concerns are homicidal ideations and repeated incidences of criminally violent activity. The following information was provided by: *Mr. O'Connor *Previous psychiatric records Mr. O'Connor still remains undiagnosed. We have noticed that his violent outbursts occur as a result of experiencing severe anxiety. Due to the neurochemical activity that we recorded in our first exam, we started him on Adderall 10 mg PO QDS in hopes that increased dopamine intake would substitute for the stimulation he gets from violent activity/imagery. Dosage was increased from 10 mg to 20 mg, then from 20 mg to 30 mg. Mr. O'Connor reports no decrease in anxiety, but an increase in energy and a diminished appetite.

Symptoms No changes from last exam.

General Notes Due to repeated assaults on our staff and our other patients, Mr. O'Connor remains in physical restraints. Chemical restraints are not an option as benzodiazepines have no effect, while genetics place Mr. O'Connor at a high risk of QT prolongation and extrapyramidal symptoms. Naturally, this eliminates the option of administering antipsychotics.

Diagnosis More time is needed with patient.

Recommendation Stimulants, antipsychotics, and antianxiety agents have been ruled out. Patient does not seem to exhibit symptoms of bipolar disorder, so testing with mood stabilizers will be a last resort. We will proceed with administration of bupropion hydrochloride.

Start Wellbutrin 100 mg PO BID X 30days # 60 (sixty)

7102IC

Clifford McDonald, MD