14th February 2025

A 22-year-old patient is brought to the emergency department by his mother after not sleeping for 4 days, spending £4,000 on new clothes, and knocking in his neighbours’ doors to tell them he is the son of God.

A 22-year-old patient is brought to the emergency department by his mother after not sleeping for 4 days, spending £4,000 on new clothes, and knocking in his neighbours’ doors to tell them he is the son of God. He has a background of depression and takes regular venlafaxine.

He is switched from venlafaxine to a different medication for this acute episode, and this is then added to his repeat prescriptions.

Four years later, he has a depressive episode after the breakdown of his marriage. He is no longer taking the above medication due to unpleasant side effects.

Which of the following would not be an appropriate management option?

Select the SINGLE most appropriate option from the list below. Select ONE option only.