A 22-year-old male patient is started on sertraline 50 mg p.o. daily after presenting with a major depressive episode. After tolerating it without difficulty for two weeks his dose was increased to 100 mg p.o. daily. Approximately 4 weeks later he reported an unusual set of new symptoms for the last week and a half. He says he feels “amped up” and just very generally agitated and nervous. He was short-tempered at work and home and was snapping at people for no good reason. He also reports difficulty concentrating at work. Last week he expressed disproportionate anger at his work and his boss told him that he was bipolar and should be put on medication. The PMHNP discusses with the patient that:

A. When symptoms are preceded by antidepressant therapy a diagnosis of bipolar does not apply 

B. His symptoms may be consistent with bipolar disorder if they persist for at least two weeks 

C. A formal assessment of the social and occupational implications of his symptom should be performed 

D. The symptoms are most likely a physiologic adaptation to the sertraline and most often normalize 
---
YouTube: https://www.youtube.com/watch?v=AGbD2hqR3K8&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=20