Evaluation and Treatment of Poor Sleep

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Mr. A, a 63-year-old man with bipolar disorder who was admitted to the hospital, was profoundly depressed and had a host of neurovegetative symptoms (including anergia, anhedonia, impaired concentration, and poor sleep [waking up several times each night and finally arising 1–2 hours earlier than usual with a pervasive feeling of dread]). Mr. A’s medications included lithium carbonate 300 mg t.i.d., duloxetine 30 mg daily, and lorazepam 1 mg t.i.d. (as needed for anxiety). An inability to sleep became a focal issue for Mr. A.​

Prim Care Companion J Clin Psychiatry 2007;9(3):224-229