IC is currently taking Trileptal 300 mg, BID and Abilify 10 mg daily for mood stabilization and Trazodone 300 mg at bedtime for sleep. Your therapy may be modified during the acute manic phase, however, some important concerns should be considered before prescribing it. First, lithium is used to treat acute manic condition, however, doctors must exercise extreme caution in using it for patients with impaired kidney function. Lithium is potentially lethal due to its narrow therapeutic window (0.6 to 1.2 mEq/ml). Secondly, it is recommended to use Olanzapine and/or Quetiapine to treat insomnia and acute agitation related to bipolar disorder. Third, SGAs have the potential to cause metabolic abnormalities and weight gain. It is therefore important to measure the patient's weight and metabolic profiles before pharmacological treatments and monitor them carefully during treatment. Fourth, drug interaction is a major issue for prescribing medications to bipolar patients. For example, antiepileptic drugs (Tegretol and Trileptal) could interact with oral contraceptive pills and lead to contraceptive failure. Fifth, a pregnancy test should be performed for bipolar patients because mood stabilizers cause teratogens. Sixth, almost all mood stabilizers and SGAs have a black box warning, so it is very important that doctors educate patients very well about drug side effects, adverse effects, and interventions (McCarron, Xiong, & Bourgeois,