The PMHNP is treating a 42-year-old woman who primarily has had episodic bipolar depression, with last manic episode

The PMHNP is treating a 42-year-old woman who primarily has had episodic bipolar depression, with last manic episode occurring approximately 8 years prior. She is sexually active and taking oral birth control. The patient has been taking Trileptal 300mg twice daily for one year, and has had unremitting anergia, dysphoria and middle insomnia. Which of the following is true of this patient’s current regimen? a. Trileptal is second-line for treatment of bipolar depression with anxious features b. Trileptal is the second most teratogenic medication used in treatment of bipolar illness and should be titrated and discontinued c. Trileptal can reduce levels of oral contraceptives, reducing the efficacy of birth control d. Trileptal poses high risk for patients with Asian lineage carrying the HLA 1505 allele

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