September 18, 1991

The patient was seen for 45 minutes for follow-up from last week. Increasing his Norpramin by 25 mg to 100 mg HS appears to have helped. This week he did not seem to be focusing on problems in relating to his parents. He said earlier in the week when he was having difficulty with registration and getting the classes he needed, he felt very down. This problem was resolved, however, and he is also sleeping through the night. I suspect it is a combination of events in general going better and improvement with the increased dose of medication. I think he is going to need an increased dosage of Nortriptyline in the fall and suspect he is more prone to depression at this time of year. He tended to be reticent to discus very many issues at this time and claimed that every little was bothering him or even on his mind at this point. He is focusing on classes and working out his schedule. He will continue to work part-time while going to school. At this point, no changes were made in medications. I do not feel it is necessary to see him as frequently again and rescheduled him for a 30 minute appointment in one month.

The Cheese Man, M.D.