February 5, 1992

The patient was seen for 45 minutes for medication review and follow-up. He had a considerably better week than before the previous visit. He commented that he was able to interact more with people and thought that this helped. His sleep has been somewhat better and he seems to be tolerating his combination of medications of 200 mg of Nortriptyline with 300 mg of Lithium Carbonate a night. He continues to spend as little time at home as possible and describes irritation towards other family members, but again talked about this more objectively. He talked about his concern over lack of goals for the near and distant future but also commented that what he would really like to do is go to Australia for a year. Because he was born there, he can claim Australian citizenship and this would be possible if he could raise the money. He hasn't discussed this very much with his parents. I gave him reinforcement in thinking more about the possibility of going. No changes were made in medications. I will see him again in two weeks but asked him to contact me next week if there is not continued improvement.

The Cheese Doctor, M.D.