April 15, 1992

The patient was seen for 30 minutes for medication review and follow-up. He continues on Norpramine, 50 mg, four tablets at bedtime and also Lithium Carbonate, 300 mg a day. He is not certain the Lithium Carbonate is making that much difference. Raising the dose, however, was a problem because he tended to get shaky on higher doses. He is quiet today but his personal appearance has improved and his affect looks less depressed. He said he was not having suicidal thoughts at this time. He is discouraged about relationships as previously and is not communicating much with his family. He is uncertain what he wants to do over the longer-term. No changes were recommended in medications. He was encouraged to continue looking at long-term plans. He still would prefer to be seen privately at this office. I do not feel his is using the individual therapy hours very effectively at this point, ½ hour seems more appropriate. I will see him again on May 14, 1992. He is aware I will be out of the office in late April and early May.

The Cheese Doctor, M.D.