ABSTRACT
CASE PRESENTATION A 33-year-old man was referred by his psychiatrist for complaints of being forgetful, fidgety, and clumsy. He had first sought psychiatric evaluation 4 years earlier and was diagnosed with adult attention deficit disorder (ADD). He had tried a variety of medications including methylphenidate, bupropion, pemoline, and sertraline without benefit. During this time period, his family reported several episodes of acute confusion and disorientation. One episode, during which he was lost for several hours, resulted in an emergency evaluation which included magnetic resonance imaging (MRI) and electroencaphalography (EEG), both normal. A subsequent psychiatrist changed his diagnosis to atypical bipolar disorder and placed him on lithium and amphetamine.
