Approach to medication-induced movement disorders Quiz: Ace Your Exams

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60-year-old man presents to his psychiatrist’s office for a follow-up appointment. He reports a fine tremor in his right hand when writing that has been present for the last two weeks. The patient has history of bipolar 1 disorder and began taking lithium one month ago. There have been no changes in his medical history since his last appointment. He does not use alcohol or other recreational substances. Temperature is 37.2°C (99.0°F), pulse is 65/min, respirations are 18/minute, blood pressure is 118/72 mmHg, and body mass index (BMI) is 22 kg/m². On physical examination, the patient is comfortable and not in distress. Cardiopulmonary examination is within normal limits, and neurological examination showa subtle, fine tremor in the bilateral upper extremities when the arms are extended during the Romberg testThe musculoskeletal exam is normal. Which of the following is the best next step in management 

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