Patient history: A 75-year-old man presents with complaints of recently developed tremors; there is nothing he can do to control them. He has no other concerns and is currently well. The man has a long-established diagnosis of bipolar disorder, which has been well maintained with lithium. His medication was recently changed. Mental state examination: The man is cooperative and communicative with good eye contact. His speech is normal, and his mood is objectively and subjectively stable.
He does not express any ideas of self-harm. There is no evidence of psychosis. He is orientated in time, place, and person and has no cognitive impairment. Physical examination: The man looks well, and there is nothing of note except a marked coarse tremor. The tremor is not rhythmic and is present at rest and when he attempts a task. There is no indication of any cogwheel rigidity or lack of facial…
