Reference no: EM133581379

Question: A 17-year-old boy presents with bizarre behavior. He is saying that he was selected by the "divine authorities to fight the evil in this world." The patient stopped attending school and stays in his room and has not been eating or sleeping in the past week. He has no significant history, takes no medication, and does not use illicit substances. Vital signs are normal. On physical examination, the patient is disorganized and disheveled, has pressured speech, and is pacing across the room. Laboratory investigations reveal no abnormalities. He is admitted after a diagnosis is made and started on appropriate treatment. Over the next week, the patient becomes calmer. Eleven days after admission, he complains of a sudden increase in sweating and stiffness of his muscles. Vital signs are temperature 102 F (38.8 C), blood pressure 162/91 mm Hg, heart rate 126 bpm, and respiratory rate 24 breaths/min. All medications are stopped, and intravenous fluids are started. What medication should be given next if the patient does not improve with these interventions?