A patient with bipolar disorder on naltrexone 50 mg daily for methamphetamine cravings, trazodone for insomnia, baclofen for muscle aches, hydroxyzine (Vistaril) for anxiety, prazosin for nightmares, and aripiprazole 10 mg daily remains anxious, angry, and continues self‑harm; what is the next best step in management?

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Last updated: February 19, 2026 • View editorial policy

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