Hi Im concerned about a 57 yr old smoker , etoh abuse hx, hx of MI , ministroke, recently discharged from ANN ARBOR VA INPATIENT psych unit. I was also a pt. I have been an RN for 34 yrs.Me, Garden variety bipolar relatively stable, retired fom the prison. He hasnt slept in 2 days has drank 8 beers and smoked a little grass today . His speech is slightly slurred and he is dwelling on pastsounds resentful. Lives alone takes Mirtazatine, 400 seroquell, dilantin and Keppra he repeted his dose of seroquel last noc he sounds slightly manic .sleep pattern while inpt 3-4 hrs I think he needs to be seen tonight what are your thoughts thanks jjeff