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A clinical picture of mania can have many causes, including amphetamine or cocaine use, acute schizophrenia, manic-depressive illness, and viral encephalitis. Accurate and complete history--of both the present episode and past experiences--is most valuable in the differentiation, along with mental status examination, physical examination, and selected laboratory tests. It is advisable to withhold drug therapy, if possible, until the initial evaluation is completed, for it may obscure the diagnosis.
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