The PMHNP is managing a patient with bipolar disorder. While the patient has had manic episodes historically, the dominant pole of his disorder is depression. He is currently being treated with valproic acid and olanzapine. Today his depressive symptoms have exacerbated and he admits to increasing suicidal ideation. He is not acutely suicidal, but his ideation is more frequent, and twice in the last month he has called the suicide and crisis hotline at 988. 

Which of the following medications would be most appropriate to add to his regimen? 

A. Lithium

B. Sertraline 

C. Lamotrigine 

D. Lurasidone

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