Depression Case Study by Paulette Sides Sasser.

1. What information, if any, would you like to know that was not included in the case?

Additional information related to the well-being and ages of the children with specific information related to the direct care and supervision of the children. The client relates that the children care for themselves related to meals. Additional information related to the competency of the patient to care for the children could give more information related to degree of impairment as well as insight of whether there should be concern for children. Depression is associated with decreased or negative parenting and has long-tern effects on children’s mental and physical health (n.d., 2009).

ORDER CUSTOM, PLAGIARISM-FREE PAPER

2. Which psychiatric symptoms are a treatment priority for this case?

Suicidal thoughts and safety of the patient and the children is the primary concern and establishing a safety plan as well as identifying persons either family or friends that are available and willing to be supportive with increasing suicidal ideation. Sense of hopelessness and lack of joy in patients’ life and feeling of guilt for spending less time with her children is of high priority.

3. What are the non-pharmacologic issues in this case (problems/complaints that cannot be addressed by medication)?

Poor appetite, diet and weight loss as well as lack of exercise and social interaction at home and at the client’s job. Lack of exercise can lead to increase in obesity, poor diet, diabetes, metabolic abnormalities which all will increase depression. The positive effects of regular exercise for those that suffer from depression including providing an outlet to lessen thoughts of depression and stimulate positive self-emotions (Murri, et. al., 2018).

Medication Choice 1

4. List one medication that would be appropriate for this case. Include the name and starting dose.

Sertraline 50mg by mouth daily with increase up to 200mg taper as needed for effect (Woo & Robinson, 2020).

5. Describe your clinical decision making. What is your rationale for choosing this medication? Also, include the mechanism of action for this medication choice, and the neurotransmitters and areas of the brain in which the medication is proposed to act on.

Sertraline is cost affective choice as the patient relates difficulty with money. Cost with discounts is around ten dollars in the U. S. thought the cost in the U. K. has increased 500% over the past 2 years (Robinson, 2021). Sertraline inhibits reuptake of 5HT serotonin with limited effect on dopamine and norepinephrine uptake (Woo & Robinson, 2020).

6. What laboratory testing/monitoring is needed for safely prescribing this medication?

No monitoring required other than monitoring for mood symptoms or allergic reactions as well as increased suicidal thoughts (Woo & Robinson, 2020)

7. Are there any contraindications or safety issues associated with this medication?

Caution in those with bleeding disorders as can interfere with platelet aggregation. Caution in those with cardiac histories related to prolonged QT interval. Monitor closely in children and elderly for increase or initial suicidal thoughts (Singh & Saadabadi, 2021)

Non pharmacologic Interventions

8. What non-pharmacologic interventions do you recommend? Do you recommend including but not limited to psychotherapy, complimentary and holistic therapies

Exercise, dietary modifications, psychotherapy to include group therapy to integrate social understanding and networking for the patients with others that suffer from depression.

Safety Risk Assessment

9. What are the safety concerns, if any, associated with this case? How will you address safety?

Safety concern related to harm to self with increased feelings of worthlessness or side-effect from beginning antidepressant. Monitor for sighs of serotonin syndrome (Woo & Robinson, 2020).

10. When would you follow up with this patient?

7 days in person as well as providing contact information to patient and family for emergent or escalating symptoms. Depression Case Study by Paulette Sides Sasser.

References:

Singh HK, Saadabadi A. Sertraline. [Updated 2021 Aug 6]. In: Stat Pearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689/