Major Depressive Disorder (MDD)

Major Depressive Disorder (MDD)

Summary of Clinical Case
A 41-year-old guy visits his primary care physician (PCP) experiencing despair, depression, and helplessness. He claims that he has trouble falling asleep and sobs uncontrollably. He noticed that the issues started about six weeks prior, and he was unable to brush them off. He no longer goes to work and started consuming greater amounts of alcohol than normal. He acknowledged that he had considered plunging his vehicle into the closest canal whenever he was by himself.
DSM-5-TR Diagnosis
Considering the symptoms that the man is experiencing, the main diagnosis is Major Depressive Disorder (MDD). MDD is viewed as a serious mental health issue marked by negative emotions and low moods that last all day. For a patient to be diagnosed with MDD based on DSM-5 TR they must have at least five indicators that should be continuous for over two weeks. These indicators include depressed mood, lack of interest in every activity, lack of appetite and losing weight, insomnia, exhaustion, inappropriate self-guilt, suicidal ideation, lack of concentration, restlessness, and psychomotor retardation (APA, 2022). The main symptoms of MDD presented by the man include feelings of helplessness, despair, and sad moods. He also has insomnia and suicidal ideas of throwing himself into the nearest canal.
Pharmacological Treatment
Based on clinical guidelines, I would prescribe Selective serotonin reuptake inhibitors (SSRIs). This is because they have overall less troubling side effects and are safe compared to other types of antidepressants (Gutiérrez-Rojas et al., 2020). Particularly, I would prescribe Lexapro for the patient. This medication inhibits the transport of human serotonin in an extremely powerful, dose-related manner.
Non-Pharmacological Treatment
I would recommend Repetitive transcranial magnetic stimulation (rTMS) to treat the patient’s depression symptoms. This is because his depression is severe and interfering with his normal functioning. rTMS is an effective treatment strategy that is FDA-approved and provided on outpatient grounds (Gutiérrez-Rojas et al., 2020). Besides, it does not need anesthesia and stimulates the brain’s nerve cells influencing depression and mood by delivering magnetic pulses. The side effects of this treatment are mild and it is very effective and safe, especially for patients who fail to respond to other types of treatment methods.
Assessment of the Treatment
10 mg once every day is the suggested dosage for Lexapro. Research shows the effectiveness for both 10 mg as well as 20 mg of Lexapro. However, it fails to indicate an additional advantage of 20 mg compared to 10 mg. This should happen at least one week after the initial dose is raised to 20 mg. Whichever drugstore an individual goes to, a supply of 30 Lexapro tablet forms in the dosage of 20 milligrams costs about $105 per supply (Gutiérrez-Rojas et al., 2020). Prices listed only apply to consumers purchasing on cash; insurance plans are not accepted. A chronic disease known as major depressive disorder exists. It hasn’t been thoroughly investigated whether Lexapro is effective in treating MDD after 8 weeks. When prescribing Lexapro for prolonged periods, a doctor should occasionally reassess the drug’s potential long-term benefits for each specific patient.

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders. Fifth edition, Text Revision (DSM-5). American Psychiatric Association
Gutiérrez-Rojas, L., Porras-Segovia, A., Dunne, H., Andrade-González, N., & Cervilla, J. A. (2020). Prevalence and correlates of major depressive disorder: a systematic review. Brazilian Journal of Psychiatry, 42, 657-672.


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