Week 2 Discussion

Week 2 Discussion

Summary of the Clinical Case

A 41-year-old man exhibits various indicators of a mental health problem. He expresses helplessness, grief, and hopelessness. His symptoms began around six weeks ago and he had no control over them. The patient also binges drinks and fails to show up for work. He also expressed suicidal thoughts about driving himself into the nearby canal.

DSM 5-TR Diagnosis

To be identified as having major depressive disorder, individuals must show more than of the following indicators: extremely sad mood, loss of enjoyment or interest, sleeplessness, tiredness, a sense of inadequacy, lack of focus, and suicidal thoughts (Gutiérrez-Rojas et al., 2020). I believe the patient has Major Depressive Disorder symptoms such as melancholy moods, getting easily distracted, weariness, lack of attention, suicidal ideas, and sleepiness. Other symptoms of depression displayed by the patient include a loss of interest in social activities and heightened sensitivity. Nonetheless, he noted a drop in appetite and energy. All of these are indications of a serious depressive disorder.

Pharmacological Treatment

A pharmacological treatment I would prescribe is fluoxetine. This is a selective serotonin reuptake inhibitor (SSRI) antidepressant drug. It functions by raising the brain’s hormone levels of serotonin (Jakobsen, Gluud & Kirsch, 2020). Fluoxetine must be used once daily, in the morning or evening, and at a dose of 20 mg per day. Oral formulations should be taken 20 mg/5 mL, capsule should be consumed from to 40 mg, tablets should be taken from 10 to 60 mg and delayed-release capsules should be taken on 90 mg.

Non-Pharmacological Treatment

An effective nonpharmacological treatment for the patient is mindfulness. Mindfulness entails paying more attention to the current moment and concentrating on patient’sideas, emotions, physical sensations, and the world surrounding him in order to enhance his psychological well-being. The goal is to have a greater awareness of his physical and mental health, and to learn how to live happier life with greater enjoyment and less anxiety (Jakobsen, Gluud & Kirsch, 2020). Mindfulness is suggested by NICE as a method of preventing depression in persons who have had a minimum of three episodes of depression in their life.

Assessment of the Treatment

Appropriateness

Fluoxetine is appropriate in the treatment approach for mild to severe depressive symptoms. Serotonin levels in the brain are raised, which causes it to work. Serotonin is believed to be beneficial for mood, emotion, and sleep (Jakobsen, Gluud & Kirsch, 2020). Fluoxetine has less adverse effects than certain other medications and aids in the recovery of many persons suffering from depression.

Cost

Generic Fluoxetine (Prozac) is offered and may be considerably less expensive than the brand name version. The cost of fluoxetine (generic) on GoodRx is $4.00.

Effectiveness

Fluoxetine is effective in treatment all levels of depression and is demonstrably more well-tolerated (ie, has a milder adverse-event profile) and safer in excess instances than previous antidepressant medications (Gutiérrez-Rojas et al., 2020). The patient’s state of mind, sleep quality, appetite, and levels of energy may all be enhanced by this medicine. It may also help him regain interest in regular activities. It might reduce worry, and unfavorable thoughts.

Safety

In comparison to TCAs, fluoxetine is more efficacious, have lesser and milder adverse effects, and are less hazardous in overdose. Patients who are unresponsive to fluoxetine can be shifted to another SSRI.

Potential for Patient Adherence

There is improved fluoxitine adherence since the course of treatment is longer.

 

 

 

 

 

 

 

 

 

 

References

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 Psychiatry42, 657-672. https://doi.org/10.1590/1516-4446-2020-0650

Jakobsen, J. C., Gluud, C., & Kirsch, I. (2020). Should antidepressants be used for major depressive disorder?. BMJ Evidence-Based Medicine25(4), 130-130. http://dx.doi.org/10.1136/bmjebm-2019-111238

 

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