W5-depression case study

Post#1-Depression Case Study by Paulette Sides Sasser

Based on the case study, answer the following questions.

Identification of target symptoms/problems:

1. What information, if any, would you like to know that was not included in the case? This interviewer appeared to follow the PHQ – 9 depression assessment tools, which is sufficient to begin the differential diagnosis (Brown et al., 2020). The interviewer seemed to ascertain the symptoms most important to the patient. She cannot concentrate, meet expectations, enjoy life, sleep, or find the energy to care for herself. Additional medication history, alcohol use, family history, and potential triggers are pertinent to the care plan (Brown et al., 2020). Medications do not mix well with alcohol. Determining how she has used alcohol over the years is essential. She identified alcohol as a critical factor during her suicidal attempt. Her medication history should also include her previous medication adherence (Brown et al., 2020). The history of mental health problems in her family and treatments that worked for first-degree relatives is valuable information to the prescriber (Brown et al., 2020). Patient participation in the medication selection is important. Several factors help narrow the list of potential medications for depression. Such factors include other health conditions, reproductive goals for women, cost, and benefit/risk evaluations for the individual patient (Brown et al., 2020).

2. Which psychiatric symptoms are a treatment priority for this case? The patient identifies the impact her depressive symptoms have had on her ability to function and relationships. The patient prioritized her lack of energy, sleep difficulties, inability to concentrate, and failure to manage responsibilities as critical needs. The practitioner should also prioritize the patient’s history of suicidal behaviors and alcohol use. Although the patient accessed professional services for her mental health needs, she needed the urging of her family to act on accessing care. During the interview, she describes a previous suicide attempt and alludes to alcohol use during the break–up of her marriage.

3. What are the non-pharmacologic issues in this case (problems/complaints that cannot be addressed by medication)? This patient reports feeling little self-worth, utilizing limited coping skills, and struggles with intimate relationships, which adds to her sense of hopelessness. Her judgment is concerning. She appears to have friends and family support. Other psychosocial needs should be evaluated by social services to support successful care.

Medication selection:

1. List one medication that would be appropriate for this case. Include the name and starting dose. Escitalopram is a substrate for CYP450 2C19 and 3A4with no significant actions on CYP 450 (Aldrich et al., 2019). With a dosage of 10 mg once daily, steady-state sh