Decision #3
After increasing the Zoloft to 50mg po daily, the client returned to the clinic four weeks
later. He reports a decrease in depressive symptoms by 50% and has been tolerating the
medication well. My final three decision options include continuing the medication at 50mg po
daily, increasing to 75mg po daily, or changing the medication to an serotonin-norepinephrine
reuptake Inhibitor (SNRI). The serotonin norepinephrine reuptake inhibitors are a drug class of
antidepressants that work by inhibiting the reuptake of both serotonin and norepinephrine
(Sansone, 2014).
Since the client has reported a 50% reduction in depressive symptoms, my decision was
to continue Zoloft at 50mg po daily. At this point, I believe we are on the right tract as there has
been sufficient symptom reduction achieved from our client and ultimately, a positive therapeutic
response. Since we have achieved a 50% reduction in symptoms, there is no clinical reason to
switch to an SNRI at this point. By the same token, I do not see a further dosage increase as
being necessary. As previously mentioned, it can take 2-3 months before maximum therapeutic
affect may be achieved. Therefore, as our client has begun to show significant progress, our best
action is to continue this dosage for another four weeks to see if full symptom remission is
possible.
Summary
It is important to note for the provider that partial response to antidepressant medication,
resistance, and relapse are common outcomes in MDD patients. Due to these potential adverse
outcomes, many patients treated medicinally for MDD can expect to go through medication
changes during the course of their treatment, particularly if their illness requires long-term
therapy (Mills et al, 2021). In the constraints of the given scenario
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