Walden NURS 6521 – Decision Making When Treating Psychological Disorders Treating Psychological Disorders

 

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Mental health issues are serious and do have debilitating outcomes, affecting normal functioning, increasing dependency levels, and not only affects the diagnosed person but also their loved ones. Mental health illness symptoms may occur temporarily or chronic and can range from mild, moderate, and severe. The mild symptoms of mental illness can be managed through life adjustment and psychotherapy, but when they are severe, a combination with medication/ pharmacotherapy is recommended. The majority of mental health experts do agree that a combination of pharmacotherapy and psychotherapy is more effective compared to implementing the individual approaches in the treatment of severe mental health issues (Pedrelli et al., 2015). This paper aims to review a case study of a Hispanic male with a major depressive disorder to assess some of the three medications proposed: Zoloft 25 mg orally daily, Effexor XR 37.5 MG orally daily, and Phenelzine 15 mg orally TID to recommend the most appropriate.

Before recommending any medications to a patient, it is best to collect sufficient information such as the patient characteristics such as age and health condition, current medication, past medical history, psychiatric history of the family, and generally the patient’s functional status. The caregiver also has to collect the patient’s objective data. After assessing the patient’s cognitive and emotional state, as in the case study, the caregiver can plan for the prescription such as patient and support education, dosage, frequency, route, and the span based on information collected (Mayo-Wilson et al., 2014). It is also best to review the medications for effectiveness, interactions, and side effects based on the patient’s condition.

Zoloft 25 Mg Orally Daily

Zoloft is a selective serotonin reuptake inhibitor (SSRI) and works by restoring serotonin in the brain. The medication is used in treating depression, post-traumatic stress disorder, panic attacks, obsessive-compulsive disorder, and social phobia. Zoloft may mend sleep disorders, appetite, mood, energy levels, and increase interest in activities which one loves (Milgrom et al., 2015). The medication may also interfere with the urge to partake in repetitive tasks that one faces in daily living, such as counting. The appropriate dosage for persons with MDD is 50mg, with a maximum upper range of 200mg for unresponsive patients.

Effexor XR 37.5 Mg Oral Daily

Also known as Venlafaxine, Effexor XR is used as a mood and energy enhancer to rejuvenate interest (Dahale e al., 2014). The antidepressant is used to treat social anxiety disorder, depression panic attacks, and anxiety. Effexor XR is a serotonin-norepinephrine reuptake inhibitor and works by restoring and balancing norepinephrine and serotonin in the brain. The oral medication is taken once daily, either in the morning or evening, and is not to be chewed as it may increase the chances of side effects. The medication is not stopped unless the caregiver orders so, and the benefits are gradual to note and may take several weeks for positive results. The 37.5 mg dosage is best at the beginning for the patient to adjust; then, it can be raised to 75mg, which is the recommended dose.

Phenelzine 15 Mg Oral TID

Phenelzine is a usual dose for depression and mostly administered to adults. The initial dose for depression is 15mg tid but can be increased to 90 mg for patients who require high monoamine oxidase inhibition. The results of Phenelzine may be noted after at least a month at 60mg daily dosing. The 15 mg dose can only be used for maintenance purposes after benefits are attained. Phenelzine is not recommended as the initial depressant to use in patient treatment, but as the last option after other medications are unresponsive on the patient (Willaert et al., 2014).

Appropriate Choice

The three medications are antidepressants and seem to have almost similar side effects such as suicidal thoughts and behavior; hence caregivers need to balance between the clinical benefits to the patient and the risks involved (Mayo-Wilson et al., 2014). From assessing the above medication in treating MDD, the first to exclude is the Phenelzine 15 mg oral TID dosage as it should be used as an alternative treatment after all other options have failed. Zoloft 25 mg orally daily is also a better prescription, but the problem is that that dosage is way below for the 50mg appropriate for treatment of MDD; hence, it may take time to restore the patient’s wellbeing. Zoloft does also have the risk of interfering with repeated tasks; thus, the patient’s job may be at stake, which may affect the patient’s wellbeing further and worsen the situation.

The recommendable medication, in this c

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