For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on ethical prescribing or decision-making. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals based on ethical prescribing guidelines or decision-making?

Based on study results, African Americans and Asians resort to other treatment options other than drugs to manage their depression (Williams, 2018). Patients from these ethnicities thus need lower doses of antidepressants to achieve the therapeutic effects. For Caucasians, SSRIs are used on standard dosage and frequency. The patient is seventy years old with hypertension; hence, adjusting the dosage to minimize the adverse effects and polypharmacy since she is already on other medications.

Include any “check points” (i.e., follow-up data at Week 4, 8, 12, etc.), and indicate any therapeutic changes that you might make based on possible outcomes that may happen given your treatment options chosen.

The progress of the patient will be evaluated after every four weeks. The possible outcomes expected include that the patient will adhere to the prescribed medications, establish a beneficial sleep-wake cycle, and adapt to dietary changes that would help in sleep quality and drug efficacy. If the patient shows signs of improvement during the clinical visits, the drug dosage will be tapered off slowly until the patient can sleep without medications. If there are no signs of improvement, the dosage will be increased and augmented with psychotherapy.

References

Abbott, J. (2016). What’s the link between insomnia and mental illness? Health. https://www.sciencealert.com/what-exactly-is-the-link-between-insomnia-and-mentalillness#:~:text=Sleep%20problems%20such%20as%20insomnia%20are%20a%20common,bipolar%20disorder%2C%20and%20attention%20deficit%20hyperactivity%20disorder%20%28ADHD%29

Korhan, O., & Ahmed Memon, A. (2019). Introductory chapter: Work-related musculoskeletal disorders. Work-related Musculoskeletal Disorders. https://doi.org/10.5772/intechopen.85479

Lala, V., Goyal, A., Bansal, A., & Minter, D. A. (2021, May 9). Liver function tests. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK482489/

Maurer, D. M., Davis, B. N., & Raymond, T. J. (2018, October 15). Depression: Screening and diagnosis. AAFP American Academy of Family Physicians. https://www.aafp.org/afp/2018/1015/p508.html

Saracino, R.M., Cham, H., Rosenfeld, B., & Nelson, C.J. (2018). Confirmatory factor analysis of the Center for Epidemiologic Studies Depression Scale in oncology with examination of invariance between younger and older patients. European Journal of Psychological Assessment. Advanced online publication. http://dx.doi.org/10.1027/1015-5759/a000510

Undurraga, J., & Baldessarini, R. J. (2017). Direct comparison of tricyclic and serotonin-reuptake inhibitor antidepressants in randomized head-to-head trials in acute major depression: Systematic review and meta-analysis. Journal of Psychopharmacology, 31(9), 1184-1189. https://doi.org/10.1177/0269881117711709

Williams, D. R. (2018). Stress and the mental health of populations of color: Advancing our understanding of race-related stressors. Journal of Health and Social Behavior, 59(4), 466-485. https://doi.org/10.1177/0022146518814251