The primary care provider asks Angela to fill out a Beck Depression Scale, which indicated she has moderate depression

Sample Answer

Pharm Week 9

The patient in the case study has moderate depression based on her presenting symptoms and scores from the Beck’s Depression Scale. I would initiate the patient on Fluoxetine (Prozac). Fluoxetine is a Selective serotonin reuptake inhibitor (SSRI) approved by the FDA for treating MDD. It is recommended as a first-line drug for treating uncomplicated MDD cases (Park & Zarate, 2019).

Fluoxetine acts by selectively inhibiting presynaptic serotonin reuptake but with minimal or no effect on the reuptake of dopamine or norepinephrine (Park & Zarate, 2019). I would prescribe Fluoxetine because it has less prominent side effects owing to its minimal anticholinergic effects.

If the patient came back in two weeks with reports of no changes in mood, I would inform her that antidepressant medications usually take 2-12 weeks at therapeutic doses and adherence to demonstrate the desired clinical response (Bauer et al., 2017). I would also inform her that the treatment would be altered if she does not demonstrate an adequate response treatment after eight weeks of treatment.

Besides, I would educate the patient that treatment failure can occur if there is noncompliance and taking a less dose than the prescribed (Park & Zarate, 2019). Potential adverse effects of Fluoxetine include nausea, diarrhea, somnolence, nervousness, anorexia, insomnia, and changes in energy levels such as body weakness, fatigue, and restlessness.

The treatment regimen with the initial dose of Fluoxetine should take eight weeks before changing the drug or dose. If the patient demonstrates clinical response and has no side effects, the dose can be increased gradually by 20mg/day, but not to exceed 80 mg/day (Bauer et al., 2017).

Treatment should continue until the depressive symptoms have fully abated. To discontinue the drug, I would taper the dose gradually over 4-6 months to reduce the incidence of withdrawal symptoms and to monitor re-emerging symptoms.

References

• Bauer, M., Severus, E., Möller, H. J., Young, A. H., & WFSBP Task Force on Unipolar Depressive Disorders. (2017). Pharmacological treatment of unipolar depressive disorders summary of WFSBP guidelines. International journal of psychiatry in clinical practice, 21(3), 166-176. https //doi.org/10.1080/13651501.2017.1306082