Answer the questions below based on the following case study.
A 41-year-old man presents to his PCP with feelings of hopelessness, sadness, and helplessness. He says that he cries for no reason, and has difficulty sleeping. He noticed that the problems began about 6 weeks before, and he did not feel able to shrug them off. He has been drinking more alcohol than usual and has stopped going to work. When on his own, he admitted that he had thought of driving his car into the nearest canal.
- Summarize the clinical case.
- What is the DSM 5-TR diagnosis based on the information provided in the case?
- Which pharmacological treatment would you prescribe including the name, dose, route and frequency of the drug in accordance with the clinical guidelines? Include the rationale for this treatment.
- Which non-pharmacological treatment would you prescribe according to the clinical guidelines? Include the rationale for this treatment excluding a psychotherapeutic modality.
- Include an assessment of the treatment’s appropriateness, cost, effectiveness, safety, and potential for patient adherence to the chosen medication. Use a local pharmacy to research the cost of the medication and provide the most cost-effective choice for the patient. Use great detail when answering questions 3-5.
How to solve
NUR 520 Florida International University Psychophar Case Study
Introduction: In this case study, a 41-year-old man presents with symptoms of depression, including feelings of hopelessness, sadness, and helplessness. He also reports crying for no reason, difficulty sleeping, increased alcohol consumption, and thoughts of self-harm. In this response, we will summarize the case, provide a DSM 5-TR diagnosis, recommend a pharmacological treatment, suggest non-pharmacological treatment options, and assess the appropriateness, cost, effectiveness, safety, and potential for patient adherence of the chosen medication.
1. Summarize the clinical case:
A 41-year-old man is experiencing depressive symptoms such as feelings of hopelessness, sadness, and helplessness. He reports crying without reason, difficulty sleeping, increased alcohol consumption, and thoughts of self-harm. These problems started approximately 6 weeks ago and have significantly impacted his daily functioning, including stopping work.
2. DSM 5-TR diagnosis based on the information provided:
Based on the information provided, the DSM 5-TR diagnosis for this individual would be Major Depressive Disorder (MDD). This diagnosis requires at least five of the following symptoms to be present for at least two weeks: depressed mood, loss of interest or pleasure, significant weight loss or gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness or excessive guilt, diminished ability to think or concentrate, and recurrent thoughts of death or suicidal ideation.
3. Pharmacological treatment recommendation:
Considering the clinical guidelines for treating Major Depressive Disorder, the first-line pharmacological treatment option would be a selective serotonin reuptake inhibitor (SSRI), such as sertraline. The recommended starting dose for sertraline is 50mg/day, administered orally, usually in the morning or evening. The dose can be increased to a maximum of 200mg/day based on the individual’s response. The frequency of administration is once daily.
Rationale for this treatment:
– Sertraline is an SSRI that has been extensively studied and proven to be effective in treating depression.
– It acts by increasing the levels of serotonin in the brain, which helps regulate mood.
– Sertraline is generally well-tolerated, and its side effects are usually mild and transient.
– It has a lower risk of drug interactions compared to other antidepressant classes.
– The once-daily dosing regimen promotes patient convenience and adherence.
4. Non-pharmacological treatment recommendation:
In addition to pharmacological treatment, a non-pharmacological treatment option that can be prescribed according to the clinical guidelines is regular exercise. Exercise has shown to have positive effects on mood and can potentially alleviate depressive symptoms.
Rationale for this treatment:
– Regular exercise has been shown to increase endorphin levels, which are known as the “feel-good” hormones.
– Exercise promotes the release of neurotransmitters like serotonin, norepinephrine, and dopamine, all of which play a role in regulating mood.
– It provides a healthy coping mechanism for stress and can help distract from negative thoughts.
– Exercise also improves overall physical health, which can enhance self-esteem and confidence.
5. Assessment of treatment’s appropriateness, cost, effectiveness, safety, and potential for patient adherence:
– Appropriateness: Both pharmacological and non-pharmacological treatments are appropriate for Major Depressive Disorder. Combining medication with exercise can provide a comprehensive approach to managing symptoms.
– Cost: The cost of sertraline can vary depending on the pharmacy and location. It is advisable to use a local pharmacy to research specific prices. Choosing a generic version of sertraline can help reduce costs.
– Effectiveness: Sertraline has been proven effective in treating depression, with response rates ranging from 50-70%. Regular exercise has also shown to have positive effects on mood.
– Safety: Sertraline is generally safe, but it may cause side effects such as nausea, headache, and sexual dysfunction. Exercise, when performed within physical limits, is generally safe.
– Potential for patient adherence: The once-daily dosing of sertraline promotes better adherence compared to medications that require multiple daily doses. Incorporating regular exercise may require motivation and lifestyle adjustments but can have long-term benefits for the patient.
Choosing the most cost-effective choice for the patient – specific pricing information can be obtained from a local pharmacy.
Please note that this response is fictional and for educational purposes only. The specific treatment approach should always be based on individual patient characteristics and formal clinical assessment.
