Depression Management
Hi Carline,
In regard to your other questions, I do agree with the patient’s diagnosis. She is experiencing symptoms that meet DSM criteria for the diagnosis. However, I’m unsure about the Prozac prescription. Prozac is an antidepressant, and an SSRI, which is the first-line treatment for depression. However, the patient reports restlessness, anxiety, sleep disturbances, and shaking. Prozac is stimulating, and Edinoff et al. (2021) state that compared to other SSRIs, it has higher rates of agitation and anxiety. So, it is possible that it may make those symptoms worse. I would recommend a drug such as sertraline which is also a first-line drug, that is less stimulating and can help with anxiety and depression (Singh & Saadabadi, 2023).(Depression Management Discussion Essay)
References
Edinoff, A. N., Akuly, H. A., Hanna, T. A., Ochoa, C. O., Patti, S. J., Ghaffar, Y. A., Kaye, A. D., Viswanath, O., Urits, I., Boyer, A. G., Cornett, E. M., & Kaye, A. M. (2021). Selective Serotonin Reuptake Inhibitors and Adverse Effects: A Narrative Review. Neurology International, 13(3), 387–401. https://doi.org/10.3390/neurolint13030038(Depression Management Discussion Essay)
Singh, H. K., & Saadabadi, A. (2023, February 13). Sertraline. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK547689/
Depression Management Discussion Essay-Solution
Response to Alora
Hello Alora,
Great post! Thank you for sharing your discussion on the management of depression. One major takeaway I noted from your discussion is the importance of selecting medications with the least side effects for specific patients. I support your claims that Prozac and Sertraline are FDA-approved and first-line medications for treating depression but have different side effects on the patients. I support your recommendations on using Sertraline over Prozac to manage depression. Both drugs belong to a class of medications known as Selective Serotonin Reuptake Inhibitor (SSRIs)(Depression Management Discussion Essay), whose mechanism of action is to inhibit serotonin reuptake, thus increasing serotonin activity in the brain to improve the patient’s mood (Edinoff et al., 2021). Both medications were among the first SSRIs to manage depression (Adjei et al., 2023). The research also adds that although both medications have similar effects on the quality of life, they differ in their pharmacodynamics, pharmacokinetics, and side effects. The mentioned differences affect the healthcare professionals’ decision on treatment selection.(Depression Management Discussion Essay)
Adjei et al. (2023) claim that Prozac may cause the patients to experience weight loss, anxiety, and agitation linked, which will have native outcomes on the treatment. On the contrary, Sertraline is highly associated with lesser side effects, such as a high incidence of diarrhea. Adjei et al. (2023) research on the impact of SSRIs on psychological distress among patients showed that patients who used Prozac (94.27%) had the highest improvement in their distress than those taking any other SSRI after one year. Sertraline came in second with 91.96% effectiveness in managing psychological distress(Depression Management Discussion Essay). Prozac has low specificity on the serotonin transporter that may be linked to the high side effects than any other SSRI. Sertraline portrays a high antagonistic activity at the sigma-1 receptor but has lesser affinity than Fluvoxamine as an agonist. In this case, healthcare professionals should have great insights into the various SSRIs to determine which ones have benefits that outweigh the risks. As such, Prozac is still preferred for treating depression as it is more effective than other SSRIs as demonstrated by Adjei et al. (2023) on its ability to improve psychological distress.(Depression Management Discussion Essay)
References
Adjei, K., Adunlin, G., & Ali, A. A. (2023, March). Impact of Sertraline, Fluoxetine, and Escitalopram on Psychological Distress among United States Adult Outpatients with a Major Depressive Disorder. In Healthcare (Vol. 11, No. 5, p. 740). MDPI. https://doi.org/10.3390%2Fhealthcare11050740(Depression Management Discussion Essay)
Edinoff, A. N., Akuly, H. A., Hanna, T. A., Ochoa, C. O., Patti, S. J., Ghaffar, Y. A., … & Kaye, A. M. (2021). Selective serotonin reuptake inhibitors and adverse effects: a narrative review. Neurology International, 13(3), 387-401. https://doi.org/10.3390%2Fneurolint13030038
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