rebuttal to a post.

In the additional box, I include the original post that you helped me with, and the student respond to it.  I want to prove to him there are other approaches please write a rebuttal to his post.  

Sathi

YesterdayLocal: Jul 26 at 10:02pm<br>Course: Jul 26 at 9:02pm

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1st Response

Hi Jean Robert,

I loved your presentation (Comprehensive Patient Assessment Essay Example). It was very informative. However, I disagree with your choice of medication for this patient . The patient is 17 year old female who is having major depressive symptoms , but also one of her key symptoms that we need to consider is her insomnia . I would add Abilify for both a mood stabilizer and to help with the psychosis . However, instead of adding Prozac , I would recommend trazodone . This is because Prozac common side effect is insomnia(Sohel et al , 2022). Mainly because this medication is known to be a stimulating medication . That means that this medication energizes and activates the brain . Since the patient is not having issues with motivation or energy levels this medication might not be indicated for this patient . Especially if this medication could potentially cause the patient to have less sleep than before. However , trazodone is an antidepressant that is frequently used to for insomnia(Boafo et al , 2020). Thus to promote the patient to get more hours of sleep and to help with her depressive symptoms I would highly recommend trazodone. By doing this we are essentially also reducing the amount of medication she is taking . Which in the long term might make this patient medication compliant often.(Comprehensive Patient Assessment Essay Example)

Resources

Boafo, A., Greenham, S., Sullivan, M., Bazaid, K., Suntharalingam, S., Silbernagel, L., Magner, K., & Robillard, R. (2020). Medications for sleep disturbance in children and adolescents with depression: A survey of canadian child and adolescent psychiatrists. Child and Adolescent Psychiatry and Mental Health, 14(1). https://doi.org/10.1186/s13034-020-00316-8

Sohel, A. J., Shutter; , M. C., & Molla, M. (2022). Fluoxetine . StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK459223/

Comprehensive Patient Assessment Essay Example-Solution

Hello,

Thank you for your time and effort in reading and responding to my comprehensive patient assessment. Your response is informative and takes great consideration of some of the patient’s symptoms to inform a treatment modality to address the psychotic features. I agree the patient has sleeping difficulties, and I understand why you would go for trazodone, whose effects include drowsiness or sleepiness. You have provided a thoughtful and evidence-based rationale for prescribing trazodone instead of Prozac, with which I partly agree.(Comprehensive Patient Assessment Essay Example)

However, I considered other side effects before prescribing Prozac, including potential exacerbation of psychosis, the need to reduce and manage weight and prevent side effects like increased nervousness and anxiety, and weakness and tiredness. Since trazodone is associated with weight and appetite changes, nervousness, weakness, and tiredness, which are symptoms the patient experiences, I would stick to Prozac and prescribe mirtazapine (Neubauer, 2023). Additionally, trazodone has been shown to cause nightmares, which might not be helpful in this case because of the psychotic features the patients currently present with (MedlinePlus, 2022).(Comprehensive Patient Assessment Essay Example)

Nonetheless, I would continue monitoring the patient for undesirable side effects and adjust the treatment plan accordingly. Your perspective was informative and provided a different angle of looking at the situation. I will consider these insights in future assessments. To add to your analysis, I would also recommend considering other symptoms like probable causes of decreased energy, nervousness, nightmares, and weight and appetite changes to ensure the patient has positive health outcomes. (Comprehensive Patient Assessment Essay Example)

References

MedlinePlus. (2022, January 14). Trazodone: MedlinePlus drug information. MedlinePlus – Health Information from the National Library of Medicine. https://medlineplus.gov/druginfo/meds/a681038.html

Neubauer, D. N. (2023, May 24). Pharmacotherapy for insomnia in adults. Evidence-Based Clinical Decision Support System| UpToDate | Wolters Kluwer. https://www.uptodate.com/contents/pharmacotherapy-for-insomnia-in-adults