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Pharmacological and Non-Pharmacological Treatment for a Patient with Depression

Essay Instructions:

Class PSYCHOPHARMACOLOGY, Chapter 6, Case 1
Trisha is a 28-year-old, unemployed white female. She is no stranger to therapy, having seen counselors for most of her teen and adult years. Her friends would describe her as a “wild woman” who takes no crap from anyone. She has held various part-time jobs for the last few years because she usually gets angry at her boss or coworkers and quits. While she has had a string of boyfriends over the years, she has been seeing one man for the last year or so. He too is unemployed and has both an alcohol and methamphetamine problem. She describes the relationship as “addictive and dysfunctional, yet exciting and hot.” Trisha is back in treatment at the urging of her parents, who describe her behavior as erratic and unpredictable. They also claim that she has periods where she “sleeps little and parties lots.” There were also several occasions in the last five years when she was so depressed she didn’t eat or want to leave the house. Her father also admits to periods of depression, and Trisha’s grandfather was diagnosed with manic depression, resulting in numerous hospitalizations in the 1950s and 1960s. Trisha’s only brother died in a car accident several years ago. He was drunk at the time, but she claims he had a long history of depression. Recently Trisha was arrested for disorderly conduct at a friend’s party. She had not slept for nearly 24 hours and was drunk and combative. When she was first approached by police, she solicited them for sex. They report that she was rather hyperverbal and hyperactive. They later had to investigate a complaint from local storeowners for bad checks she wrote in excess of $7,000.
Questions: Remember to answer these questions from your textbooks and clinical guidelines to create your evidence based treatment plan. At all times, explain your answers.
1. Summarize the clinical case.
2. Create a list of the patient’s problems and prioritize them.
3. Which pharmacological treatment would you prescribe? Include the rationale for this treatment.
4. Which non-pharmacological treatment would you prescribe? Include the rationale for this treatment.
5. Include an assessment of treatment’s appropriateness, cost, effectiveness, safety, and potential for patient adherence.

Essay Sample Content Preview:

Psychopharmacology Case 1
Your Name
Subject and Section
Professor’s Name
Date
1 Summarize the clinical case.
This is a case of a 28-year-old female with a history of depression, with symptoms such as losing appetite and the lack of willingness to engage in recreational activities. She also had anger management problems, as evidenced by jumping from one part-time job to another for the past few years secondary to conflict with her colleagues and combative at a friend’s party. Moreover, she had a history of jumping from one boyfriend to the next, and the recent boyfriend has a history of alcohol and substance abuse. She also presented with hyperactive symptoms, such as partying with almost no sleep. Family history revealed that her father and brother had depression, and her grandfather had manic depression.
2 Create a list of the patient’s problems and prioritize them.
1 Manic episodes. These episodes are characteristic of bipolar I disorder. These are characterized by the reduced necessity for sleep, continuous flow of ideas, enhancement of objective-directed actions, disproportionate participation in pleasurable activities with a high probability of adverse outcomes, and severe mood disturbances (Substance Abuse and Mental Health Administration, 2016; Michigan Medicine, n.d.). The majority of the patient’s presentation is of manic episodes, including being awake for almost 24 hours, demonstrating hyperactivity (i.e., partying a lot) and hyperverbal utterances, and engaging in unsafe but pleasurable practices (i.e., soliciting for sex, staying in a relationship with an addict, and writing bad checks).
2 Depressive episodes. The Substance Abuse and Mental Health Administration (2016) explained that these include sleep disturbances, lack of interest in previously pleasurable activities, and loss of appetite. Novick et al. (2010) reported that 25% to 60% of patients with bipolar disorder are at risk of committing suicide, while between 4% to 9% complete suicide. The risk increases with challenges in social and occupational functioning, increased self-blame, impulsivity, recurrent or persistent depressive occasions, substance abuse, and co-existence of anxiety disorders.
On top of these, the patient had a significant family history of major depressive disorder. It was placed second on the list because the symptoms are not recurring nor persistent.
3 Which pharmacological treatment would you prescribe? Include the rationale for this treatment.
Initially, mood stabilizers shall be given to the patient. These decrease the active symptoms of mania and prevent future occurrences or recurrence. An example of this is lithium, which diminishes the intensity and incidence of manic episodes. Moreover, it also helps alleviate the concomitant depression previously present in the patient (Casarella, 2020; Goldberg, 2019).
Second-generation antipsychotics (SGAs), specifically, Quetiapine, have been proven to be an effective first-line treatment in bipolar depressive episodes. Norquetiapine, the drug’s metabolite, anchors with the norepinephrine reuptake blocker, which elucidates its effectiveness in reducing depressive symptoms. However, an antidepressant can also increase its effic...
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