What medication would you first prescribe to this patient?
Angela has presented key medical concerns with the main issue being ranging insomnia depression of unknown cause to emotional dysregulation disorder having a feeling of senseless life. The patient will need mood fixation medication. The best medication to prescribe for Angela is coupling an antidepressant medicinal drug with psychotherapy (counseling and talk therapy). The antidepressant of choice is selective serotonin reuptake inhibitors more specifically sertraline (Zoloft) When this is combined with ramelteon (Rozerem); a drug that mimics the action of melatonin, treatment of insomnia would be achieved (Chew et al., 2016). However, before deciding to use the combination of the drugs, effective drug interaction should be observed. Two drugs can be used for the treatment of different symptoms in a patient, but the two drugs may combine to produce unusual side effects, therefore, worsening the health condition of the patient.
Selective serotonin reuptake inhibitors such as fluvoxamine should not be taken together with ramelteon to manage depression symptoms (Levin, 2019). The medication sertraline will be taken as 25 mg PO qDay for social anxiety disorder. Alongside the medication, psychotherapy which is a talk therapy that targets clinical depression will be used to help her restore the mental issue from the social and medical problems cutting across cognitive therapy, behavioral therapy, and cognitive behavioral therapy and helping in the primary focus of the patient. a combination of the therapy and medication should help her gain her emotional balance including engaging in physical exercise.
She comes back in 2 weeks and states she has not noticed a change in her mood since starting on the medication. What would be your response?
The drug selective serotonin reuptake inhibitors are effective after a dosage duration of between 2 to 4 weeks (Hieronymus et al., 2016) The duration of drug efficacy is fluid, it varies depending on natural physiological responsiveness to a drug that is specific to a given individual. Some people will take a shorter duration to start noticing health beneficial changes attributed to the drug use while others will take a longer period. Sertraline is contraindicated in patients with documented hypersensitivity to the drug or its components (Rauch et al., 2019). The coadministration of sertraline with thioridazine, pimozide, or monoamine oxidase inhibitors, including linezolid or methylene blue, is also contraindicated. Patients who are taking other serotonergic medications should receive education regarding the risks of coadministration with sertraline. The advice is to encourage Angela to be strict with her medication as the medication combination takes time to restore normality and ease the major symptoms. Angela should not rule out the drug effectiveness since she is within the standard range for the drug efficacy duration. She needs to have the drugs alongside taking her therapy sessions seriously and getting socially engaged including being physically active to help her restore her mental health.
What are the possible problem with the medication you prescribed?
A drug is a foreign substance to the body; the body will perceive it and generate the counter antibody to its effect. When the body counteracts the effect of the drug in the system, the effect of this counteraction is manifested in terms of signs and symptoms and is described as the possible side effects. Again, individuals have specific genetic makeup, and their physiology is different. This fact will explain why it is not universal for a side of a drug to be attributed to a specific sign and symptom. In other word perception of a drug in the body differ from one person to another.
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