Description
Candice Rawlins
Hello class,
Psychoactive drugs help relieve depression and other psychological issues. Therefore, medications like fluoxetine 20mg act by affecting the processes involved in neurotransmission to alter the body’s chemistry and reduce depression. however. The side effects of such drugs affect their usage and may lead to poor adherence. Side effects may also cause other physical and psychological issues like poor sleep and anxiety. Fluoxetine 20mg, for instance, is linked to the side effects that are listed in the text like poor sleep and fatigue. If the side effects continue, patients’ other life aspects may be affected. Therefore, as the practitioner, prescribing a different drug for the patient can be adequate.
In Linda’s case, the fluoxetine 20mg had adverse effects that affected her. Therefore, she must get medications that have fewer side effects so that she can be more comfortable. One alternative that can be prescribed is Lexapro. The medication is among the Selective serotonin reuptake inhibitors. Like Fluoxetine, it also targets serotonin only. It has a half-life that is briefer than fluoxetine (Sepúlveda-Lizcano et al., 2023). Therefore, it usually has fewer side effects. Therefore, it is preferred for older patients and individuals whose metabolism is slower and therefore the medication stays in their systems longer and causes the side effects to be prolonged. Another alternative to fluoxetine 20mg that can be recommended is Venlafaxine. Venlafaxine is a second-line treatment that can be given to people who are adversely impacted by the side effects of SSRIs (Salahinejad et al., 2022). As the practitioner, it would be important to also educate Linda on how the new drug may affect her. Giving patients adequate information about the drugs they take helps them in dealing with side effects and adhering.
Zhaofei Liu
Hello Dr. Schvon Bussey and Classmates,
The patient’s symptoms are not adequately controlled. Since fluoxetine should take effect in no longer than 8 weeks, it is time to reevaluate the patient’s condition and treatment outcomes and make changes accordingly. To plan any change in the care plan, I need to thoroughly assess the patient to decide how the patient has responded to fluoxetine. According to Stahl (2020, p. 301), many patients have only a partial response where some symptoms are improved but others persist. Other patients may be nonresponders, sometimes called treatment-resistant or treatment-refractory. Some patients may experience an apparent lack of consistent efficacy due to the activation of latent or underlying bipolar disorder and require antidepressant discontinuation and a switch to a mood stabilizer.
If Linda has been responding to the treatment but needs an increase in the dose, fluoxetine can be increased up to 80mg daily. Otherwise, for patients with treatment-resistant depression, treatment strategies include augmentation (adding a treatment) and switching treatment. Thase and Connolly (2023) suggested initially using augmentation interventions; some evidence suggests that the benefit of augmentation is modestly superior to switching antidepressants. Augmenting an antidepressant with a second drug may provide faster, complementary, or synergistic effects compared with switching antidepressants. In addition, augmentation avoids withdrawal symptoms that may arise when the initial antidepressant is discontinued. Therefore, I will add another antidepressant from another drug class, such as Bupropion, 225–450 mg in 3 divided doses (maximum single dose 150 mg) (Stahl, 2020, p. 119). From the given information, the patient does not demonstrate signs and symptoms of underlying bipolar disorders, so I am not considering a mood stabilizer at this time.
Furthermore, it is critical to order the appropriate psychotherapy. Psychotherapy can be used in conjunction with antidepressants. I will order the therapy based on the patient’s needs and medical situation. According to the National Institute of Mental Health (2023), when medication relieves symptoms, psychotherapy can help a person address specific issues. These might include self-defeating thinking, irrational fears, problems interacting with others, or difficulty coping with situations at home, school, or work.
