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Continuing Patients Natalee Williams
Nataleeâ€™s symptoms such as reserved behavior, irritability, lack of appetite, acting up at school, sleeplessness, and weight loss are pertinent to those of depression disorder (WHO, 2017). Accordingly, I would administer the Childrenâ€™s Depression Inventory during the interview to assess for depression. Despite the patientâ€™s obvious depression symptoms, a differential diagnosis is available. Bipolar disorder is a persistent and complicated mood condition marked by episodes of mania (bipolar mania), hypomania (bipolar hypomania), and sadness (bipolar depression). The symptoms exhibited by Natalee did not warrant a different diagnosis of adjustment disorder accompanied by mood swings, sorrow, or bipolar illness. Possible mood disorders with a medical origin may require further evaluation.
Prescription and Patient Education
The criterion for providing psychoactive substances to a child is to begin therapy with an extremely low dose and increase it gradually while evaluating the childâ€™s response to treatment. I would recommend fluoxetine (Prozac) with a morning oral starting dose of 10 mg. Prozac is FDA-approved for children older than eight years (Sohel et al., 2020). It is well-established that selective serotonin reuptake inhibitors (SSRI) are effective.
As the patientâ€™s primary care provider, Trinaâ€™s understanding of the drugâ€™s mechanism of action is vital for the correct prescription adoption. I would begin by explaining to Trina that Prozac is an SSRI antidepressant that increases brain serotonin levels. As little Natalee may be confused by medical jargon such as serotonin, I would assure her that the drug will improve her mood. I would tell Trina that Serotonin is recognized as the feel-good transmitter that contributes to well-being and regulates positive mood, appetite, and sleep-wake cycle (Fischer & Ullsperger, 2017). Lastly, I would like to caution Trina that while the drug can improve Nataleeâ€™s symptoms, it may cause headaches, dizziness, exhaustion, and sleepiness. I would urge her to continue monitoring Natalee over the next few weeks to assess if Prozacâ€™s side effects warrant medical intervention.
Sandra Monica Delgado
Natalee Williams Case Study
The case study reflects the condition of Natalee Williams, who presented herself to the healthcare facility with her mother, Trina. Natalee was previously diagnosed with depression, and her mother presently fears the hormonal change because she has started mensuration. Trina is concerned that the sertraline 12.5 mg daily medication will no longer work. The post explores the possible action needed to promote recovery from major depressive disorder, as expressed by Natalee.
The Patient Health Questionnaire (PHQ-9) is useful in patientâ€™s screening. The tool identifies different mental disorders whose symptoms are evident in Nataleeâ€™s case. The PHQ- 9 diagnosed multiple health concerns, including panic, anxiety, sleep disorder, and depression (Levis et al., 2020). For Nataleeâ€™s case, DSM-5 is crucial in identifying at least symptoms during screening for two weeks. The use of the DSM-5 instead of the PHQ-9 is geared at identifying the specific mental condition experienced by Natalee.
The best medication for Natalee includes an antipsychotic that manages psychosis-like hallucination and disordered thoughts. Medications like serotonin reuptake inhibitors like citalopram, fluoxetine, and vilazodone are preferred, which are recommended for children above eight years by Food and Drug Administration (FDA). The recommended initial dose of 10-20 mg is preferable for Natalee. The dosage can be increased gradually to a maximum amount of 90 mg once a week, depending on the severity of the symptoms.
Trina needs comprehensive information on the selective serotonin reactive inhibitor. She needs to know the required dosage and be encouraged to air out concerns or side effects to the clinicians. She should acknowledge the depression symptoms to help her understand the daughter and guide her on the recovery path. Natalee will be included in the conversation through the mother’s efforts, who would act as her primary caregiver.
The fluoxetine has adverse side effects that must be included in the patient education. The side effects include nausea, anxiety, and headache, loss of appetite, insomnia, and drowsiness (Orlova et al., 2018). Natalee should have sufficient rest during drowsiness, especially after medication. Trina should acknowledge these signs to avoid preparing her psychologist during her daughterâ€™s prescription.