Case 1: Volume 1, Case #1: The man whose antidepressants stopped working. Ethnicity plays a primary role in determining how different individuals respond to their prescribed antidepressant medications (Lett et al., 2016). For example, the genetic specifics of people from one ethnic background may differ from those of another ethnic group. The differences determine the rates at which members of an ethnic group metabolize the medications prescribed by medical practitioners (Lett et al., 2016). In the long run, a significant variation will be evident in the response of patients to antidepressant drugs. In this regard, this paper uses case 7 to address the impact of ethnicity on antidepressant medications. The patient had a case of complex mood disorder that has lasted for long.
First, the assessment of patient history and treatment specifics is the first step in diagnosing long term mood disorders. In some cases, mood disorders are complex, and patients may present difficulty in interaction and treatment. Some of the questions that can uncover the incidence of a complex mood disorder include: -
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How often do you experience episodes of restlessness or aggression?
Have you felt any sadness, emptiness, or fear of being close to people in the last two weeks?
Do you feel anxious or agitated very often? Do you have any fear of being alienated from your family?
People in the Patient’s Life
In addition to asking the questions above, talking to essential figures in the life of the patient is essential. For example, the family could provide a detailed account of the behavioral traits that the patients portray. Moreover, the nurses that oversee the treatment of the long term mood disorder can also provide essential information for the assessment of the patient’s situation.
Three Differential Diagnoses for the Patient
The best differential diagnostic approach is to assess the physical and psychotic condition of the patient. For example, physical exams include the assessment of the state of the thyroid gland. The gland should show signs of optimal activity. The under activity of the gland can contribute to the development of mood disorders that last for long. Secondly, a neurological examination is necessary. The physical exam assesses whether the essential chemicals for alleviating mood are present in the brains. The lack of adequate neurotransmitters is a predisposing factor to long term mood instability. Lastly, a physical examination can be done on the adrenal gland to determine the cause of an unstable mood for the patient. An inactive adrenal gland can cause anxiety.
Contraindications
In this regard, a consideration of the pharmacodynamic and pharmacokinetic attributes of the patient and drugs administered is necessary. As mentioned earlier, the rate of metabolism due to ethnic predicaments is a necessary consideration. Some of the drugs that the patient could utilize to remedy the mood disorder are Paroxetine. The drug aids to lower anxiety and stabilize the moods of patients (Stahl, 2014). Despite the different transport rates of serotonin due to genetic differences, the drug is effective. The nurse could prescribe Paroxetine alongside Fluoxetine, which aids in treating major depressive disorders. Fluoxetine has inhibitor properties for mental slowing, reducing the prevalence of depression (Stahl, 2014). The medications above should be provided at a higher dose, considering the patient’s health history.
Lessons Learned
The dosage ensures that despite the genetic and metabolic factors affecting the impact of antidepressants, serotonin will still be availed to the brain. Depression can present untreatable cases, where the provided medications do not meet the expected outcomes. However, the cases are not entirely immune to treatment. The long term unstable moods can be remedied by the use of the above medications, in conjunction with CBT (Cognitive Behavioral Therapy). Some cases also require the stimulation of the brain to be receptive to chemicals that alleviate the mood.
References
Lett, T. A., Walter, H., & Brandl, E. J. (2016). Pharmacogenetics and Imaging-
Pharmacogenetics of Antidepressant Response: Towards Translational Strategies. Cns Drugs, 30, 12, 1169-1189.
Stahl, S. M. (2014). The prescriber’s guide (5th ed.). New York, NY: Cambridge University
Press.
