Facilitating optimal care for the Hispanic male is an essential component especially since antidepressants are in most instances considered to be one of the most viable options. Besides, this is a preference that is far much more popular compared to counselling. It is clear that the Hispanic American male is experiencing depression despite not exhibiting some of the common symptoms such as suicidal thoughts and homicidal ideation. Elements such as gaining a substantial amount of weight, insomnia and also poor concentration, however, are still pointers to this client being depressed. Also, although Hispanic individuals are in most cases opposed to pharmacological interventions, this happens to be effective when compared to other involvements. It is, nevertheless, imperative to note that the complexity of the symptoms being experienced have to be evaluated in order to determine the best treatment incentive. The three optimal decisions that can be made in this particular case are, offering tricyclic anti-depressants (TCAs), providing monoamine oxidase inhibitors and giving the patient selective serotonin reuptake inhibitor (SSRI).
Decision #1
The first selection involving tricyclic anti-depressants (TCAs) is mainly based on their inhibitory properties which cause an impact on the brain monoamine metabolism (Kupfer, 2005). The reason for this selection is mainly based on the ability of TCAs to ensure that substantial levels of norepinephrine and serotonin are maintained in the patient`s brain. Through this decision, the expectation was to elevate the mood levels of the patient and this is mainly what TCAs seek to achieve. This differs entirely from some of the occurrences which were observed such as blocking of histamine which subsequently resulted in the patient reportedly having a dry mouth and also suffering from constipation. The results differed in the sense that the side effects of using the medication had to be exhibited and also, TCAs are best when applied after other alternative sources of medication have failed. Despite this, when TCAs are used together with antipsychotics such as amitriptyline, they are known to have a high level of efficiency.
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Decision #2
The second decision involves administering monoamine oxidase inhibitors. The decision was arrived at due to their known efficacy in handling even the most complex incidences of depression (Youdim, Edmondson & Tipton, 2006). It is, nevertheless, evident that response to drugs is likely to vary depending on one`s ethnic affiliation due to the imminent metabolizing of enzymes (Yasuda, Zhang & Huang, 2008). Besides the Federal Drug Administration (FDA) consents to categorization of antidepressant drugs as Hispanic and Not Hispanic (Garcia, Franks, Jerant, Bell & Kravitz, 2011). In this case, it was expected that administration of the monoamine oxidase inhibitors would assist in the deamination of dopamine and also regulate the degradation of serotonin and catecholamines thought to be the area where therapeutic action for the brain occurs (Yasuda, Zhang & Huang, 2008). Though this ended up being an effective form of intervention, it occurred that discontinuation of the treatment resulted in side effects such as insomnia within 2 to 3 weeks of the patient not using the drugs. This, nonetheless, does not discount the effect of MAO-A inhibitors in treating the depression being experienced by the Hispanic individual.
Decision #3
The final decision involved providing selective serotonin reuptake inhibitor (SSRI) to the patient. The choice was mainly based on the ability of more alerting SSRIs to act as a medication for sleep related problems. As a result, there were expectations that upon using the drugs, the patient would manage to counter the insomnia which he is experiencing. Also, clinical experiences have revealed that SSRIs are relatively safe for use compared to other forms of antidepressants (Shih, et al., 2019). What was essentially not anticipated is the experiences such as changes in appetite and sexual dysfunction that are bound to affect the patient.
Also, ethical considerations that are likely to influence the clinical decisions being made are mainly based on the effectiveness of the drug and also corrective usage. For instance, SSRIs work best for all ages, whereas, TCAs have mainly being deemed to be more useful when utilized on young individuals yet the patient is 32 years old. Finally, there is also a requirement that while communicating with clients no half-truths are told to them. This may affect their consideration and consent to use drugs that might be deemed effective and as a result impact on the treatment plan.
References
Garcia, E. F., Franks, P., Jerant, A., Bell, R. A., & Kravitz, R. L. (2011). Depression treatment preferences of Hispanic individuals: exploring the influence of ethnicity, language, and explanatory models. The Journal of the American Board of Family Medicine , 24 (1), 39-50.
Kupfer, D. J. (2005). The pharmacological management of depression. Dialogues in clinical neuroscience , 7 (3), 191.
Shih, I. F., Haan, M. N., Paul, K. C., Yu, Y., Sinsheimer, J. S., & Ritz, B. (2019). The Roles of Physical Activity and Inflammation in Mortality, Cognition, and Depressive Symptoms among Older Mexican Americans. American journal of epidemiology , 188 (11), 1944-1952.
Yasuda, S. U., Zhang, L., & Huang, S. M. (2008). The role of ethnicity in variability in response to drugs: focus on clinical pharmacology studies. Clinical Pharmacology & Therapeutics , 84 (3), 417-423.
Youdim, M. B., Edmondson, D., & Tipton, K. F. (2006). The therapeutic potential of monoamine oxidase inhibitors. Nature reviews neuroscience , 7 (4), 295-309.
