ASSIGNMENT: PATIENT MEDICATION GUIDE

ASSIGNMENT: PATIENT MEDICATION GUIDE

ASSIGNMENT: PATIENT MEDICATION GUIDE

For this assignment, in 3-5 pages you will develop a patient medication guide for treatment of depressive disorders in a vulnerable population (your ASSIGNED population is adolescents.  Be sure to use language appropriate for your audience (patient, caregiver, parent, etc.). You will include non-copyright images and/or information tables to make your patient medication guide interesting and appealing. Limit your patient medication guide to 5 pages. You will create this guide as an assignment; therefore, a title page, introduction, conclusion, and reference page are required. You must include a minimum of 3 scholarly supporting resources outside of your course provided resources.

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In your patient guide, include discussion on the following:

• Depressive disorder causes and symptoms
• How depression is diagnosed for the vulnerable population of your choice, why is this population considered vulnerable
• Medication treatment options including risk vs benefits; side effects; FDA approvals for the vulnerable population of your choice
• Medication considerations of medication examples prescribed (see last bullet item)
• What is important to monitor in terms of labs, comorbid medical issues with why important for monitoring
• Special Considerations (you must be specific, not general and address at least one for EACH category; you must demonstrate critical thinking beyond basics of HIPPA and informed consent!): legal considerations, ethical considerations, cultural considerations, social determinants of health
• Where to follow up in your local community for further information
• Provide 3 examples of how to write a proper prescription that you would provide to the patient or transmit to the pharmacy.

ASSIGNMENT: PATIENT MEDICATION GUIDE SAMPLE ESSAY

Depression is a common mood disorder that affects individuals across the lifespan. It is a major cause of disability worldwide and greatly contributes to the global burden of disease. The purpose of this assignment is to create a patient medication guide for the treatment of depression in adolescents.

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Depressive Disorder Causes and Symptoms

Physical, social, and emotional changes, including exposure to abuse, poverty, and violence, put adolescents at risk of mental health problems. The more risk factors an adolescent is exposed to, the higher the potential effect on their mental health. Stress is a major contributor to depression in adolescents. Factors that cause stress in adolescents include exposure to hardships, pressure to match up with peers, and exploring identity (Grover et al., 2019). Adolescents with a history of childhood behavioral disorders are also at risk of developing depression.

Adolescents with depression present with a depressed mood present for most of the day and nearly every day, diminished interest or pleasure in activities, and reduced energy or increased fatigue (Chakraborty & Bandyopadhyay, 2018). Associated symptoms include reduced confidence or self-esteem, irrational feelings of self-reproach or unnecessary guilt, reduced ability to think or concentrate, sleep disturbance, changes in appetite and weight, and recurrent thoughts of death or suicide, or suicidal behavior.

How Depression Is Diagnosed in Adolescents

Depression in adolescents is diagnosed through clinical symptoms. At least four of the above-mentioned symptoms must be present for two weeks to diagnose mild depression, six for moderate depression, and eight for severe depression (Chakraborty & Bandyopadhyay, 2018). Screening tools are also used to diagnose depression including the Patient Health Questionnaire (PHQ-9) for Adolescents, Mood and Feelings Questionnaire, Child Depression Inventory, and the Beck Depression Inventory (Korczak et al., 2023).

Medication Treatment Options

Antidepressant medications are used in adolescents with more severe depressive symptoms or conditions where psychological therapy is ineffective or impossible.  Selective serotonin reuptake inhibitors (SSRIs) are the recommended first-line medications for treating depression in adolescents. There are only two FDA-approved SSRIs to treat adolescent depression, fluoxetine, and escitalopram. Korczak et al. (2023) found that most guidelines recommend Fluoxetine as the first-line drug for depression in adolescents. Moderate evidence supports treatment with sertraline and escitalopram.  Besides, most guidelines recommend at least two full SSRI trials before considering other classes of antidepressants. This is because other antidepressant classes have limited efficacy data and poor tolerability among adolescents.

Fluoxetine is typically initiated at 10 mg/d and increased after one week to 20 mg/d. It may take 2–6 weeks for positive effects to be established. Nonetheless, fluoxetine is associated with mania and suicidal ideations and behavior in adolescents. SSRIs have side effects like nausea, insomnia, headache, anorexia, dry mouth, diarrhea, drowsiness, and anxiety. Murphy et al. (2021) explain that the risks of medications should be weighed against those of failing to adequately treat depression in adolescents.

Monitoring Treatment

Adolescents on SSRIs should be continually monitored for suicidal ideation and unusual behavior. Weight should be regularly monitored to identify any metabolic side effects, and vital signs should be monitored for adverse changes (Murphy et al., 2021). Besides, adolescents on SSRIs should be regularly assessed for insomnia, anxiety, and sexual dysfunction.

Special Considerations

Legal action is needed for adolescents identified to be exposed to neglect, mistreatment, or abuse. Clinicians should screen for these risk factors in adolescents presenting with depressive symptoms and timely report to the relevant authorities (Grover et al., 2019). Ethical consideration applies to principles of nonmaleficence and beneficence. The clinician has a moral duty to promote patient safety by implementing treatment interventions established t be safe and effective for adolescents. The adolescent patient culture should be considered during assessment and treatment. The clinician should obtain information on the adolescent’s cultural practices for mental health, cultural beliefs about mental health, and cultural factors hindering access to mental health services (Grover et al., 2019). Clinicians should also consider SDOH that increases adolescents’ risk of developing depression, like living conditions, discrimination or exclusion, stigma, and lack of access to quality support and services.

Follow Up In Your Local Community

Texas has various Adolescent Residential Treatment Centers where you can follow up if you have depressive symptoms. They provide evidence-based treatment programs that help adolescents recover from substance abuse, addiction, and depression. At the teen residential treatment centers in Texas, teenagers access the most successful elements of mental health, addiction, and drug abuse programs.

Prescriptions

 Conclusion

Depression in adolescents is attributed to a complex interaction of biological, environmental, social, and psychological factors. Depressed adolescents have a depressed mood, diminished interest in activities, and reduced energy levels. Depression in adolescents is screened based on clinical symptoms and using screening tools. Fluoxetine and escitalopram are the only two FDA-approved medications for depression in adolescents.

References

Chakraborty, A., & Bandyopadhyay, U. (2018). A clinic-based descriptive study of childhood mental disorders according to DSM-5. Int J Sci Res, 7, 44-5.

Grover, S., Raju, V. V., Sharma, A., & Shah, R. (2019). Depression in Children and Adolescents: A Review of Indian studies. Indian Journal of psychological medicine, 41(3), 216–227. https://doi.org/10.4103/IJPSYM.IJPSYM_5_19

Korczak, D. J., Westwell-Roper, C., & Sassi, R. (2023). Diagnosis and management of depression in adolescents. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 195(21), E739–E746. https://doi.org/10.1503/cmaj.220966

Murphy, S. E., Capitão, L. P., Giles, S. L. C., Cowen, P. J., Stringaris, A., & Harmer, C. J. (2021). The knowns and unknowns of SSRI treatment in young people with depression and anxiety: efficacy, predictors, and mechanisms of action. The Lancet. Psychiatry, 8(9), 824–835. https://doi.org/10.1016/S2215-0366(21)00154-1