Olivia is Showing Symptoms of Depression
Olivia is a 16-year-old biracial female. She reports feeling down and depressed nearly every day for the past 2 weeks. She has also withdrawn from drama club, an extracurricular activity that she previously enjoyed. She denies any recent losses or being bullied but feels that her ability to concentrate has decreased. Her mother shares that Olivia is spending more time sleeping or napping alone in her room, seems sullen and withdrawn and irritable when she does interact with family. Olivia’s mother notes that Olivia’s appetite has declined and that Olivia remarks that she is not hungry with most meals. Olivia’s mother tells the provider that Olivia does not seem interested in most of her usual activities or her phone. Olivia comments to the provider that she feels that her family and friends would be better off if she "weren’t around." She denies thoughts or plans of hurting herself or others.
Select a first-line medication, based on tolerability and low side effect profile, for the treatment of her severe depression. Please include the available evidence and treatment guidelines. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions, including interactions with CAM. Identify an additional (possibly off-labeled) use of the medication not related to depression or psychosis. Discuss evidence and treatment guidelines to determine appropriate therapeutic options for this patient. Include the name of the medication in the subject line so that the medications can be followed. Include references using APA format.
Olivia is Showing Symptoms of Depression Olivia is showing symptoms of depression. Thus the medication that would best work to treat the condition is Fluoxetine. Fluoxetine is a specific serotonin reuptake inhibitor for treating bipolar, premenstrual dysphoric disorder, panic attack disorder, depressive disorders, and OCD. Patients with depression have a low concentration of serotonin in their cerebrospinal fluid (Molla et al., 2014). Notably, Presynaptic serotonin (5HT1A) receptors are in the dorsal raphe nucleus and appear in the prefrontal cortex. Fluoxetine reacts by blocking the reuptake of serotonin into presynaptic serotonin neurons by reuptake transporter protein found in the presynaptic terminal. Additionally, Fluoxetine exhibits a mild reaction at the 5HT2A and 5HT2C receptors.
Notably, Fluoxetine reuptakes serotonin, which produces an activating impact on the body. Thus, it has a long half-life of 2 to 4 days, showing the initial antidepressant effect within 2-4 weeks. Therefore, Fluoxetine should be administered once a day, either in the morning or in the evening, at a dose of 20mg daily. In addition, some patients may require a dosage of 60-80mg daily based on evidence that its efficiency might be delayed from being released in the body to 90mg a week. Also...
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