Impact of ethical Considerations on Treatment Plan and Communication with Patient

 

The informed agreement of the custodial parents to raise the dosage of depression medication is the first ethical factor to be taken into account. The clinician must carefully monitor the harmful effects of a serotonergic drug. Patient education on medication compliance and use will enhance results and guarantee patient safety. Additionally, it is crucial to inform all patients who receive prescriptions for sertraline of any potential side effects and to avoid and identify sertraline toxicity (Singh, 2020). 

Serotonin syndrome, which includes myoclonus, muscular stiffness, diaphoresis, tremor, hyperreflexia, agitated delirium, and hyperthermia, can be caused by serotonin poisoning from taking too much sertraline. As Singh (2020) further reiterates, stopping the medicine and receiving supportive care is necessary for treating serotonin syndrome.

Decision 3#

I would increase the dosage to 75 mg

Reason for Decision 3#

Even in individuals without chronicity, early antidepressant medication termination has been linked to a 25% recurrence incidence within two months Patients who don’t respond well to a 25 or 50 mg/day starting dose may benefit from dose increases up to a 200 mg/day maximum (“Zoloft Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD,” 2022). 50% of the patient’s depressive symptoms have improved. Therefore, increasing the medication’s dose to 75 mg is the wisest course of action.

Reason for Not Selecting Other Options

The patient’s depressive symptoms have lessened by 50%. As the client responds to this therapy, there is no reason to switch the client’s medication to an SNRI. Therefore, increasing the dosage of the present drug is the recommended course of action. Once an antidepressant has been chosen, the dosage should be adjusted according to the patient’s age, the treatment environment, co-occurring disorders, concurrent pharmacotherapy, or pharmaceutical side effects.

Lowering the dosage or changing the patient’s medication should be done if side effects appear (Dwyer & Bloch, 2019). Patients who do not fully react to therapy should not have the acute phase of their care abruptly ended. An incomplete response to treatment is linked to poor functional outcomes.

The diagnosis should be re-evaluated, side effects and therapy compliance should be evaluated, comorbidities and psychosocial variables should be addressed, and the treatment plan changed if a moderate improvement in symptoms does not occur four to eight weeks following treatment commencement (Singh, 2020). Patients with effective pharmacotherapy should continue treatment for four to nine months at the same dosage to lower the likelihood of recurrence. In the next stage, depression-specific cognitive-behavioral therapy is also advised (Singh, 2020).

Intended Achievement with Decision 3#

The anticipation was too great to lessen symptoms. Recent research proposes an equivalent mechanism for why SSRIs do not immediately take effect (Hengartner, 2020). The SSRIs’ inability to directly target the serotonin transporter is given as the explanation (Hengartner, 2020). Although certain SSRIs (like Lexapro, for example) bind to the transporter directly, this is not the actual mechanism of action. Antidepressants, on the other hand, specifically target the serotonin transporter-coding genes in human DNA. They reduce the activity of these genes, thereby decreasing the number of serotonin transporter molecules in the brain (Hengartner, 2020)