Decision #1
Which decision did you select?
Begin Zoloft 25 mg orally daily.
Why did you select this decision?
Zoloft is a selective serotonin reuptake inhibitor (SSRI) that functions by restoring serotonin balance in the brain to improve mood, particularly the client’s depression. Besides that, it is highly effective in treating mood disorders and depression among children. In addition, starting at the lower dose of 25 mg since antidepressants tend to increase anxiety when first used Stahl, 2014) Case Study: An African American Child Suffering From Depression.
What were you hoping to achieve by making this decision?
The prescribed medication was intended to improve the client’s mood and address the depression by restoring the serotonin balance in the brain (Stahl, 2014).
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
The prescription and its dosage was intended to improve the client’s mood and address the depression (Stahl, 2014). But, this objective was not achieved. Instead, the client returned to the clinic after four weeks reporting that she had not experienced any changes to her depressive symptoms. The lack of response is likely the result of the low medication dosage with a higher dose anticipated to further improve the serotonin balance in the brain to alleviate the depressive symptoms (Stahl, 2013). Case Study: An African American Child Suffering From Depression
Decision #2
Increase Zoloft dose to 50 mg orally daily.
Why did you select this decision?
The dosage was increased since the initial dose did not achieve the desired outcome of reducing the depressive symptoms. The increased dose is anticipated to further improve serotonin balance in the brain thereby reducing the depressive symptoms (Stahl, 2014).
What were you hoping to achieve by making this decision?
The decision to increase the prescribed medication dose was intended to reduce the client’s depressive symptoms by improving serotonin balance in the brain (Stahl, 2014).
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
The expected result from increasing the dosage to 50 mg was to reduce the depressive symptoms. This was achieved since the client visited the clinic four weeks later with the depressive symptoms reduced by 50% and client reporting that he was tolerating well (Stahl, 2014).
Decision #3
Maintain the current dose of Zoloft at 50 mg orally daily.
Why did you select this decision?
The decision to maintain the current dose was made for two reasons. Firstly, the client was responding well to the current dosage with clear symptoms reduction. Secondly, the client had adjusted well to the current dosage to imply that it was an optimum dosage for reducing the symptoms without presenting adverse effects (Stahl, 2014).
What were you hoping to achieve by making this decision?
The decision to maintain the current dosage was made with the intention of building on the current positive results. The dosage is already working in relieving the depressive symptoms, and maintaining it is expected to continue the current trend of relieving the symptoms (Stahl, 2014) Case Study: An African American Child Suffering From Depression.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
It was expected that additional symptoms reduction would be reported beyond the current 50%. But this was not the case with no further reduction in symptoms reported after four weeks. Given that the 50% reduction in symptoms was not full remission, the client was responding to the medication so that a change in drugs was not warranted, then the next step would be to recommend the use of psychotherapy as an additive therapy to complement the prescription medication. This decision is informed by ethical justifications that the client is already responding to medication whose dosage cannot be increased so that psychotherapy is recommended as a complement that would provide additional benefits (Stahl, 2013; Stahl, 2014). Besides that, the standard safe Zoloft dose for children is 50 mg daily for mood disorders and depression. Increasing the dose beyond 50 mg daily is likely to reduce the symptoms further but also
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