Pharmacotherapeutics for Depression
Margo is a 49-year-old divorced woman who works as a bank teller. She tells her primary care provider (PCP) that she feels tired all the time and she is gaining weight because she has no interest in her usual exercise activities and has been overeating, not from appetite but out of boredom. She notices that she has difficulty falling asleep at night and awakens around 4 a.m. most mornings, without her alarm, and cannot go back to sleep even though she still feels tired. She finds little joy in her life but cannot pinpoint any particular concern. The PCP asks Angela to fill out a Beck’s Depression Scale, which indicated she has moderate depression.
Your first line of treatment leads you to prescribe citalopram for Margo that she is to take daily and return for follow-up in 6 weeks.
- Write that prescription. (Be sure to indicate drug name, strength, amount per dose, route, frequency of dose, amount to dispense, allow generics, and number of refills.)
- Provide Margo with written education regarding her prescription. (Include what she should expect when first taking the drug, appropriate activity warnings, when to expect improvement, side effects she may experience, and anything she should report to the provider). Write this is a narrative form as though you were talking to the patient.
Expert Solution Preview
Introduction:
This scenario requires a medical professional to prescribe pharmacotherapy for a patient with moderate depression. The medication prescribed is citalopram, and the medical professional is also tasked with providing written education regarding the prescription.
1. Prescription:
Drug Name: Citalopram
Strength: 20 mg
Amount per dose: 1 tablet
Route: Oral
Frequency of dose: Once daily
Amount to dispense: 30 tablets
Allow Generics: Yes
Number of refills: None
2. Written Education:
Dear Margo,
I understand that you are experiencing fatigue, weight gain, and sleep difficulties. I have prescribed to you citalopram, which is an antidepressant medication that will help alleviate some of the symptoms you are currently having.
When taking citalopram, you may experience side effects such as nausea, dry mouth, and drowsiness. These side effects are not uncommon and should go away within a few weeks. However, if you experience any severe side effects or any thoughts of suicide, please contact me immediately.
You should start to feel the effects of the medication within 1 to 4 weeks; however, it may take up to 8 weeks for the medication to reach its full benefits. I advise that you avoid alcohol while taking this medication and let me know if you are taking any other medications, as they may interact with citalopram.
It is essential to continue taking citalopram as prescribed by me to ensure that you receive the maximum benefits of the medication. If you have any questions or concerns, please do not hesitate to contact me.
Sincerely,
Your Medical Professional.
