NRNP 6675 Week 9 Discussion: Prescribing for Older Adults and Pregnant Women Example 2

ZOLOFT is an FDA-approved medication for major depressive disorder. It is used to treat panic attacks, obsessive-compulsive disorder, post-traumatic stress disorder, and premenstrual syndrome. It can help improve sleep, appetite, and energy levels that can restore interest in daily living. For off-label medications, doxepin is often prescribed for depression and anxiety (Hardy & Reichenbacker, 2019). It is in the class of medications known as tricyclic antidepressants.

It works by boosting the levels of certain natural chemicals in the brain that are necessary for mental equilibrium. Doxepin can also be taken as a pill to help with insomnia. Cognitive-behavioral therapy (CBT) is a safe and effective treatment for a generalized anxiety disorder during pregnancy.

Risk and Benefit Assessment

The main risk for Zoloft is that it can cause congenital disabilities in children. These defects include atrial septal defects, cleft palate, and omphalocele. The benefit is that the medication raises the amount of serotonin in the brain Cuomo et al. 2918). As the level of serotonin increases, so does the patient’s mood. Patients, therefore, experience improvements in appetite, sleep, mood, and energy levels.

Doxepin works on the central nervous system to increase the levels of various chemicals in the brain. The medication can improve energy levels and sleep for patients (Akmasi & Meza, 2019). The risk is that it may cause a condition that affects the heart rhythm and fainting symptoms that require medical attention immediately.

Clinical Practice Guidelines

The treatment of depression necessitates a thorough examination and accurate diagnosis. The evaluation must be based on a complete medical history, a thorough physical examination, and a thorough mental state examination (Gautam et al., 2017). All sources, especially the family, must be used to gather information about the past. The diagnosis must be documented using the most up-to-date diagnostic criteria.

References

Almasi, A., & Meza, C. E. (2019). Doxepin. https://europepmc.org/article/NBK/nbk542306

Cuomo, A., Maina, G., Neal, S. M., De Montis, G., Rosso, G., Scheggi, S. & Fagiolini, A. (2018). Using sertraline in postpartum and breastfeeding: balancing risks and benefits. Expert Opinion On Drug Safety, 17(7), 719-725. https://doi.org/10.1080/14740338.2018.1491546

Gautam, S., Jain, A., Gautam, M., Vahia, V. N., & Grover, S. (2017). Clinical practice guidelines for the management of depression. Indian Journal Of Psychiatry, 59(Suppl 1), S34.

Hardy, L. T., & Reichenbacker, O. L. (2019). A practical guide to the use of psychotropic medications during pregnancy and lactation. Archives of Psychiatric Nursing, 33(3), 254–266. https://doi.org/10.1016/j.apnu.2019.04.001