Assessing and Treating Vulnerable Populations for Depressive Disorders Essay

Assessing and Treating Vulnerable Populations for Depressive Disorders Essay

Assessing and Treating Vulnerable Populations for Depressive Disorders Essay

Assessing and Treating Vulnerable Populations for Depressive Disorders Sample Essay

Major depression is one of the mental health problems with increasing prevalence globally. It acts as a source of disease burden because of its associated high costs, loss of productivity, and premature deaths. Major depression affects all the populations, including children. Pharmacological and non-pharmacological interventions are largely utilized to treat major depression and prevent relapse. Therefore, this educational paper focuses on the treatment of major depression in children.

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Diagnosis of Major Depression

Children diagnosed with major depression present with several symptoms. One of them is having depressed mood all the time almost every day. They are also helpless and feel guilty most of the times throughout the day. Their mood is depressed, which make them less interested in pleasure or activities they liked before. The children also demonstrate changes in their appetite and body weight. A decline in appetite may lead to unintentional weight loss while increase causes weight gain. The children also experience problems in sleep quality and quantity, feel fatigued and appear isolated. They also become easily irritable, lack concentration and have difficulties in making decisions. Children may also have suicidal thoughts, attempts, or plans (Coda, 2022). These symptoms affect all their aspects of life and function and cannot be attributed to other causes such as health conditions, medications, or substance use or abuse.

FDA-Approved Drugs

The FDA has approved the use of fluoxetine as the only drug for use in the treatment of major depression in children. Fluoxetine is  drug that belongs to the class of selective serotonin inhibitors. Fluoxetine produces its effects by inhibiting the reuptake of serotonin in the presynaptic cleft. The inhibition results in an increase in serotonin level, which improves the mood of the patient (Feeney et al., 2022). The drug acts by binding to specific receptors in the brain referred as 5-HT2 to produce its effect. Besides raising the levels of serotonin, fluoxetine also increases the levels of dopamine and noradrenaline in the prefrontal cortex. Fluoxetine is administered via the oral route because of its high oral bioavailability. It is metabolized in the liver and excreted through urine (Findling et al., 2020).

Side Effects and Monitoring Considerations

Fluoxetine is associated with several side effects. They include insomnia, weight gain, drowsiness, tachycardia, vomiting, and nausea. Children should be monitored closely for adverse effects of fluoxetine. They include suicidal thoughts, attempts, or plans. Children and family members should be informed to contact their healthcare providers should there be a sudden change in their children’s behavior. Too much energy or depressed mood despite the treatment may indicate adverse effect of fluoxetine. Children should also be assessed for weight gain since it may affect their self-identity. Fluoxetine should not be co-used with other medications. For example, the concurrent use of fluoxetine with tricyclic antidepressants predisposes patients to hypertensive crises. Children and their families should be follow-up to determine their use of other medications, hence, promotion of safety in the treatment of depression. Cardiac function should also be monitored among children prescribed fluoxetine. This is attributed to the increased risk of cardiac problems such as tachycardia (Learning, 2022; Skidmore-Roth, 2022). Patients should report incidences of palpitations for the practitioners to tapper the dosage.

Conclusion

In conclusion, fluoxetine is the only FDA-approved drug for use in treating major depression in children. The drug increases serotonin levels in the brain. Patients should be educated about the side and adverse effects of fluoxetine. Practitioners should monitor children prescribed fluoxetine to ensure safety and quality outcomes in the treatment process.

References

Coda, F. (2022). 2023 Foundations of Psychiatric-Mental Health Nursing. Amazon Digital Services LLC – Kdp.

Feeney, A., Hock, R. S., Fava, M., Hernández Ortiz, J. M., Iovieno, N., & Papakostas, G. I. (2022). Antidepressants in children and adolescents with major depressive disorder and the influence of placebo response: A meta-analysis. Journal of Affective Disorders, 305, 55–64. https://doi.org/10.1016/j.jad.2022.02.074

Findling, R. L., McCusker, E., & Strawn, J. R. (2020). A Randomized, Double-Blind, Placebo-Controlled Trial of Vilazodone in Children and Adolescents with Major Depressive Disorder with Twenty-Six-Week Open-Label Follow-Up. Journal of Child and Adolescent Psychopharmacology, 30(6), 355–365. https://doi.org/10.1089/cap.2019.0176

Learning, J. & B. (2022). 2023 Nurse’s Drug Handbook. Jones & Bartlett Learning.

Skidmore-Roth, L. (2022). Mosby’s 2023 Nursing Drug Reference—E-Book. Elsevier Health Sciences.

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Assignment:

Assessing and Treating Vulnerable Populations for Depressive Disorders

Mood disorders can impact every facet of a human being’s life, making the most basic activities difficult for patients and their families. This was the case for 13-year-old Jeanette, who was struggling at home and at school. For more than 8 years, Jeanette suffered from temper tantrums, impulsiveness, inappropriate behavior, difficulty in judgment, and sleep issues.

As a PNP working with pediatric patients, you must be able to assess whether these symptoms are caused by psychological, social, or underlying growth and development issues. You must then be able recommend appropriate therapies.

Assignment- develop a patient medication guide for treatment of depressive disorders in a vulnerable population (your choice for one vulnerable patient population to choose from: children, adolescents, older adults, dementia patients, pregnant women or one not listed of your choice!). Be sure to use language appropriate for your audience (patient, caregiver, parent, etc.). You will include non-copyright images and/or information tables to make your patient medication guide interesting and appealing. Limit your patient medication guide to 2 pages. You will create this guide as an assignment; therefore, a title page, introduction, conclusion, and reference page are required. You must include a minimum of 3 scholarly supporting resources outside of your course provided resources. 

• It is important that you describe the pharmacology of the medications that you choose. It is vital that a practitioner understand the pharmacology, indications, side effects and monitoring considerations for all medications in order to make an informed decision on the most appropriate therapy.

Required Readings:

• Baek, J. H., Nierenberg, A. A., & Fava, M. (2016). Pharmacological approaches to treatment-resistant depression. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 44–47). Elsevier.
• Fava, M., & Papakostas, G. I. (2016). Antidepressants. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 27–43). Elsevier.
• Howland, R. H. (2008a). Sequenced Treatment Alternatives to Relieve Depression (STAR*D). Part 1: Study design. Journal of Psychosocial Nursing and Mental Health ServicesLinks to an external site., 46(9), 21–24. https://doi.org/10.3928/02793695-20080901-06
• Howland, R. H. (2008b). Sequenced Treatment Alternatives to Relieve Depression (STAR*D). Part 2: Study outcomes. Journal of Psychosocial Nursing and Mental Health ServicesLinks to an external site., 46(10), 21–24. https://doi.org/10.3928/02793695-20081001-05
• Lorberg, B., Davico, C., Martsenkovskyi, D., & Vitiello, B. (2019).  Principles in using psychotropic medication in children and adolescents. In J. M. Rey & A. Martin (Eds.), IACAPAP e-textbook of child and adolescent mental healthLinks to an external site.. https://iacapap.org/_Resources/Persistent/45bdffb25befc353c9f61988e82105029504ab85/A.7-Psychopharmacology-2019.1.pdf

Medication Resources:

•             U.S. Food & Drug Administration. (n.d.). Drugs@FDA: FDA-approved drugsLinks to an external site: https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm

 

Note: To access the following medications, use the Drugs@FDA resource. Type the name of each medication in the keyword search bar. Select the hyperlink related to the medication name you searched. Review the supplements provided and select the package label resource file associated with the medication you searched. If a label is not available, you may need to conduct a general search outside of this resource provided. Be sure to review the label information for each medication as this information will be helpful for your review in preparation for your Assignments.

Review the following medications:

• amitriptyline
• bupropion
• citalopram
• clomipramine
• desipramine
• desvenlafaxine
• doxepin
• duloxetine
• escitalopram

In this weekly assignment, I look forward to reading what you have learned from the course resources and your personal experiences.  In your assignments, please be detailed in your description of the medications, including uses, potential adverse effects, monitoring and potential drug interactions.  I ask that your assignments be clearly written, with proper sentence and paragraph structure.  Please review your work prior to submission to assure that there are no spelling or grammar deficiencies. The assignment should include all of the elements listed in the assignment.

The use of citations, directly from the resources, should be minimal.  You should be putting the information that you gather, into your own words when you are completing the discussions and assignments.