Depression and Medication Guide for Compliance Essay

Depression and Medication Guide for Compliance Essay

Depression and Medication Guide for Compliance Sample Essay

Adolescents, in particular, frequently experience depression. The illness hinders their capacity to succeed academically as well as to create and sustain relationships and can have long-lasting effects, particularly if it goes unrecognized. Moreover, depression in kids and teens is frequently accompanied by behavioral issues, drug misuse, and/or other mental illnesses (Selph & McDonagh, 2019). Parents are not always able to notice the issue since depression in children and adolescents might present differently than it does in adults. Treatment options exist for depression. In addition to helping children and adolescents feel better, psychotherapy, medicines, and other interventions can reduce symptoms and improve academic performance, the ability to form and sustain good relationships, and self-confidence. The origins, risk factors, symptoms, diagnosis, and treatment of depression in children and adolescents are covered in this patient guide.

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Causes and Symptoms

Causes

Although the actual origin of depression is unknown, several other problems might be at play. According to Copeland et al. (2020), the following are the most typical risk factors for serious depression: family history of depression, high levels of stress, abuse or neglect, trauma, other psychiatric diseases, the death of a parent, caregiver, or other loved one, smoking, ending of a relationship, other chronic illnesses (like diabetes), and other behavioral, learning, or developmental difficulties

Presentations

There are moments when many kids feel depressed or melancholy. Periodic sorrow is a typical aspect of maturing. But, if children consistently show signs of sadness, irritability, or loss of enjoyment of life, it may indicate that they have a severe depressive disorder, often known as depression (Selph & McDonagh, 2019). Typical signs of depression among kids and teens include: feeling or acting gloomy, sad, tearful, or irritated, not having as much enjoyment as they formerly did, less time with friends or participating in extracurricular activities changes in weight or appetite, getting less or more sleep than normal, having less energy or feeling exhausted having the impression that everything is their fault or that they lack any talent, more difficult to concentrate, not caring as much about school, performing poorly in school, or having suicidal thoughts or wishing to die.

Diagnosis

A complete physical examination and assessment of the mental and cognitive functions are part of the initial stage of diagnosis. If necessary, laboratory tests may be performed to rule out certain medical conditions that might resemble mental conditions. They could include conditions affecting the liver or kidneys, anemia, or seizure disorders. The child’s symptoms and developmental history will be included in the psychiatric history. It is important to extract information about the student’s familial and social history, including any mental illnesses, as well as the educational environment, all of which may contribute to long-term or extreme stress. Direct interviews with the kid can take many different forms, from open-ended inquiries for young children to questions demanding more in-depth responses for teens, as well as the observation of play and parent-child interactions for newborns and very young children. The medical expert must rule out neurological or learning issues that might impair the child’s typical growth and learning ability in addition to the child’s symptoms. The USPSTF now advises screening for anxiety in kids and adolescents aged 8 to 18 and for major depressive disorder (MDD) in teenagers aged 12 to 18 years (Selph & McDonagh, 2019).

Medication Treatment Options

Antidepressants have been prescribed to treat a variety of mental health issues in kids and teenagers, including symptoms of depression. While treating minor to moderate depressive symptoms, severe symptomatology may require a combination of antidepressant and non-pharmacological therapies, such as psychotherapy (Zhou et al., 2020). The selective serotonin reuptake inhibitor (SSRI) Prozac is recommended as the first-choice medication for the treatment of teenage depression due to its efficacy and approval (Xiang et al., 2022). Second-line antidepressants include sertraline, escitalopram, and citalopram. Tricyclic antidepressants, (2)-adrenoceptor antagonists, and selective noradrenaline reuptake inhibitors (SNRI) are some additional antidepressants that may be used in place of or in addition to other antidepressants, but not as first- or second-choice treatments. After a comprehensive risk-benefit analysis, patients and parents must be adequately informed of “off-label” use before the start of medicine.

Table 1:Antidepressants for Adolescents

Drug Class	Examples	Side effects
Selective serotonin reuptake inhibitors	fluoxetine	the feeling or state of being ill, indigestion, constipation, and diarrhea.
Tricyclics	Amitriptyline	constipation, dry mouth, blurred vision, and problems with the urine passage.
Psychoactive or antipsychotic medications	risperidone	constipation, dry mouth, and weight gain.
Stimulants	amphetamines	excitement, discomfort in the bladder, worry, and fits of sobbing.

Medication Considerations

The FDA advises doctors to prescribe the fewest number of dosages possible to help reduce the risk of deliberate or unintentional overdose. Families can lessen the risk of suicide by locking up all medications in the house (Xiang et al., 2022). Parents, caregivers, and medical professionals must regularly supervise any child or adolescent who is taking an antidepressant for depression or any other illness. The initial few months of antidepressant medication or when the dosage is changed provide the greatest risk of suicidal thoughts and actions.

Monitoring

Antidepressant-treated adolescents must be watched for the appearance of uncommon but dangerous side effects, such as suicidal thoughts and actions, mania, and serotonin syndrome. Antidepressants should be used for 12 months to treat severe depressive disorder; they should be taken indefinitely to treat anxiety and obsessive-compulsive disorder (Tsujii et al., 2022).

Table 2: Monitoring recommendations for patients treated for major depressive disorder

Monitoring parameter	Agent	Frequency
Electrocardiogram for QT prolongation	Tricyclic antidepressants	baseline, following the titration of the first dosage, and at dose modifications
Liver function test	Agents with hepatic liability	beginning of therapy, at 6, 12, and 24 weeks into treatment, and as clinically necessary
BMI and waist circumference	Agents with known weight gain liability	Baseline at intervals of one month and six months
Vitamin D, B12, folate, zinc, magnesium	All antidepressants	Baseline
Electrolytes for hyponatremia	SSRIs, mirtazapine, SNRIs and TCAs	baseline and one month later if clinically necessary in high-risk populations, such as youngsters

Special Considerations

The ethical issues surrounding the assessment and management of depression are particularly compelling due to the frequency of depressive symptoms and the diversity of readily available remedies. Compliance with the law, beneficence, nonmaleficence, fairness, honesty, confidentiality or privacy, faithfulness, autonomy, and integrity are among these moral requirements (Copeland et al., 2020). The caregiver or legal guardian of the patient must obtain informed consent before a pediatric depression evaluation or treatment plan may be carried out.

Follow up

Some people react to antidepressant medication within two weeks, but for the majority, the full effect takes four to six weeks or longer. Typically, the dosage is progressively raised throughout the first several weeks. At the beginning of treatment, the patient generally visits the prescribing doctor more regularly (every 1 to 4 weeks for the first several months) (Tsujii et al., 2022). Follow-up gradually decreases to once every three months as the patient stabilizes. If issues arise, more regular visits are resumed.

Proper Prescriptions

Conclusion

Children and teens who experience depression or anxiety might benefit from antidepressant medication. Although serious adverse effects are rare, antidepressant usage in adolescents and teenagers must be closely monitored. A U.S. Food and Drug Administration (FDA) black box warning concerning the possibility of increased suicidal thoughts and actions in certain people younger than 25 is present on antidepressant labels. Although the suicide warning may initially seem terrifying, it’s crucial to learn the details. Learn what the warning signifies and enquire about all available treatments. With your child’s doctor, you can use this information to assess the advantages and disadvantages of various treatment choices and make an informed decision regarding your child’s health.

References

Copeland, W. E., Alaie, I., Jonsson, U., & Shanahan, L. (2020). Associations of Childhood and Adolescent Depression With Adult Psychiatric and Functional Outcomes. Journal of the American Academy of Child & Adolescent Psychiatry, 60(5). https://doi.org/10.1016/j.jaac.2020.07.895

Selph, S. S., & McDonagh, M. S. (2019). Depression in Children and Adolescents: Evaluation and Treatment. American Family Physician, 100(10), 609–617. https://www.aafp.org/pubs/afp/issues/2019/1115/p609.html

Tsujii, T., Sakurai, H., Takeuchi, H., Suzuki, T., Mimura, M., & Uchida, H. (2022). Predictors of response to pharmacotherapy in children and adolescents with psychiatric disorders: A combined post hoc analysis of four clinical trial data. Neuropsychopharmacology Reports, 42(4), 516–520. https://doi.org/10.1002/npr2.12299

Xiang, Y., Cuijpers, P., Teng, T., Li, X., Fan, L., Liu, X., Jiang, Y., Du, K., Lin, J., Zhou, X., & Xie, P. (2022). Comparative short-term efficacy and acceptability of a combination of pharmacotherapy and psychotherapy for depressive disorder in children and adolescents: a systematic review and meta-analysis. BMC Psychiatry, 22(1). https://doi.org/10.1186/s12888-022-03760-2

Zhou, X., Teng, T., Zhang, Y., Del Giovane, C., Furukawa, T. A., Weisz, J. R., Li, X., Cuijpers, P., Coghill, D., Xiang, Y., Hetrick, S. E., Leucht, S., Qin, M., Barth, J., Ravindran, A. V., Yang, L., Curry, J., Fan, L., Silva, S. G., & Cipriani, A. (2020). Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder: a systematic review and network meta-analysis. The Lancet Psychiatry, 7(7), 581–601. https://doi.org/10.1016/s2215-0366(20)30137-1

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For this assignment, you will develop a patient medication guide for treatment of depressive disorders in a vulnerable population ( adolescents). 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 5 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.

In your patient guide, include discussion on the following:

• Depressive disorder causes and symptoms
• How depression is diagnosed for the vulnerable population of your choice, why is this population considered vulnerable
• Medication treatment options including risk vs benefits; side effects; FDA approvals for the vulnerable population of your choice
• Medication considerations of medication examples prescribed (see last bullet item)
• What is important to monitor in terms of labs, comorbid medical issues with why important for monitoring
• Special Considerations (you must be specific, not general and address at least one for EACH category; you must demonstrate critical thinking beyond basics of HIPPA and informed consent!): legal considerations, ethical considerations, cultural considerations, social determinants of health
• Where to follow up in your local community for further information
• Provide 3 examples of how to write a proper prescription that you would provide to the patient or transmit to the pharmacy.