Running Head: PEDIATRIC DEPRESSION THERAPY 2
PEDIATRIC DEPRESSION THERAPY 2
Pediatric Depression Therapy
September 14, 2020
Pediatric Depression Therapy
This case involves an 8-year old boy who presents with a chief complaint of sadness. The boy’s mother further notes how the son has been isolating himself from others and has been having irritation and reduced appetite. From a general perspective, the patient is expressing signs of depression and would benefit from a psychiatric therapist who can evaluate his case. According to the mental health analysis conducted by the psychiatric therapist, the results on the rating scale indicated severe depression. This paper will explain the decision to treat the patient with a 50mg dosage of Zoloft to relieve his depressive symptoms.
The first decision choice is to treat the patient with Zoloft PMHNP should begin with a daily dose of Zoloft 25 mg. Unfortunately, the patient did not exhibit any relief of depressive symptoms during a four-week follow-up period. Rather than switch the patient to a new medication, it is better to increase the Zoloft to 50mg daily. Finally, an additional visit four weeks later showed an impressive decrease in symptoms. This proves that Zoloft has been effective, and the current prescription should be maintained.
Rationale and Mechanism of Action
Zoloft falls under the group of drugs known as selective serotonin reuptake inhibitors (SSRIs). From research, the drugs are believed to be effective in managing any form of depression. The pediatric population is among the many groups of people who have successfully approved the safety of using drugs to treat depression. As previously mentioned, this patient scored a 30 on the childhood depression scale. Such a score implies that the child is under severe depression, and he needs immediate intervention (Dobson, & Strawn, 2016). Looking at the antidepressant scale, Zoloft remains the ideal option to go with because it best handles pediatric patients struggling with depression.
According to the case presented, Paxil 10mg can also be applied. However, it does not best fit the scenario because the patient is still young, and the drug has more adverse side effects. Besides, managing the resultant symptoms of the drug can be problematic for young individuals. The drug is usually administered when depression symptoms are severe, for instance, when the patient thinks of committing suicide.
An additional alternative drug that can be used is Wellbutrin 75mg. However, the alternative is ruled out for use in this particular case because it is only used as a plan B or a backup drug in case SSRI drugs fail to work. More importantly, Wellbutrin has not been approved by the FDA for use in children due to its interactions with norepinephrine (Patient Information Sheet, 2017). purpose of using medicine is eliciting desired outcomes. The medication can also be applied when the level of depression is not pronounced. Thus, it is not ideal in addressing the current case. A combination of Zoloft and Paxil is not recommended. Combining the two drugs, which belong to an everyday SSRI work towards a similar mechanism of action. This can eventually result in toxic doses, and ultimately resulting in serotonin syndrome (Weersing et al., 2017). Taking all the facts mentioned above into account, Zoloft remains the best choice of drug to address the mentioned case scenario.
The mechanism of action for Zoloft is associated with an inhibition of the reuptake of serotine within the central nervous system. The drug further works by blocking the reuptake of serotine that can be absorbed into human platelets.
First Line FDA approved medications for Pediatric Depression
First-line FDA approved medicines are SSRIs drugs which are manufactured to handle depression amongst adolescents (Skarphedinsson et. al., 2015). This is because a good number of people exhibit mild conditions and that such medications are typically taken once in a day. The medicine is usually applied to individuals with mild symptoms.
Based on the patient’s improvements in symptoms, it is evident that Zoloft 50mg daily is the best option for this young child. While Paxil is an alternative option, it is not feasible in this situation. Wellbutrin is not even an option as it is not approved for use in children and could result in terrible consequences. Zoloft is the most responsible and effective decision in this case scenario.
Dobson, E. T., & Strawn, J. R. (2016). Pharmacotherapy for Pediatric Generalized Anxiety Disorder: A Systematic Evaluation of Efficacy, Safety, and Tolerability. Pediatric Drugs, 18, 1, 45-53.
Patient Information Sheet. (2017). Brown University Child & Adolescent Psychopharmacology Update, 19, 1–2. https://doi-org.ezp.waldenulibrary.org/10.1002/cpu.30237
Skarphedinsson, G., Weidle, B., Thomsen, P., Dahl, K., Torp, N., Nissen, J., Melin, K., Hybel, K., Valderhaug, R., Wentzel-Larsen, T., Compton, S., & Ivarsson, T. (2015). Continued cognitive-behavior therapy versus sertraline for children and adolescents with obsessive-compulsive disorder that were non-responders to cognitive-behavior therapy: a randomized controlled trial. European Child & Adolescent Psychiatry, 24(5), 591–602. https://doi-org.ezp.waldenulibrary.org/10.1007/s00787-014-0613-0
Weersing, V. R., Brent, D. A., Rozenman, M. S., Gonzalez, A., Jeffreys, M., Dickerson, J. F., Lynch, F. L., … Iyengar, S. (2017). Brief Behavioral Therapy for Pediatric Anxiety and Depression in Primary Care: A Randomized Clinical Trial. Jama Psychiatry, 74, 6, 571-578