Ethnicity and Antidepressants - Essay Example

"Ethnicity and Antidepressants" is a wonderful example of a paper on social and family issues.
Since the diagnosis of the patient has already been established, my focus would mainly be to understand his situation more. The first question I would present to my client is, what activities do you still enjoy doing? The purpose of this question is to understand aspects of life that my client still bases his happiness on. This will be of great help in recommending therapeutic sessions around them outside the office, as well as identifying other situations that may improve his condition.  The second question is regarding the medicine discontinuation, were these actions self-initiated or a recommendation from the physician?  This will be informative in analyzing my client’s compliance with medicine. My last question to the client will be, what do you expect as the outcome of our sessions? This will be to gauge my client’s expectations and level of motivation towards our meeting.

 The people I would like to speak to are my client’s family: his wife and children. One of the questions I would as is, do they feel safe around my client? And the second question is, what are some of the behavior changes do they notice towards my client before each episode.  

With such recurrent relapse of depression, it is essential to rule out all medical issues as the cause. Therefore, I would first order a blood test to check out the electrolytes, liver function, toxicology screening, and kidney (Howland, 2008a). This will be followed by a CT scan to rule out all possibilities of a brain tumor.

From my observation in the medical notes about the patient, my analysis is that the patient could either have an anxiety disorder, melancholic depression, or major depressive disorder (American Psychiatric Association, 2013). Most incidences of depressive situations were mostly caused by life incidences and significant changes in life. For example, the first episode was after a diagnosis of atrial fibrillation, and the death of his mother. Therefore, it is conclusive that my patient is anxious about the unknown, especially life changes taking place in his life.

According to the information, my client has become resistant to the two lines of drug therapy for depression. Hence I recommend Isocarboxazid (Stahl, 2014b).  It should be given as 10mg a day, and if it is proven ineffective, it should be added 10mg every day until it gets to 40mg (Stahl, 2014b). If the therapeutic response has been attained, then the dosage should begin to be reduced gradually after four days, and this should not affect the therapeutic intervention. Also, I recommend MAOIs drug, Phenelzine, which should be given 45mg a day, in three tablets at different times. This is because of the pharmacokinetics and pharmacodynamics of Isocarboxazid as the patient has a cardiac problem, atrial fibrillation (Stahl, 2013).

With many Monoamine oxidase inhibitors (MAOIs), hypertension is an area of interest for all races (Stahl, 2014b). This is because some of the patients re-diagnosed with high blood pressure hence the need for a restricted tyramine diet, and therefore foods like yeast and cheese should be avoided (Stahl, 2013) (Yasuda, 2008).

My first change will be to place the client under lifelong therapeutic sessions for my client as well as medication. Secondly, during our therapy sessions, I will apply Psychoanalysis and psychodynamic therapies to understand the issue, the main cause of the depression (Howland, 2008a).

The case study has been very informative on different approaches that are required to treat the patient. It has shown me how important it is to recommend persistent taking of antidepressants and session therapy for people with several episodes (three or more recurring episodes) and those who have a family history of depression (Howland, 2008a).  The second lesson is the need for proper analysis and issuing of the right drugs to every patient.