Therapy for Pediatric Clients with Mood Disorders - Essay Example

Week 2: Therapy for Pediatric Clients with Mood Disorders

The pediatric mental health issues ranging from bipolar disorder to depression are referred to as affective disorders or mood disorders. Current studies have tried to make a relationship between anxiety disorders among adults and affective disorders in children. Research shows that the onset of psychopathologic disorders in adults can be connected to the emotional or behavioural symptoms displayed in adolescents or children (Maughan et al.,2013). Fundamentally, mood disorders remain the most under-diagnosed health issues, especially in children. Undiagnosed mood disorders can expose children to other health risks such as substance use disorders and disruptive behaviour. In most cases, adolescents and children with mood disorder do not always exhibit the symptoms as adults do. Therefore, it is quite difficult for parents or caregivers to recognize the disorder, especially if the child cannot easily express his or her feelings (Chop, 2018). Treatment of mood disorders depends majorly on the symptoms. Essentially, treatment aims at reducing the symptoms of the condition. To provide effective treatment to a patient, the PMHNP must conduct a complete assessment of past health history, pharmacological interventions, and psychological therapies that need to be included in the treatment plan. This paper seeks to assess the best treatment a pediatric patient presenting mood disorders.

Summary of the Patient

An eight-year-old African American male was brought to the emergency room by his mother, who had an issue of being sad. The mother said that the boy detaches from his age mates. Besides, the mother noticed that the boy had irritation problems and had no appetite. The patient exhibits some symptoms of depression. The boy had to consult aa nurse for psychiatric assessment since his laboratory and physical examinations were normal. The result of the scale indicated a score of 30, which was severe depression. Therefore, the patient needs immediate attention to alleviate the symptoms.

Decision 1

Options: Zoloft 25 mg orally daily, Paxil 10 mg daily, Wellbutrin 75 mg BID

Given the age, symptoms, history, and the score of the child on depression, the PMHNP need to decide on which medication to prescribe to the patient. Healthcare providers need to consider the patient's age before prescribing any antidepressants and analyze both risks and benefits. The PMHNP need to conduct a thorough assessment to determine whether the medication is appropriate. Before administering any form of antidepressant, laboratory tests should be conducted to rule out any other medical condition that may cause depression. In regards to this case study, the healthcare professional need to identify the most effective medication to prescribe to the pediatric patient. The PMHNP should be aware of the various antidepressants, including selective serotonin-norepinephrine reuptake inhibitor (SNRI), selective serotonin reuptake inhibitor (SSRI), and monoamine oxidase inhibitor (Schultz & Malone, 2013).

Some of the choices are, to begin with, Zoloft 25 mg orally daily, Paxil 10 mg daily, and Wellbutrin 75 mg orally BID. I decided to start with Zoloft 25 mg orally. Research shows that Sertraline is effective in treating depression in pediatric patients. Essentially, the response rate of the management of the condition is between 40 to 70 per cent. According to Magellan Health (2013), Wellbutrin and Paxil should not be prescribed to children below 18 years. For instance, Wellbutrin leads to anorexia and seizures when given to young patients. The main purpose of the therapy is to minimize the symptoms without escalating the current impact of the condition on the child. However, the result of the therapy did not meet the expectations since the patient went back after four weeks. The patient did not show any changes in the signs that the patient had portrayed initially.

Decision 2

In the second decision, I decided to increase the amount of Sertraline by further 25 mg orally daily. As cited by Magellan Health (2013), Sertraline is best option for depressed children, and it can be dissolved up to 200 mg. I did not choose the 37. 5 mg of Sertraline since it is below the needed treatment for the treatment. The other reason for my decision is that there was no increase in stress for the boy. The purpose of administering the medication is to reduce the illness symptom. Nevertheless, the outcome of the therapy did not still meet the outcomes as I thought the signs would minimize by 50 per cent, which did not turn out to be the case.

Decision 3

The decision led to a decrease in depressive symptom by approximately 20 per cent after four weeks of increasing Sertraline by 25 mg. As stated by Stahl (2008), a response is demonstrated when an individual minimizes the symptoms and signs. The purpose of choosing the current dose is because the pediatric patient responded positively to the medication. The purpose of the treatment is to continue administering the medication with an aim of eliminating the symptoms. The medication matched my expectations by eliminating the signs and symptoms.

Conclusion with Ethical Consideration

The ethics of prescribing medications to pediatric patients and their relatives is something that healthcare providers should be upheld. One of the ethical challenges is informing the parent and the children of the consent including anticipated advantages, challenges, and possible alternatives (Neville et al., 2014). As cited by Vitiello (2012), children below 14 years cannot give consent in regards to their treatment. However, the regulation of age and consent varies from one country to another. In this case, the PMHNP should inform the parents of the benefits and risks of the treatment. If the therapy is based on scientific research, the medical professional need to inform the child and the parent of the procedure of the condition (Neville et al.,2014). The healthcare practitioner can start by addressing the issues of response and adherence even as they cooperate with the parents after obtaining permission to go ahead with the prescription. The role of the parent is to oversee and inform the doctor about the response of the patient over time. The other alternative in this case to increase Sertraline which was to minimize the signs and symptoms. In this situation, the drug cannot be changed to SNRI at this particular stage.

In a nutshell, children and adolescents with mood disorders need immediate attention to avoid the development of other serious health problems. As a healthcare provider, it is prudent to choose the best treatment that would work for pediatric patients to prevent further health complications. Sertraline is the best alternative for children with mood issues. In this case, the medical practitioner needs to continue to use Sertraline to eradicate the symptoms of the disease.