Pharmacologic Intervention for Moderate Depression: Empowering Margo’s Journey to Wellness

QUESTION

Margo is a 49-year-old divorced woman who works as a bank teller. She tells her primary care provider (PCP) that she feels tired all the time and that she is gaining weight because she has no interest in her usual exercise activities, and that she has been overeating, even though she is often not really hungry. She notices that she has difficulty falling asleep at night and awakens around 4 a.m. most mornings, without her alarm, and cannot go back to sleep even though she still feels tired. She finds little joy in her life but cannot pinpoint any particular concern or event causing this problem. The PCP asks Angela to fill out a Beck’s Depression Scale, which indicates she has moderate depression.

• Choose a pharmacologic intervention for Margo.
• Prescribe a medication for Margo.
• Provide Margo with written education regarding her prescription. (Include what she should expect when first taking the drug, appropriate activity warnings, when to expect improvement, side effects she may experience, and anything she should report to the provider).

ANSWER

Pharmacologic Intervention for Moderate Depression: Empowering Margo’s Journey to Wellness

Introduction

Margo’s presentation of fatigue, weight gain, loss of interest in activities, overeating, and difficulty sleeping suggests she is experiencing moderate depression. As her primary care provider (PCP), my goal is to provide her with an appropriate pharmacologic intervention that can alleviate her symptoms and improve her quality of life. This essay outlines the chosen medication, prescription details, and essential education to empower Margo in her path towards recovery.

Pharmacologic Intervention

Selective Serotonin Reuptake Inhibitors (SSRIs) have shown effectiveness in treating depression, including moderate depression. Considering Margo’s symptoms and the safety profile of SSRIs, this class of medication is a suitable choice.

Prescription

Medication: Sertraline (Zoloft) 50 mg tablets
Dosage: Take one tablet orally daily in the morning
Dispense: #30 tablets
Refills: 3

Patient Education

Introduction to Sertraline

Sertraline is an SSRI used to treat depression and anxiety disorders.
The medication works by increasing serotonin levels in the brain, improving mood and emotional well-being.

Expected Initial Effects

Margo may not experience immediate improvements; it may take 2-4 weeks for the full therapeutic effect to be evident.
During the initial days, she may experience mild side effects such as nausea, dizziness, or headache, which often resolve on their own.

Activity Warnings

It is essential for Margo to continue engaging in her usual daily activities and exercise routines, as physical activity can complement the effects of the medication.

Sleep Disturbances

Sertraline may improve her sleep patterns over time; however, she may experience sleep disturbances during the initial weeks of treatment.

Reporting to the Provider

If Margo experiences severe side effects, allergic reactions (e.g., rash, difficulty breathing), or if her depression worsens, she should immediately contact her PCP.

Timing and Compliance

Margo should take the medication at the same time each day to establish a consistent level in her bloodstream.
It is essential for her to take the full course of medication as prescribed, even if she starts to feel better, to prevent relapse.

Avoid Alcohol and Drug Interactions

Margo should avoid alcohol consumption while on sertraline, as it may worsen side effects or reduce the medication’s effectiveness.
It is crucial for her to inform her PCP about any other medications or supplements she is taking to avoid potential interactions.

Conclusion

By prescribing sertraline and providing comprehensive patient education, Margo can embark on her journey to overcome moderate depression. The pharmacologic intervention, coupled with lifestyle adjustments and regular follow-ups with her PCP, will enable Margo to experience improved mood, increased energy, and restored joy in her life. It is essential for her to understand the medication’s effects, report any concerns, and adhere to the prescribed treatment plan to achieve the best possible outcome. Through this collaborative approach, Margo can look forward to a brighter and healthier future.