ASSESSING AND TREATING PATIENTS WITH ANXIETY DISORDERS
Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt patients to seek care from their primary care providers or emergency departments. Once it is determined that there is no organic basis for these symptoms, patients are typically referred to a psychiatric mental health practitioner for anxiolytic therapy. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with anxiety disorders.
Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.
At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.
Introduction to the case (1 page)
- Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)
- Which decision did you select?
- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
- Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
- What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #2 (1 page)
- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
- Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
- What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #3 (1 page)
- Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
- Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
- What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
- Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Conclusion (1 page)
- Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.
** Case study results are attached in file that is to be used to complete assignment
** rubric and outline of paper are also attached
**paper is to be no more than 5 pages
**scholarly peer review resources are to be used and no more than 5 years old
Expert Solution Preview
Introduction:
The patient case study involves a middle-aged Caucasian male who presents with symptoms of anxiety, including chest pains and shortness of breath. The patient has a history of hypertension, hyperlipidemia, gastroesophageal reflux disease (GERD), and depression. The aim of this Assignment is to assess and treat the patient’s anxiety, considering factors that may impact his pharmacokinetic and pharmacodynamic processes.
Decision #1:
The selected decision is to prescribe Sertraline 25 mg PO daily for the patient’s anxiety disorder. This decision was based on moderate evidence supporting the effectiveness of Selective Serotonin Reuptake Inhibitors (SSRIs) in treating anxiety disorders. It was also chosen due to the patient’s comorbid depression and previous successful treatment with SSRIs.
The first option, Buspirone, was not selected because it is a slow-onset medication with little evidence supporting its use in treating anxiety disorders. The second option, Alprazolam, was not chosen due to the higher risk of abuse potential and dependence.
The goal of this decision was to alleviate the patient’s anxiety, improve his symptoms, and avoid potential drug misuse or dependence.
Ethically, it is essential to communicate the potential side effects and the importance of therapy compliance to the patient. Additionally, patients with anxiety disorders may be at risk for suicidal thoughts or behaviors, and it is crucial to monitor the patient’s mental state for deterioration.
Decision #2:
The chosen decision is to titrate Sertraline to 50 mg PO daily after 2 weeks of the initial prescription. The selected dosage has been shown to be effective in treating anxiety disorders and depression. The decision was also based on the patient’s previous response to an SSRI.
The first option, Escitalopram, was not selected due to its potential to interact with the patient’s hypertension medication. The second option, Venlafaxine, was not chosen due to the higher risk of side effects and drug interactions.
The aim of this decision was to evaluate the patient’s response to the medication and adjust the dosage if needed, leading to symptom improvement.
Ethically, it is important to be transparent about the potential side effects and the importance of compliance with medication. Ensuring that the patient is informed and understands the treatment plan is essential to maintaining the patient’s trust.
Decision #3:
The selected decision is to continue with Sertraline 50 mg PO daily as the patient’s anxiety and depressive symptoms have improved. The patient’s tolerance of the medication has also been demonstrated, making a change unwarranted.
The first option, adding cognitive-behavioral therapy (CBT), was not selected in this case because the patient has shown improvement under pharmacologic treatment alone. The second option, increasing the Sertraline 75mg PO daily, was not chosen due to the higher risk of side effects.
The goal of this decision was to maintain symptom improvement and avoid unnecessary dosage changes that may increase the risk of adverse effects.
Ethically, it is important to regularly check in with the patient regarding their mental state, side effects, and medication compliance. Monitoring the patient’s progress and making adjustments as necessary to achieve the desired outcomes is essential to providing the best care possible.
Conclusion:
In conclusion, the selected treatment plan for the patient’s anxiety disorder includes Sertraline 25 mg PO daily, titrating to 50 mg PO daily after two weeks, and maintaining that dosage. This plan was chosen based on the patient’s comorbid depression and past successful treatment with SSRIs. Ethical considerations, such as informed consent and monitoring for suicidal ideation, were also taken into account. Overall, the treatment plan aims to alleviate the patient’s anxiety symptoms, with evidence-backed clinical interventions.
