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Pharmacologic Intervention for Margo: Selective Serotonin Reuptake Inhibitor (SSRI)

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.
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).

Sample Answer

Pharmacologic Intervention for Margo: Selective Serotonin Reuptake Inhibitor (SSRI)
Margo’s symptoms, including fatigue, weight gain, loss of interest in activities, overeating, difficulty falling asleep, and a lack of joy in her life, along with the moderate depression indicated by her Beck’s Depression Scale results, suggest that she may benefit from an antidepressant medication. One commonly prescribed class of antidepressants is Selective Serotonin Reuptake Inhibitors (SSRIs).

Medication: [Insert name of SSRI]
Written Education for Margo:
Dear Margo,

I understand that you have been experiencing symptoms of depression and have been diagnosed with moderate depression based on the results of the Beck’s Depression Scale. To help alleviate your symptoms and improve your quality of life, your primary care provider has prescribed a medication called [insert name of SSRI].

What to Expect when First Taking the Drug:

It may take a few weeks for the medication to reach its full effect, so it is important to be patient and consistent with taking the medication as prescribed.
Initially, you may experience some mild side effects such as nausea, headache, or dizziness. These side effects are usually temporary and tend to subside after a few days or weeks.
Appropriate Activity Warnings:

It is important to continue engaging in your usual exercise activities, even if you currently have no interest in them. Regular physical activity can help improve your mood and overall well-being.
However, be cautious about overexertion or pushing yourself too hard while taking the medication. Listen to your body and adjust your activity level accordingly.
When to Expect Improvement:

As mentioned earlier, it may take a few weeks for the medication to start working effectively. During this time, it is normal to experience some ups and downs in your mood.
If you do not notice any improvement after several weeks or if your symptoms worsen, please inform your primary care provider. They may need to adjust the dosage or explore alternative treatment options.
Side Effects You May Experience:

While SSRIs are generally well-tolerated, they can cause some side effects. Common side effects include nausea, diarrhea, dry mouth, headache, and sexual dysfunction.
If any side effects persist or become bothersome, it is essential to inform your primary care provider. They can provide guidance on managing these side effects or consider adjusting the medication if necessary.
Anything You Should Report to the Provider:

It is crucial to keep an open line of communication with your primary care provider throughout your treatment. Be sure to report any unusual or severe side effects that you experience.
Additionally, if you notice any changes in your mood, suicidal thoughts, or worsening of your depression symptoms, it is important to seek immediate medical attention.
Remember, medication is just one aspect of managing depression. It is also important to engage in self-care activities, seek support from loved ones, and consider therapy or counseling to address underlying issues. Your primary care provider will closely monitor your progress and make any necessary adjustments to ensure you receive the best possible care.

If you have any further questions or concerns, please do not hesitate to reach out to your primary care provider. They are there to support you on your journey towards improved mental health.

Wishing you all the best on your path to recovery.

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