Reuptake Inhibitor (SSRI): A Case Study
Mrs. B has many symptoms of depression such as a decline in energy, loss of interest in enjoyable activities, unintentional weight loss, and sadness (Jackson and Cates, 2016). An appropriate first line medication that could be prescribed is a specific serotonin reuptake inhibitor (SSRI) (Jackson and Cates, 2016). These medications usually require tapering when starting and stopping the medication. (Jackson and Cates, 2016). Furthermore, SSRIs are less sedating than many other antidepressants making the class a good option for Mrs. B. Some associated side effects with SSRIs include, sexual dysfunction, central nervous system stimulation, and gastrointestinal disturbances (Jackson and Cates, 2016). I think that I would prescribe Paroxetine for
the patient due to her age and the possibility that she may be having symptoms associated with menopause. If she were this medication may be helpful for vasomotor symptoms as well. According to Handley and Williams (2015), Paroxetine 10mg one tablet daily by mouth was shown to be effective for treating hot flashes. Mrs. B should be advised to consult with the provider before taking over the counter (OTC) medications due to the risk of serotonin syndrome with SSRIs. Serotonin syndrome may occur due to an accumulation of serotonin in the body and medications causing it include SSRIs, serotonin norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), triptans, opioids, and OTC medications containing dextromethorphan (Jackson and Cates, 2016). Furthermore, it remains important to assess Mrs, B’s thyroid hormone level to ensure that she is not being overtreated with levothyroxine as this may being influencing her depression (Katz, 2016). St. John’s wort has shown efficacy in mild to moderate depression; however, it has potential for numerous drug interactions and side effects such as headache, fatigue, nervousness, and gastrointestinal irritation (Jackson and Cates, 2016). Therefore, I would advise Mrs. B to avoid taking St. John’s wort since I have prescribed her Paroxetine.
the patient due to her age and the possibility that she may be having symptoms associated with menopause. If she were this medication may be helpful for vasomotor symptoms as well. According to Handley and Williams (2015), Paroxetine 10mg one tablet daily by mouth was shown to be effective for treating hot flashes. Mrs. B should be advised to consult with the provider before taking over the counter (OTC) medications due to the risk of serotonin syndrome with SSRIs. Serotonin syndrome may occur due to an accumulation of serotonin in the body and medications causing it include SSRIs, serotonin norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), triptans, opioids, and OTC medications containing dextromethorphan (Jackson and Cates, 2016). Furthermore, it remains important to assess Mrs, B’s thyroid hormone level to ensure that she is not being overtreated with levothyroxine as this may being influencing her depression (Katz, 2016). St. John’s wort has shown efficacy in mild to moderate depression; however, it has potential for numerous drug interactions and side effects such as headache, fatigue, nervousness, and gastrointestinal irritation (Jackson and Cates, 2016). Therefore, I would advise Mrs. B to avoid taking St. John’s wort since I have prescribed her Paroxetine.