29 Dec The Benefits and Limitations of Antidepressant Medications response to 2 colleagues

SOCIAL WORK

SOCIAL WORK

SOCW 6443 –Psychopharmacology and Bio-psychosocial Considerations for Social Workers

Discussion 1: The Benefits and Limitations of Antidepressant Medications response to 2 colleagues

 

While antidepressants can be effective, clients might be hesitant to use them for a variety of reasons. Mental health professionals can anticipate some of these hesitations and be prepared to support a physician’s recommendation by providing the client with appropriate information, reasoning, and explanation in a way that is meaningful. However, mental health professionals must balance advocacy for continuing treatment when client hesitations and other considerations might warrant a reevaluation by the psychiatrist.

 

For this Discussion, consider the medications (even controversial medications) that a psychiatrist may prescribe for depression and their possible side effects. Select one particular antidepressant that evidence suggests is effective in treating depression and consider the benefits and limitations. Consider how a client being medically treated for depression might react to taking this medication and having potential negative side effects. How might you as a mental health professional support the recommendation of the medication despite its limitations?

 

• By Day 7 (Note!!! PLEASE WRITE OUT EACH QUESTION BEFORE PROVIDING A RESPONSE. Follow the prompt please.!!! “Please I need an excellent paper”

 

Respond to two of your colleagues’ posts by: see below, ½ a page each with 2 references each

• Offering an alternative medication and strategy to address client hesitations and support the psychiatrist’s recommendation

• Offering additional support for the suggested drug and the strategy to address client hesitations and support the psychiatrist’s recommendation

• Detailing current research that corroborates or refutes this drug and explain how this might impact a physician’s choice of this drug

 

Be sure to support your responses with specific references to the to the Learning resources. If you are using additional articles, be sure to provide full APA-formatted citations for your references both within the text and on the referencing section. PLEASE ALWAYS INCLUDE THE REQIRED TEXTBOOK as part of the references and if possible some of the REQUIRED READING if applicable. Please always start by referring to THE TEXTBOOK, below

REQUIRED TEXTBOOK

Psychopharmacology Demystified 2011

Author: Lichtblau, Leonard

ISBN-13:

ISBN-10:

Edition/Copyright: 2011

Publisher: Cengage Learning

 

REQUIRED

Handbook of Clinical Psychopharmacology for Therapists 8TH 17

Author: Preston, John D.

ISBN-13: 978-1-62625-927-0

ISBN-10: 1-62625-927-5

Edition/Copyright: 8TH 17

Publisher: New Harbinger Pub.(cc)

 

Learning Resources

Required Readings

 

Lichtblau, L. (2011). Psychopharmacology demystified. Clifton Park, NY: Delmar, Cengage Learning.

• Chapter 2, “Pharmacotherapy of Depression” (pp. 21–34)

Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2017). Handbook of clinical psychopharmacology for therapists (8th ed.). Oakland, CA: New Harbinger.

• Chapter 7, “Depressive Disorders” (pp. 77-93)

• Chapter 16, “Antidepressant Medications” (pp.175-200)

• Appendix C, “Psychotropic Drug Interactions (pp. 293-308)

 

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.

 

Use the DSM-5 to guide you through your understanding of the diagnostic criteria for mental disorders.

 

National Institute of Mental Health. (2016). Antidepressant medications for children and adolescents: Information for parents and caregivers. Retrieved from https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml

 

As you review this website, consider the variety of medications used for mental health treatment.

 

Spiegel, A. (2012, January 23). When it comes to depression, serotonin isn’t the whole story. [Blog post]. Retrieved from http://www.npr.org/blogs/health/2012/01/23/145525853/when-it-comes-to-depression-serotonin-isnt-the-whole-story

 

As you review this blog, consider the information provided and how depression was treated in the past and how it is currently treated.

 

Document: Depression Case Studies (PDF)

 

Select a case study from this document to complete this week’s Discussion 2

 

Optional Resources

 

MSW home page

 

Use the link below to access the MSW home page, which provides resources for your social work program.

 

Jonathan roberto

RE: Discussion 1 – Week 3

COLLAPSE

 

Neurobiology of Depression and Antidepressants

Clinical depression and depressive disorders whether being reactive, biological, reactive-biological, or atypical are primarily indicative of the presence of dysregulation or deficiency in the neurotransmission process specifically the associated neurotransmitters of norepinephrine (NE), serotonin (5-HT), and dopamine (DA) (Preston, 2017). This dysregulation may be caused or induced by chronic stress, medical illness resulting in biochemical and hormonal changes causing Central Nervous System (CNS) impairment, or drug that may have a negative impact on 5-HT, NE, and DA neurotransmission such as alcohol, antianxiety medications, medical disease medications, and corticosteroids and hormones (Preston, 2017). Neurological disease may cause additional affect dysregulation and additional factors such as poor nutrition and deficiency of certain amino acids which are essential for neurotransmitter production (Preston, 2017).

The primary neurobiological course of action of antidepressant medications first involves the blocking of reuptake of one or more neurotransmitters, mainly 5-HT, NE, and DA. This initial block causes down regulation of the number of postsynaptic receptors. This down-regulation of postsynaptic receptors leads to the turning on and off od mRNA genes and messaging system. This then leads to better metabolizing and elimination of the 5-HT, DA, and NE storage in the presynaptic neuron eventually making more of these neurotransmitters available (Preston, 2017).

Sertraline (Zoloft) Medication

For this discussion and most modern pharmacological antidepressants in which are prescribed, the antidepressants of focus will include Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) and Monoamine Oxidase Inhibitors (MAOIs). SSRIs specifically blocks the neuronal uptake of 5-HT and manipulates the neurotransmission process mentioned prior eventually making more 5-HT available and is effective in the treatment of depression (Lichtblau, 2011). SNRIs are dual action and specifically utilize the same mechanism of action as SSRIs however involving the additional neurotransmitter NE and the readily available production of both neurotransmitters (Preston, 2017). MAOIs are typically used when neither SSRI or SNRI medications are ineffective as they pose more hypertensive risk and sudden rise in high blood pressure (Preston, 2017). These medications involve the monoamine oxidase enzyme which breaks down catecholamines in NE neurons increasing NE transmitter levels (Lichtblau, 2011). SSRIs are the most commonly prescribed antidepressants for the treatment of depression as they are shown to be effective and are safer and tend to have fewer side effects then the other antidepressants mentioned (Preston, 2017). Specifically, regarding the SSRI Zoloft, its advantages involve the medication to not be as sedating as other antidepressants and are not commonly prone to initially cause anxiety during initial treatment like other SSRI’s tend to. Lastly, Zoloft has very few concerning drug-drug interactions (Preston, 2017). The one primary disadvantage of Zoloft is that it may be more prone to causing the adverse side effect of gastrointestinal issues. Although the one disadvantage mentioned is of most relevance, just like other SSRIs and antidepressants other side effects can be common such as sexual dysfunction, and the potential for weight gain.

Engaging with the Hesitant Client

Clients may often be hesitant to take a recommended medication such as an SSRI antidepressant for various reasons possibly being the potential risks and side effects involved. It is important to first validate the client’s ambivalence to taking the recommended medications to provide an initial foundation for the growth and development of the therapeutic alliance and trust. Additionally, it may be important to provide the client with education about antidepressants and how they work on a biological level and can be effective especially in conjunction with psychotherapy (Preston, 2017). It is also important to mention that typically the side effects associated with antidepressants, especially SSRIs like Zoloft diminish over time, however it is important to be transparent with the client informing them of the potential side effects that may occur in a supportive fashion (Preston, 2017). Lastly, providing education emphasizing hope and the potential for eventually tapering off medication completely especially when the client engages in psychotherapy and interventions such as that of cognitive behavioral may provide comfort and reduce the client’s reluctance eventually leading to full engagement in treatment and medication adherence (Preston, 2017).

 

 

 

References

Lichtblau, L. (2011). Psychopharmacology demystified. Delmar Cengage Learning.

Preston, J. D., O’Neil, J. H., & Talaga, M. C. (2017). Handbook of Clinical Psychopharmacology for Therapists. New Harbinger publications.

 

 

Brittany Schrodt

RE: Discussion 1 – Week 3

COLLAPSE

Discussion 1 Psychopharmacology and biopsychosocial considerations

a brief description of the antidepressant medication that you selected and explain its benefits and limitations (including neurobiological considerations).

An antidepressant medication I selected is bupropion also known by Wellbutrin. This antidepressant is utilized for treating comorbid anxiety. Comorbid conditions consist of anxiety and depression. These conditions share similarities within symptoms. Benefits of bupropion range from the ability to treat a few conditions. It Is also favorable towards treating the elderly population due one daily use of an extended-release formula. Researchers Berigan (2022) states the tolerability aspect creates a preference of bupropion. Contrary to benefits limitations are side effects such as dry mouth dizziness weight gain, blurred vision, constipation, seizures and a risk of suicidal ideations (Handbook of Clinical Psychopharmacology for Therapists, pg.198).

Next, explain how you would support the psychiatrist’s recommendation to use the medication to a hesitant client despite its limitations.

I would support a therapist recommendation to the use of medication through educating the client on the medications along with likelihood of adverse effects. Patient engagement and person-centered techniques alongside motivational interviewing. Brown et al. (2011) explains effective patient education needs to be multifactorial and individualized. Different settings and methods can be effective. When a patient feels empowered, they are more motivated to manage and try suggested treatments. Involving patients gives them control in treatment decisions. In the event alternate treatment is available providing options could aid with the treatment goal (Medication Adherence, 2011).

References

Berigan T. R. (2002). The Many Uses of Bupropion and Bupropion Sustained Release (SR) in Adults. Primary care companion to the Journal of clinical psychiatry, 4(1), 30–32. https://doi.org/10.4088/pcc.v04n0110a

Brown, M. T., & Bussell, J. K. (2011). Medication adherence: WHO cares?. Mayo Clinic proceedings, 86(4), 304–314. https://doi.org/10.4065/mcp.2010.0575