Impact of Ethnicity on Antidepressant

Impact of Ethnicity on Antidepressant

Three Questions for the Patient

The materials presented for the case study provide an avenue for asking questions after a careful review. This would include concerns about the psychiatric history of the patient.

Several questions can be presented, however, they can be narrowed down to three. For example, was the decision to discontinue the medication following an instance of depression personal or instructed by the physician in charge. By presenting this question, one can get to know the patient’s medication compliance. Additionally, it would be imperative to know if the patient ceased the use of prescribed medication when the symptoms stopped.

Furthermore, what were the prevailing circumstances during each depressive episode? Asking this question can enlighten the practitioner on what triggered the patient before experiencing depressive episodes. From the patient records, there is a history of depression and alcohol abuse. It would be prudent to ask if anybody in the family has received treatment of the conditions. Asking this question can help determine a patient’s perception and understanding of psychiatric treatment.

Feedback from Individuals in the Patient’s Life

The records indicate that the patient has been married long enough. Consequently, questions can be presented to his spouse regarding the information that the patient failed to share or those that he was not honest about while undergoing the depression episodes. As such, the patient’s wife becomes an essential source of information. She can answer questions such as if there is a conflict between them. Additionally, she can provide information like if the family is having any stressor.

With three children, they can be presented with questions if they could have noticed symptoms leading to depression. The professional could ask the children if the parents fought while growing up or what the behaviors of their father were.

The physical and Diagnostic Exams for the Patient

With no simple test for depression, it is important to test for other conditions causing the symptoms. Physical examination should be performed to check on the cardiovascular and the respiratory system while checking on the vital signs. Another test that can be performed is the dexamethasone suppression test (Zaninotto et al., 2016). This test assesses the negative impacts of dexamethasone, which can remain at high levels in depressed patients. Depressive disorders have also been associated with particular inflammatory biomarkers. The blood test analyzes nine biomarkers.

Three Differential Diagnosis

From the symptoms listed, the patients could be suffering from several conditions. One is Recurrent Major Depressive Disorder with melancholic characteristics due to depressive symptoms like bad moods (Smith et al., 2013).  Other diagnosis could be thyroid imbalance and panic disorder.

Additionally, a MAOI should be started for this patient since he became resistant to the first and second-line drug therapy for depression (Murphy et al., 2013). A daily dose of 45mg of Phenelzine divided into three doses can work for the patient.

Ethnicities

With several MAOIs, there is a high chance of hypertensive crisis for the patient because of his race. This is a more significant concern hence the restriction of tyramine diet. As such, foods including yeast and cheese should be avoided.

Changes in therapy and lessons learned.

After carefully analyzing the patient information, it is paramount to change the course of treatment. In the course of the case study, many lessons were learned. For example, it is important to comply with medication. Again, proper medical selection is vital in treating patients.

In conclusion, the study involved a male aged 63 years plagued with recurrent depression. The patient experienced success and failure with medication and treatment, which could have resulted from medical incompliance or improper medication.