Assessing and Treating Clients with Anxiety Disorders Expected Results

Assessing and Treating Clients with Anxiety Disorders Expected Results

With Zoloft, the expected results at the prescribed dosage of 50 mg twice a day was an overall reduction in the symptoms of generalized anxiety disorder within 2 to 4 weeks. The client was expected to return with at least a 50% remission rating on the HAM-A scale. By the end of week four, the patient is expected to report a reduction of fears concerning works and nervousness (O’Hara et al., 2019). The symptoms of anxiety such as constriction in the chest and breathlessness should improve by the end of week four.

Differences between Expected Results and Actual Results

The patient returned to the clinic after four weeks reporting that the feeling of shortness in breath and chest constriction had improved. Consequently, he reported that he had a reduced amount of concerns and worry about his work. However, a check on the HAM-A scale indicated a reading of 18 from the previous 26, which is less than the expected 50%. The results are modest but do not meet the expectation of the treatment.

Decision Point Two

Selected Decision

Increase the Zoloft dose to 75 mg PO twice a day

Reason for Selection

Given that the drug was active in its action, it is recommendable that the dosage is increased to 75mg orally daily. The rationale behind this decision is that at a lower dose, Zoloft had reduced the symptoms of chest tightness and shortness of breath by some degree but not entirely (Nojoumi, Ghaeli, Salimi, Sharifi, & Raisi, 2016). It thus follows that a higher concentration would diminish the symptoms even further. Previous studies show that Zoloft among other SSRIs can be administered progressively until a maximum level that deliberates for maximum benefit to the patient. Increasing the dose to 100mg is not recommended, as the dosage for psychotropic medications is often to be increased progressively while observing physiological reactions to avoid undesired effects (Cuijpers et al., 2014). Also, maintaining the dose at 50mg PO twice daily will have no improvement. Thus, the correct decision is to increase the dosage to 75 mg.

Expected Results

The expected outcome of the increased dosage to 75mg was complete elimination of symptoms of chest tightness, shortness of breath and feelings of fear within 2 to 4 weeks (Bernik et al., 2018). Other symptoms that are associated with a generalized anxiety disorder are also expected to be resolved entirely within this time.

Differences between Expected Results and Actual Results

The client, however, came back to the clinic after four weeks with an overall symptom reduction of 61% according to the HAM-A scale. This is particularly below the anticipated outcome, but still a significant improvement in the patient’s condition. However, the drug was effective in managing the patient’s condition, and it is believed that with time, it would be expected that the body will be able to fully adapt to the concentrations of the drug and a complete remission the symptoms will be achieved.

Decision Point Three

Selected Decision

Continue Zoloft dose to 75 mg PO twice a day

Reason for Selection

Psychotropic agents can have increased effects within a maintained optimum dosage. A dosage that can clear up to 50% of the associated symptoms of a condition with no associated side effects can be maintained as an optimal therapeutic dose and will be able to clear the symptoms fully with time (Rothschild, 2014). This way, it is suggested that the dose of Zoloft be maintained at 75mg PO daily. It is also recommended that the client include non-pharmacological measures such as watching his diet and weight patterns as the drugs may have reduced effectiveness in people who are overweight. It is not advisable to increase the dosage to 100mg PO daily, as the previous dosage was already effective, and an increase in dose may elicit undesired side effects.

Expected Results

It is anticipated that the ongoing dosage will continue being effective in managing the patient’s condition. After 2 to 4 weeks, the patient is expected to come back to the clinic with full remission of symptoms of chest tightness and shortness of breath (O’Hara et al., 2016). It is also expected that he will no longer be nervous about work.

Differences between Expected Results and Actual Results

After four weeks, the client came back to the hospital, with fully resolved symptoms. He no longer complained of shortness of breath, or chest tightness or fear. This outcome perfectly matched the expectation of the maintained dosage to clear the symptoms relating t