Decision #2 The decision at this point is to increase the Dosage of Sertraline to 50 mg daily. Reasons For Selecting the Decision

Decision #2 The decision at this point is to increase the Dosage of Sertraline to 50 mg daily. Reasons For Selecting the Decision

When the patient visited the hospital one month later, there was no notable improvement in the symptoms previously exhibited. Since the symptoms seem to be persistent and not improving, it important to increase the Sertraline dosage for possible improvement instead of going for another medication. It was not prudent to start with a higher dose as it has been shown that such a situation can lead to a higher risk of self-harm among adolescents (Clevenger et al., 2018). Therefore, it is recommended that a lower dosage should be the first line before gradually increasing to find the right dosage. The right dosage can then be obtained through titration.

Why the Other Two Options Were Not Selected

In the management of illnesses such as mood disorders, in the case where a child fails to respond to the first line of treatment, then, it is key to find out if the dosage used was appropriate and if the right duration was given. This medication is available in different doses; hence it is key to start from the lowest in the case of a child and gradually increase the dosage as necessary. There are high chances that the patient would have positive outcomes, and it is even better if side effects are diminished even at higher doses. Fluoxetine was not chosen since the guideline are the Sertraline dosage should be gradually brought down before completely eliminating it and introducing another medication (Yan & Goldman, 2018)

What I was hoping to Achieve

One of the expectations is that the patient will present with at least a fifty percent improvement in the symptoms connected to the major depression. Indeed, current data indicate that Sertraline may not be able to lower the depressive symptoms in a patient within one month, though other symptoms may improve (Clevenger et al., 2018). Therefore, using the medication for the next weeks added to the previous weeks may eventually improve outcomes.

How the Ethical Consideration May Impact Treatment Plan

One of the central ethical considerations, in this case, is informed consent from the accompanying mother to allow the increase of the medication’s dosage as required (“American Psychiatric Association,” 2013). However, the possible side effects of a higher dosage of the medication have to be considered. The patient is also to be educated on adherence for better outcomes.