Week 4: Therapy for Patients With Major Depressive Disorder (MDD)

Week 4: Therapy for Patients With Major Depressive Disorder (MDD)

Decision #1

The first decision I chose was to begin Zoloft 25mg po daily. Consensus guidelines

recommend fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft) as first-line

treatments for moderate to severe depression in children and adolescents (Clark, Jansen, and

Cloy, 2012). Sertraline is an antidepressant medication belonging to a group known as selective

serotonin reuptake inhibitors, or SSRIs. Sertraline increases the level of serotonin in the brain,

which leads to an improved sense of well-being, mood, appetite, and regulation of the sleep-

wake cycle. Sertraline is an effective and safe short term treatment for children and adolescents

with Major Depressive Disorder, or MDD (McClure, Leibenluff, Pine, 2004).

Paxil is not the best choice for the patient in our scenario. Although it has been shown to

be effective in treating adult depression, it has not been shown to be effective in treating children

with MDD and is not FDA approved for such use. The other option we are given is to prescribe

Wellbutrin. This is another medication that has successfully treated adults with depression and

MDD. However, the safety of using this drug in the adolescent population has not fully been

established and would not be the best choice to prescribe in our scenario.

Before prescribing, the parent must be made aware of the risk for suicidal thoughts or

behavioral changes increase during the initial months antidepressant medication therapy or

dosage adjustments. Therefore, monitoring his behaviors in an important point of education.

The parent should be made aware of the need to follow up with the mental health provider

regularly after initial treatment begins. As we learned, the child seems withdrawn in class and

the ability to make friends or excel academically may be at risk