Assessing and Treating Pediatric Clients With Mood Disorders

Assessing and Treating Pediatric Clients with Mood Disorders

Decision One

The first decision that I made entailed a prescription of Paxil 10 mg to be taken orally daily for a period of four weeks. There are a number of reasons that justify the rationale behind the prescription. First and foremost, Paxil is an effective drug used to treat severe depression, anxiety disorders, panic attacks, post-traumatic stress disorder as well as a severe type of premenstrual syndrome known as premenstrual dysphoric disorder (Federal Drug Association, 2017). The drug works by assisting to reinstate the balance of serotonin – a natural substance found in the human brain. Paxil is classified as a selective serotonin absorption inhibitor.

By prescribing Paxil, I hoped to achieve a number of objectives. First of all, this medication has the capacity to improve the mood of the depressed boy. It may also enhance his appetite, sleep, energy level as well as assist the child to restore his interest in daily living (Jackson, 2014). Moreover, Paxil has the ability to reduce unusual anxiety, fear, negative thoughts such as death-related thoughts as well as the frequency of panic attacks. Another advantage associated with Paxil is that the drug is completely absorbed after ingestion and the elimination time is approximately 21 hours (Shives, 2008).

Difference between Expectations and Outcomes

There was a significant difference between what I expected to achieve and the results of decision one. First, although the drug managed to reduce the degree of depression by 5 points as demonstrated by the rating scale, it occasioned unanticipated side effects such as diarrhea, vomiting and nausea (Poznanski & Mokros, 1996). This state of affairs might have been contributed by the biological characteristics of the child, dosage, as well as the severity of the depression condition (Ciraulo & Shader, 2011).

Decision Two

It was necessary to change prescription from Paxil 10mg to Prozac (Fluoxetine) 10mg. A number of reasons informed my decision to change medication. First, Prozac is a selective serotonin absorption inhibitors antidepressant.

The drug affects special substance in the human brain that might be unbalanced in individuals with anxiety, obsessive-compulsive symptoms, panic attacks and most importantly depression. Fluoxetine is used to address major depressive disorders, panic disorder, obsessive-compulsive disorder, and bulimia nervosa – eating disorder.

By changing medication from Paxil to Prozac, I hoped to achieve a more efficient solution to the depression disorder.  Prozac is more effective in blocking the absorption of serotonin into human platelets compared to Paxil (Eli Lilly and Company, 2004). Moreover, after the ingestion of this drug, it is absorbed into the circulatory system after six to eight hours. In fact, this drug can be effectively absorbed regardless of whether or not the patient has taken a meal (Eli Lilly and Company, 2004).

Difference between Expectations and Outcomes

The main difference between my expectations and the outcome of the prescription is that Prozac was unable to clear all the symptoms. In my view, 25% reduction in symptoms and the elimination of the side effects was not good enough. I expected the client to recover fully and lead a normal life after the completion of the prescribed dosage. The drug was more effective than Paxil nevertheless.

Decision Three

I decided to continue the Prozac dose because the drug seemed more efficient in reducing the depression levels of the eight-year-old African American male. After taking Prozac 10mg for four weeks, the patient recorded 25 percent reduction in depression-related symptoms in addition to the total elimination of the various side effects triggered by Paxil (Poznanski & Mokros, 1996).

With this dosage, I was hoping to reduce the depression symptoms further. I also had plans to give a higher dose of the drug in order to increase the efficiency of the medication in terms of blocking the absorption of serotonin in the brain. However, this proved unnecessary as the boy continued to improve with time.

Apparently, there was no notable difference between what I expect to achieve and the outcomes of decision three. In other words, the prescription achieved my expectations in totality.

Ethical Considerations

From an ethical perspective, treating depression requires more than drugs. The first thing that ought to be considered is the role of evidence-based psychotherapy, particularly cognitive behavior therapy (CBT).

As research demonstrates, CBT is as effective as conventional medicine at addressing hopelessness, guilt and negative thoughts in the depression patients. In that connection, application of CBT could enhance my treatment plan by reducing psychic distress as well as tackling stressors. Challenging negative thoughts requires enhanced communication between the caregiver and the patient.

Other ethical considerations that might affect the treatment plan and communication with the client include the age of the client and the role of the guardian. For instance, given the tender age of the boy, it would be important to engage in age-appropriate discussions that would foster interest and allow the patient to open-up (Segal & Haskell, 2014). Moreover, communication between the caregiver and the boy’s mother must be guaranteed as part of an effective treatment plan.