Title: Challenging Case presentation on treatment resistant patient
Challenging Case presentation on treatment resistant patient.
Challenging case: please use this case: ( A 34-year old African American male presented to the hospital with increasing depression. Patient also has history of ADHD and chronic depression. Patient was recently treated with Paxil, but he still notices his symptoms to continue to get worse to the point where he made a suicide attempt. The patient has tried multiple antidepressant but failed everything. Patient does not recall the trial medication ever helping, instead he made him worse. Patient have period of elevated mood, even get into impulsive behavior, such has partying and having multiple affair that involve multiple sex partner. In conclusion, this patient is very complex individual with treatment resistant depression and possible bipolar 2 spectrum disorders).
With the case above, please answer the following questions: no introduction needed, just the question answer.
1. What made this situation challenging for you/what was the challenge?
2. What role did you have in resolving this challenge?
3. What “evidence” did you/your preceptor bring to the case to help resolve this challenge?
4. What did you learn/what pearls can you share after having been involved with this challenge?
5. How will this (if at all) change your practice?
Challenging Case Presentation on Treatment Resistant Patient
- The situation was made challenging for me by failure of the patient to respond to the medication options. The patient had treatment resistant depression as he could not respond to the multiple antidepressants administered.
- My role in resolving the challenge was to assess and monitor the situation of the patient. I also had a role of administering suitable medication and providing therapy to help manage the situation of the patient. Attention deficit/hyperactivity disorder (ADHD) affects the memory of a person and such individuals require close monitoring and reminder, especially when it comes to taking their medications.
- The evidence that was brought to help in addressing this challenge included assessment of the previous behaviors expressed by the patient and medication attempts. For instance, the depression signs the patient experience, the Attention deficit/hyperactivity disorder and depression signs, the Paxil treatment, and other symptoms such as attempts to commit suicide, samples of antidepressants given, the history of changing behaviors such as impulsive behavior, and elevated mood.
- I have learned a valuable lesson from the experience of this challenge. One, that patients with ADHD require attention and monitoring, especially when under medication as they may forget to take medicine. I have also learned that before placing a patient to any medication, it is important to carry out assessments to establish what exactly they suffer from. Further, I have also learned that some patients are resistant to certain treatment and it is important to have another plan on how to help them manage their condition. Apart from medication, therapy is also an important component when dealing with ADHD patients.
5. The scenario and the experience have given me more insights when dealing with such cases in the course of my practice. Patients respond differently to medication and it becomes important that during such episodes, in my practice, I will know the amicable course of actions to help such patients.(2017) study employed, there are very little room for generalizing the study’s findings.
Fostick, L. (2017). The Effect of Attention-Deficit/Hyperactivity Disorder and Methylphenidate Treatment on the Adult Auditory Temporal Order Judgment Threshold. Journal of Speech, Language & Hearing Research, 60(7), 2124-2128. Doi: 10.1044/2017_JSLHR-H-16-0074
Svedlund, N. E., Norring, C., Ginsberg, Y., & von Hausswolff-Juhlin, Y. (2017). Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among adult eating disorder patients. BMC Psychiatry, 171-9. Doi: 10.1186/s12888-016-1093-1