SSRI Case Study

The patient was admitted to the hospital by her daughter after discovering that she had abandoned her medication and was significantly experiencing adverse effects from the withdrawal. The patients’ medical history included renal dysfunction, anemia, malnourishment, back pain, and a family history of mental health. The patient has a psychiatric history of being previously placed in the same clinical structure eight months ago due to related issues including the failure to take her medication and increased levels of mental health conditions that led

Special attention should be giving to understanding informed consent and any challenges that may be presented and prescribing ethically medications to special populations such as children. According to the Gerald Tietz of the Washington law review (1986), indicates that it is well within a practitioner’s scope of duty to inform the patient of significant effects were injuries that may be related to the prescribing of any particular pharmacological treatment. This informed consent should be expanded to include the harms were dangerous presented also with non-use of additional treatment interventions such as therapy or CBT. Additional trends identified in ambulance pediatrics (Cooper, Arbogast & Ding, 2006), or the trends and the prescription of antipsychotic medications for children in the United States of America. The information taken from the national ambulatory medical care survey in regards to the US population indicated that between 1995 and 2002 there were nearly 6,000,000 visits to health providers by children in the US that had been subscribed or prescribed antipsychotic medications. Nearly 1/3 of the prescriptions for lease populations were provided by non-mental health service professionals. The study of the department of pediatrics at Vanderbilt University in Nashville also indicated that over half of the prescriptions for these children were given based on behavioral indications or affective disorders which find a way

Mr. Gillespie is a 21 year old male who presented to the ED after an intentional overdose on 20 600mg of Gabapentin. Per documentation from ED staff Mr. Gillespie reported he became angry at his grandmother tonight and tried to "prove a point." Mr. Gillespe reported to staff threatened to overdose on his on pills, however dumped them in the toilet. He expressed after making threats to overdose on his prescribed Celexa did not phase his grandmother, he proceeded to take her Gabapentin. Per documentation Mr. Gillespe has been living with grandmother for 2 weeks and before that was living with his mother in Cary. At the time of the assessment Mr. Gillespie was calm and cooperative. He denies current suicidal ideation, homicidal ideation, and symptoms of psychosis. He appears guarded during the assessment. He reports tonight his grandmother and he got into an argument over him getting a job. He reports his grandmother informed him he has to be out by Friday. Mr. Gillespe denies history of self harm. He

The claimant was admitted to Tennova Healthcare Lebanon from 5/17/2016 to 6/01/2016. On 5/16/2016, the claimant had some drinks and was not able to drive home. She was in a confused state and apparently her son drove her home. She was last seen about 1 o'clock in the morning and was put to bed. The claimant's mother tried to contact her in the morning, mid morning, and got no response. Her mother went to her house at about 1 in the afternoon and found her in the bathroom laying between the commode and the wall breathing but unconscious. The EMS was summoned and she was brought to the emergency room. She reportedly had taken several tablets of sedatives. In May 2 or 5, the claimant was given Valium 2 mg for some leg discomfort and muscle spasm.

This writer met with the patient to address the conflicting issue with his medication. According to the patient, his PCP was prescribing him with his benzodiazepine medications; however, the patient says, " I had to seek a psychiatrist because it was only temporary." This explains the conflicting issues with the Rx Scripts on file. The patient started his treatment with his now psychatrist on 6/12/2017 and signed an ROI. Addressing picking up his medication from two different pharmacy, the patient was advise that he needs to be pick up his medication with only one pharmacy as it is required. The patient agreed to the terms and said, " I like CVS better than Walgreens. Sometimes they would my refill to Walgreens or whatever is closer to me,

Pt has x5 hx of IP hospitalizations, most recent was April 2015 due to SI. Pt currently receive intensive in home therapy x2 week through integrated helath services. She also receives outpatient psychiatry thorugh Dr. Burk Seigle. Pt is currently prescrived Vyvanse 50 mg daily, Abilify 5mg daily, Clonidine .01mg daily. Pt has not been compliant with Vyvanse or Clonidine due to pt mother does not want medication to be come addicted to medication. Per report from mother she is trying to wean pt off her medication to help stabilize

Client reported feeling down within the last month and using heroin to cope. Client also reported feeling better and motivated towards the end of the month. Client completed a Beck Depression Inventory in which he scored a 6 indicating normal ups and downs. Client VA records confirm a diagnosis for PTSD and the medication list includes, Sertraline and Setraline HCL, as well as methadone to which the client appears compliant. Client reported he is medication compliant. Client denied any S/I or H/I.

D-Met with the patient as she placed on HOLD due to recent concern of her overall well-being reported by Nurse Frank as he reported to this writer yesterday of his concerns that the patient's boyfriend is refusing her to increase on her methadone due to an agreement and the patient tends to appear emotional. Upon meeting with the patient, the patient immediately knew why she is meeting with her and started to get emotional. Denies feeling SI/HI. According to the patient, she had an agreement with her boyfriend of which she agreed to increase her dose up to 55mgs as her boyfriend will closely monitor her recovery. The patient does not feel unsafe around her boyfriend as she reported. This writer strongly advised the patient that she has rights to her own recovery process because it's her in the recovery and seeking treatment, at which the patient agreed. But says, "I am fine with my current

Patient is a 35 year old male presenting to the ED involuntarily as petitioned by his cousin due to threatening to shoot himself with a gun. At the time of assessment, patient denies feeling suicidal or having a plan. When confronted about admitting being suicidal and having a plan to nursing staff and TACT, Mr. Crowson stated "He is here because he is going through withdrawals and his mother is lying." The Mr. Crowson reports in the past year he has lost his father. Mr. Crowson reported wanting to receive Methadone from hospital to help with withdrawal symptoms. He expressed feeling body aches, stomach cramps, chills, irritability, angry, and verbally aggressive behavior. Patient refuses to finish full assessment.

D-This writer agreed to meet with the patient as he was placed hold to attend group. Reported stability on his current dose and denies the need for a dose increase when offered by this writer. This writer reviewed the patient's record and learned that he obtained his 3rd take home bottle on 01/04/2017. The patient is aware that he in order for him to obtained the 4th take home bottle, he must attend the take home bottle group. Addressing his medication, this writer noticed that the patient has not refilled the following medications:

It is a basic principle of law in this country that an adult, mentally competent person has the right to refuse treatment. The court of appeal has emphasised that provided the patient has the necessary mental capacity, which is assessed in relation to the decision to be made, then he or she can refuse to give consent for a good reason, a bad reason or no reason at all (Dimond, 2008). However, in this case it is in the best interest of the patient that the MDT administrated medication covertly. The legal issue identified in this case relates to the issue of consent. Within the case study professionalism had to challenged when it came to the capacity of the patient. The MDT had to resolve the legal issues associated with capacity and consent.

Mr. Moore is a 24 year old male who presented to the ED with reports of experiencing depressive symptoms, vague suicidal ideation without a plan, and recent episodes of anxiety. At the time of the assessment Mr. Moore denies current suicidal ideation, homicidal ideation, and symptoms of psychosis. He reported to suicidal ideation would come and go, however never had a plan . Mr. Moore appears calm, cooperative and in good spirits during assessment. He reports a history of anxiety, depression, and emotional trauma by father at the age of 8 years old. Mr. Moore expressed he started noticing increase anxiety when he had to speak in large groups, present in school, driving, and engaging in social actives. He states, "Over the past 16 years my father has been out my live, when I was younger he would hit me if he felt I said anything out of line." Mr. Moore reports recent relationship issues and separation with his fiance. He reports due to him not engaging in many social actives his fiance has left him. He reports for many year going to Randolph Counseling Center for his anxiety. He reports positive results from services. Mr. Moore mention coming to the hospital last Thursday for his anxiety and bring prescribed a 30day supply of Ativan, which he reports has helped him become more stable when engaging in actives,like driving his mother's car. He reports depressive comes and goes depending on the mood he is in. He describes symptoms on occasion as feelings of

In less than a years time, Kyle Warren had been seen by four different medical doctors, each one with their own diagnosis that included autism, bipolar disorder (also known as manic depression), insomnia, attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Kyle's pill regimen kept multiplying, consuming daily harmful cocktail of mind- altering drugs including Risperdal (anti-psychotic), Prozac (antidepressant), Adderall (psycho-stimulant) and two sleeping medicines. Kyle Warren was only eighteen months old at the time (Wilson 11). Kyles story is not rare, in fact, it has became what I refer to as a “to common” case. For that matter, it was a story much like this one that got me interested in the

a 44 year old Divorced African Male came into Henry Ford Hospital ED as a walk-in and told the HFHS staff that he was having mental health issues he does still struggle with depression and anxiety. The consumer stated that he initially went into the hospital after his brother was shot twice in the head. At that time the client reports that he was placed on Risperdal, while at Kingswood in January, and he became a zombie at that time. He stated that he has been in and of the hospital multiple times since then, and each time, he has been placed on Risperdal and he doesn't feel that his meds were ever adjusted correctly.

SM moved to Arlington, Texas in October of 2016 from North Carolina after having difficulty living alone without support. He has had medication from his previous primary care provider in North Carolina. He recently attempted to go to the Dallas VA and had difficulty making an appointment in order to refill his medications. He reported that his current plan is to get an appointment with TRICARE for medication management. According to his report, his only psychotropic medication is currently Wellbutrin. While still in North Carolina SM has been taking medication which he received from his primary care provider in North Carolina. SM was also seeing a psychologist once a week, but then abruptly stopped going to him and has not reconnected with