Medication Guide: Managing Major Depressive Disorder and Panic Disorder
For Patient 3: 72-year-old male with a diagnosis of major depressive disorder and panic disorder, with a cardiac history and taking antihypertensive medications.
 
1. Classification of Medication:
 
• Selective Serotonin Reuptake Inhibitors (SSRIs)
 
• Rationale: SSRIs are often preferred in older adults due to their favorable side effect profile and efficacy in treating both depression and panic disorder. They also have a lower risk of adverse cardiovascular effects compared to other antidepressant classes.
 
2. Starting Dose and Frequency:
 
• Start with Sertraline 25mg once daily in the morning.
 
• Dose may be titrated up to 50-200mg/day based on response and tolerability, typically over 1-2 weeks. 3. How the Medication Works:
 
 • Sertraline increases serotonin levels in the brain by blocking its reuptake, which helps regulate mood and anxiety symptoms.
 
4. Duration of Treatment:
 
• Continue taking Sertraline as directed by your healthcare provider, even if you start to feel better. It may take several weeks for the full therapeutic effects to be noticed. 5. Common Side Effects:
 
• Nausea
 
• Insomnia
 
• Headache
 
• Sexual dysfunction
 
• Diarrhea
 
• Dry mouth 6. Urgent Considerations:
 
• Contact your healthcare provider immediately if you experience worsening depression, suicidal thoughts, or any unusual changes in mood or behavior. Directions for Taking Medication:
 
• Take Sertraline orally, with or without food, preferably in the morning.
 
• Swallow the tablet whole with a glass of water; do not crush or chew. Missed Dose Instructions:
 
• If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double up on doses. Medication Interactions:
 
• Avoid taking MAO inhibitors, including certain antidepressants and linezolid, while on Sertraline.
 
• Consult your healthcare provider before taking any other medications, including over-thecounter drugs and herbal supplements. Foods to Avoid:
 
• There are no specific food interactions with Sertraline. However, maintaining a balanced diet is important for overall health. Follow-up Appointment Date:
 
• Please schedule a follow-up appointment in 4 weeks to monitor your response to Sertraline and adjust the treatment plan as needed. Legal and Ethical Considerations:
 
• Prescribing medications involves legal and ethical responsibilities to ensure patient safety and well-being. It’s important to discuss risks, benefits, and alternatives with the patient and obtain informed consent. Social Determinants of Health:
 
• For patients facing financial hardship, assistance programs, generic medication options, or community resources can be explored to help cover medication costs.
 
• Transportation barriers can be addressed by offering telehealth appointments or assisting in arranging transportation services for clinic visits. Recognizing and addressing these barriers are crucial for ensuring equitable access to healthcare.