Assessing and Treating Anxiety Disorders
Introduction
Anxiety disorder is a common condition that causes shortness of breath, and anxiety attacks. Clients should seek immediate treatment to avoid adverse effects of the symptoms. In the current case study, the patient requires Zoloft, since it is a Food and Drug Authority (FDA) approved medication (Mula, 2018). The series of decisions depends on patient outcomes and expected outcomes. It is not necessary to introduce other drugs since evidence-based practice shows Zoloft can treat anxiety disorders alone. Psychiatrists should educate patients on anxiety disorders, the side effects of their drug, and the need to take the medication consistently (Stahl, 2013). They should also consider various ethical issues that guide the treatment of anxiety disorders. Patients of anxiety disorders should take medications such as Zoloft to suppress symptoms and avoid adverse effects. Recent studies have shown that anxiety disorders can have a significant impact on an individual’s quality of life, making effective treatment crucial (Hofmann et al., 2022). Furthermore, a comprehensive treatment plan should include a combination of medication and therapy to achieve optimal results (Kessler et al., 2023).
Decision #1
The best medication at the beginning of treating anxiety disorders is Zoloft. The first decision will involve prescribing Zoloft 50mg orally daily. The patient should take the drug for four weeks. The drug is approved for use among adults and children to treat generalized anxiety disorders (Mula, 2018). It is one of the popular drugs among clinicians since it has high therapeutic strength and fewer side effects. The only known side effect of Zoloft is weight gain, which subsides when a client stops taking the medication (Mula, 2018). Clinicians also prefer the drug since it has no addictive capabilities compared to other drugs used to treat anxiety disorders. Research has shown that Zoloft is effective in reducing symptoms of anxiety disorders in both adults and children (Walkup et al., 2022). Additionally, a study published in the Journal of Clinical Psychopharmacology found that Zoloft was well-tolerated and effective in treating generalized anxiety disorder ( Davidson et al., 2023).
Zoloft is an effective drug since it works on the brain by eliminating an imbalance of chemicals that trigger mood changes or depression. Patients with anxiety disorders experience anxiety attacks, chest tightness, and negativity about their life (Stahl, 2013). During the administration of the drug, it is essential to caution the patient against taking other drugs and substances. For example, the client should stop taking any alcohol or other illegal or over the counter drugs since they will interfere with the brain chemicals and hinder recovery. The patient’s adherence to the medication regimen is crucial to achieving optimal results (Kessler et al., 2023).
The purpose of selecting the drug among other available options is to realize specific patient outcomes. One of the expectations was to eliminate anxiety attacks, relieve chest tightness, and fear about the future. Patients of generalized anxiety disorder suffer from various symptoms such as anxiety attacks or shortness of breath, feelings of impending doom, and chest tightness (Olthuis et al., 2016). The patient also comes to the clinic complaining of worrying about his job or a negative incidence that is about to unfold in his life. A comprehensive treatment plan should address these symptoms and improve the patient’s overall quality of life (Hofmann et al., 2022).
Decision #2
The second decision is based on the outcome of decision #1. According to the outcome, the patient is responding positively to the drug without any side effects. It is thus essential to continue with the drug without changing it. Evidence-based practice shows that during the treatment of mental disorders, clinicians should not constantly change the medication (Love & Love, 2019). The reason is that drugs may take several weeks before significant improvement is realized. The decision is thus to continue with Zoloft but to increase the dosage to 75mg orally daily. One of the reasons for increasing the dose is to enhance the therapeutic ability of the drug. It is also recommendable to start with a low dosage in the treatment of mental conditions (Love & Love, 2019). High doses can cause side effects which can undermine recovery. For example, Zoloft causes suicidal thoughts if taken in large amounts. Clinicians thus take precautions to start with a low dose and make observations for the need to increase the dosage. A study published in the Journal of Clinical Psychopharmacology found that increasing the dosage of Zoloft can lead to improved treatment outcomes (Davidson et al., 2023).
The expectations while administering the drug is to reduce the HAM-A score considerably. A reduction in the HAM-A score is a sign that the patient is improving. Another expectation was to reduce the severity and frequency of symptoms such as anxiety attacks, chest tightness, and feelings of impending doom. For example, I expect that the client will come back to the clinic with an optimistic perspective on his job. Persistent symptoms of generalized anxiety disorder may undermine the quality of life of an individual (Vicario et al., 2019). Therefore, effective treatment is necessary to promote recovery. According to research, drugs prescribed for anxiety disorders may take several weeks, and thus I am hopeful for a positive report. A comprehensive treatment plan should include regular follow-up appointments to monitor the patient’s progress and adjust the treatment plan as needed (Kessler et al., 2023).
Decision #3
The third decision has several options. The first option is to continue with the medication, increase the dosage or change the medication. One of the best decisions is to continue with Zoloft 75mg orally daily since it is already achieving considerable improvements (Vicario et al., 2019). Zoloft is one of the antidepressant drugs that can be used alone in the treatment of generalized anxiety disorder. Clinicians can recommend a change of the drug or introduction of a new one in case the condition is not improving (Umylny et al., 2017). The patient is thus required to take the medication for another four weeks and report back to the clinic on the 12th week. Additionally, it is not advisable to introduce a new drug at such a stage of treatment. The reason is that the new drug may interfere with the current drug, trigger side effects or prolong the treatment (Umylny et al., 2017). Polypharmacy is thus not an option at this stage. The decision will also involve educating the patient about the weight gain weight but encourage them to take the medication consistently. A study published in the Journal of Clinical Psychopharmacology found that patient education is crucial in improving treatment outcomes (Walkup et al., 2022).
The expectation of continuing with the medication is that the patient will experience a complete recovery. After the four weeks, I expect that the client will record 100 percent in the HAM-A score rating scale. Another expectation is that the patient will remain positive about his job security. He should also not experience chest tightness. I also expect that the patient should not experience anxiety attacks (Umylny et al., 2017). The expectations are hinged on the purpose of administering Zoloft. The drug is approved by FDA for the successful treatment of generalized anxiety disorder.
Ethical Considerations Impacting Treatment and Communication
Treatment of anxiety disorders requires psychiatrists to inform their patients about drugs. A patient needs to know the drug they are taking and any side effects. For example, in the current case study, Zoloft will trigger weight gain (Gilbert et al., 2017). The clinicians should comprehensively explain to the patient that the side effect is normal. However, in the case that weight gain triggered adverse effects, the psychiatrist would need to change the medication. Clinicians should also explain to the patient that a high dosage of the drug can cause suicidal thoughts. The dosage is aligned to the age of the patient due to pharmacodynamics and pharmacokinetics factors. Therefore, the patient should take the medication only as prescribed without increasing frequency or dosage (Vicario et al., 2019). Psychiatrists should also monitor patients during the clinics to ensure the drug is not causing adverse negative effects (Stahl, 2013). The psychiatrists must take the necessary precautions to avoid legal issues. Educating the patient is also essential to ensure accurate adherence to the prescription. A comprehensive treatment plan should include regular follow-up appointments to monitor the patient’s progress and adjust the treatment plan as needed (Kessler et al., 2023).
Conclusion
Treatment and management of generalized anxiety disorders require a series of accurate and evidence-based decisions. Clinicians should make decisions that can relieve shortness of breath, anxiety attacks, and improve positive thoughts. One of the best decisions is to prescribe Zoloft 50mg orally daily. The drug is approved by the FDA for the treatment of generalized anxiety disorders. Psychiatrists should increase the drug progressively depending on the patient outcomes. It is also essential to avoid polypharmacy since it can trigger negative effects that can undermine recovery. Treatment of anxiety disorders also requires ethical considerations. The considerations are important to minimize side effects and promote steady and quick recovery. The current case study of a patient with anxiety disorder requires a prescription of Zoloft which is accurate and reliable.
References:
Davidson, J. R., et al. (2023). Zoloft in the treatment of generalized anxiety disorder: A randomized, double-blind, placebo-controlled study. Journal of Clinical Psychopharmacology, 33(1), 34-41.
Gilbert, A. L., Balio, C., & Bauer, N. S. (2017). Making the legal and ethical case for universal screening for postpartum mood and anxiety disorders in pediatric primary care. Current Problems in Pediatric and Adolescent Health Care, 47(10), 267-277. https://doi.org/10.1016/j.cppeds.2017.08.001
Hofmann, S. G., et al. (2022). The effect of anxiety disorders on quality of life. Journal of Clinical Psychology, 78(1), 1-11.
Kessler, R. C., et al. (2023). The prevalence and correlates of anxiety disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry, 22(1), 34-45.
Love, A. S., & Love, R. (2019). Anxiety Disorders in Primary Care Settings. Nursing Clinics, 54(4), 473-493. DOI: https://doi.org/10.1016/j.cnur.2019.07.002
Mula, M. (2018). Pharmacological treatment of anxiety disorders in adults with epilepsy. Expert Opinion on Pharmacotherapy, 19(17), 1867-1874. https://doi.org/10.1080/14656566.2018.1527905
Olthuis, J. V., Watt, M. C., Bailey, K., Hayden, J. A., & Stewart, S. H. (2016). Therapist‐supported Internet cognitive behavioral therapy for anxiety disorders in adults. Cochrane Database of Systematic Reviews, (3). https://doi.org/10.1002/14651858.CD011565.pub2
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Umylny, P., German, M., & Lantiere, A. (2017). Treating postpartum mood and anxiety disorders in primary care pediatrics. Current Problems in Pediatric and Adolescent Health Care, 47(10), 254-266. https://doi.org/10.1016/j.cppeds.2017.08.003
Vicario, C. M., Salehinejad, M. A., Felmingham, K., Martino, G., & Nitsche, M. A. (2019). A systematic review of the therapeutic effectiveness of non-invasive brain stimulation for the treatment of anxiety disorders. Neuroscience & Biobehavioral Reviews, 96, 219-231. https://doi.org/10.1016/j.neubiorev.2018.12.012
Walkup, J. T., et al. (2022). Treatment of anxiety disorders in children and adolescents. Journal of Child and Adolescent Psychopharmacology, 32(1), 2-12.
