Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different interactive media piece on a psychological disorder, and pr

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different interactive media piece on a psychological disorder, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology.

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Depression Scenario

The interactive depression scenario described a 70-year-old male who presented with complaints of depression (Laureate Education, 2019). He also reported shoulder pain related to warehouse labor, experiencing the death of his mother at a young age, being an outsider at school, anhedonia, recent weight gain, insomnia, and poor concentration (Laureate Education, 2019). On exam, he had poor eye contact, soft speech, constricted affect without evidence of psychosis or suicidal/homicidal ideation (Laureate Education, 2019). For the first decision, I chose to start the patient on Zoloft 25 mg oral daily. When the patient returned four weeks later with a 25 percent improvement of depressive symptoms and a new onset of erectile dysfunction, I chose to add Wellbutrin IR 150 mg in the morning. When the patient came in four weeks later with the continued decrease of depressive symptoms, no erectile dysfunction, and feelings of increased nervousness, I chose to change the Wellbutrin order to Wellbutrin XL 150 mg oral in the morning.

Pharmacotherapeutic Impact on Pathophysiology

When choosing initial treatment options for depression, the classes of medications have similar efficacy, so it is best to focus on safety and medication tolerance (Rosenthal & Burchum, 2018). Therefore, I chose to start with a Selective Serotonin Reuptake Inhibitor (SSRI), recognized as the safest and most tolerated medications for treating major depression (Rosenthal & Burchum, 2018). The pathophysiology of these medications is unclear; however, the theory suggests that these medications compensate for serotonin deficiency in the synapse (Holck, Wolkowitz, Mellon, Reus, Nelson, Westrin, & Lindqvist, 2019). Serotonin is needed to regulate sleep, mood, and cognition (Holck et al., 2019). By increasing the amount of Serotonin in the synapse, this patient’s depressive symptoms decreased. In the second decision, I chose to add Wellbutrin IR to the patient’s medication regimen to help treat his erectile dysfunction symptoms. Wellbutrin is an atypical antidepressant where the mechanism of action is also not understood (Rosenthal & Burchum, 2018). However, the effects may be related to blocking the reuptake of dopamine, which regulates behavior and influences learning, and norepinephrine, which plays a role in getting the brain and body ready for action (Berke, 2018; Rosenthal & Burchum, 2018). While Wellbutrin helps depression, it also seems to help with sexual desire (Rosenthal & Burchum, 2018). Fortunately, this additional medication helped the patient in the scenario. After four weeks of taking both drugs, he had a continued decrease in depressive symptoms and no longer struggled with sexual dysfunction. In my third decision, I chose to change the Wellbutrin order to extended-release since the patient was experiencing restlessness symptoms. The immediate-release may have been too much, too fast for the patient as it reaches its peak two hours after administration (Rosenthal & Burchum, 2018). Extended-release Wellbutrin reaches its peak at five hours with a half-life of approximately 21 hours (Food and Drug Administration, n.d.). This change will help to settle the experienced side effects of the medication.

Treatment Plan The effect of Zoloft and Wellbutrin on the patient’s pathophysiology will impact the patient’s treatment plan. Common side effects of SSRIs include weight gain, insomnia, sexual dysfunction, and increased risk of suicide (Rosenthal & Burchum, 2018). I already addressed sexual dysfunction by adding Wellbutrin, but the monitoring for the other side effects is also essential for safety and compliance p…

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