History of depression as a teenager

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Reference no: EM132470542

Depression

Patient is a 25 year old female, history of depression as a teenager, treated with "therapy", has never taken an antidepressant medication. Presents today with 2 months of feeling lethargic, decreased interest in leaving house, decreased appetite, and frequent tearful episodes (more than 3 per day). Patient denies any suicidal or homicidal ideations.

Surgical History- None

Medical history- None other than depression as a teenager.

Gynecologic- G-0, P-0, Pt having menstrual cycle q 35 days lasting 5-6 days. Has had 4 sexual partners, not currently sexually active.

Medications- None

Allergies- Seasonal allergies, no medication allergies

Social- Nonsmoker, occasionally drinks 1-2 times per month in a social settings. Not exercising regularly. Pt is single, living with roommate and working as a receptionist for a dental office. No recent change in relationship status.

Family History- Paternal Grandparents all with history of obesity, hypertension and type 2 diabetes, Maternal grandparents- Healthy, Father- history of hypertension. Mother- healthy. Older Sister- history of depression.

Vital Signs- T- 98.4, HR- 72, RR- 18, BP- 116/64, Ht- 5 ft 4 in, wt- 145, BMI- 24.89

Physical Exam- All WNL

Name 2 different screening tools you can use to evaluate patients with symptoms of depression. What are the benefits of each of the tools you have chosen.

Based on the screening tool results and your discussion with the patient you have decided to start an antidepressant medication.

What Medication and dose would you start and why (Note: there are many medication that would work well in this situation. I am interested in your reasoning for choosing the medication discussing possible side effects and effectiveness for this patient)

Prior to starting the medication what blood work would you want to consider? Use this blood work to rule out other medical differentials as well as monitoring for the chosen medication.

What anticipatory guidance is important as the patient starts the medication?

When do you want to see the patient again for follow up?

What are other lifestyle changes the patient can make to help with treatment?

Reference no: EM132470542

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