Problem:
62-year-old female with a pre-established diagnosis of Major Depressive disorder. She states "I don't think the medication is working." She presents today with complaints of low mood, inability to initiate sleep at night (early insomnia), lack of motivation and thoughts of "Wishing I was not here." She denies any intent or plan. However she does have a history of a Suicide attempt 5 years ago. Client is currently taking Lexapro 20 (Escitalopram) mg daily. Per old records she has taken, Prozac (fluoxetine), Zoloft (Sertraline), and Paxil (Paroxetine). She states they have not been effective. She has no known allergies. Client has history of being non-compliant with diet and exercise. Her medical history includes nerve pain from Sciatic. Denies any cardiac or respiratory issues. Denies history of seizures or head injuries. Vital signs are WNL.