Assignment Problem: James is a 52-year-old male with a diagnosed major depressive disorder. He comes to see you because he wants a another opinion. James states that he has been on almost every antidepressant and is not getting any relief. He states that his last psychiatric provider had him on Escitalopram (Lexapro) 40mg once a day and he is still depressed. James reports that his symptoms are isolation, hopelessness, poor hygiene, sleeping and eating too much. When you assess him, you find that he has been on the following medications: Fluoxetine (Prozac), Sertraline (Zoloft), and Venlafaxine (Effexor) without relief. You complete a thorough assessment on him and determine that he does have major depressive disorder and appears to be treatment resistant.
Allergies: NKDA
Questions:
1) Based on the information in the case study, would you add or change his medication, and if so, what medication, dose, and time of administration. Provide current literature (EBP, research article, or text reference) to support your decision.
2) Based on the medication you prescribe what education would you provide James?