Natalee’s symptoms and the information given by her mother allow diagnosing a major depressive disorder (MDD). This condition is characterized by a sudden change in the patient’s mood that has lasted for at least two weeks (Sadock, Sadock, & Ruiz, 2015). Since the girl’s mood change occurred about eight weeks ago, it is possible to diagnose MDD. Other important symptoms that Natalee has include the loss of appetite, the change in weight, lack of energy, changes in activity (Sadock et al., 2015). Also, the girl has problems thinking since her school performance has decreased considerably. Finally, there is a family history of MDD, which increases the likelihood of the girl’s primary diagnosis. Differential diagnoses may involve a “mood disorder due to a general medical condition” (Sadock et al., 2015, p. 368). Also, since the patient is a child, the attention-deficit/hyperactivity disorder should be considered.
The most suitable medication for Natalee is fluoxetine (Prozac) since it is the only one approved by the Food and Drug Administration (FDA) for children aged eight or older. It is highly important to prescribe drugs in caution in this situation because the patient is young and because there are serious side effects. Fluoxetine helps to treat depression and eating disorders, which are some of Natalee’s symptoms (“Fluoxetine,” 2018). This drug belongs to the class of selective serotonin reuptake inhibitors, which means it elevates the amount of serotonin – the substance in the patient’s brain which is responsible for maintaining mental balance (“Fluoxetine,” 2018). The initial pediatric dose of Prozac for patients with MDD is 10 to 20mg. Further, the patient should receive a 20mg dose every day. Prozac will be administered in the morning or the evening (Sohel & Molla, 2018). The medicine is only available in an oral formulation, including tablets, capsules, or liquid form.
It is necessary to educate the patient’s mother about the fluoxetine’s work. Trina should be informed that it may take several weeks before her daughter feels the full benefit of the drug (“Fluoxetine,” 2018). Also, Trina should make sure that Natalee takes her medication as prescribed, at the same time every day, without increasing the dose. Missed doses can lead to a relapse in symptoms, so regularity is crucial. Also, Trina should be instructed that a sudden pause in taking fluoxetine may lead to withdrawal symptoms, such as irritability, anxiety, mood changes, or tiredness (“Fluoxetine,” 2018). Therefore, she should be thoroughly attentive regarding her daughter’s intake of the prescribed medicine. Also, it is necessary to inform Trina that if any side effects develop, they are likely to disappear with time (Sohel & Molla, 2018). Thus, being consistent with the doses is crucial and will eventually lead to positive outcomes.
Despite the likelihood of Prozac to alleviate the symptoms of MDD, the drug has some serious side effects and risks that should be discussed with the mother. The most common of these include anxiety, nervousness, problems with sleeping (difficulty falling asleep or staying asleep), weakness, loss of weight or appetite, headache, and confusion (“Fluoxetine,” 2018). However, there is one rather severe side effect that requires extreme cautiousness. Fluoxetine has been reported to increase the development of suicide risk in patients (Mitchell, Davies, Cassesse, & Curran, 2014). Due to this fact, the drug has been issued a black box warning by the FDA. The black box warning was announced due to data indicating an increased risk of suicidality among patients treated with fluoxetine (Mitchell et al., 2014). Therefore, it is of utmost importance for Trina to take notice of any changes in Natalee’s behavior. The girl should not be left by herself, and Trina needs to do her best to reduce her daughter’s negative and depressive thoughts.
Mitchell, A. M., Davies, M. A., Cassesse, C., & Curran, R. (2014). Antidepressant use in children, adolescents, and young adults: 10 years after the Food and Drug Administration black box warning. The Journal for Nurse Practitioners, 10(3), 149-156.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
Sohel, A. J., & Molla, M. (2018). Web.