agitation and suicidal ideation.
agitation and suicidal ideation.
Plan of Care
The plan of care for the patient includes remission of symptoms. Remission is defined as an absence of depressive symptoms or a PHQ-9 score of less than 5, and this is the goal of therapy. Treatment will also begin with pharmacological and nonpharmacological interventions. A referral to a therapist can also be ordered to help the patient get through the depression.
Mainstay of Treatment
Treatment consist of the selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), norepinephrine reuptake inhibitors (NRIs), tricyclic antidepressants (TCAs), and dopamine agonists (DAs) are the first line of treatment. Non-pharmacological treatment include behavioral therapy with combination of psychotherapy can also be beneficial to the patient.
Follow Up Plan
Follow up treatment is necessary to assess adherence to therapy. The patient at 6 weeks should experience a 25% reduction in baseline symptom severity. Initially the patient should be seen one to two weeks after initiation of medication therapy than once in the succeeding four to eight weeks. If patients remain symptom free patients can be treated for 15 months to five years.
Patient Education
It is important that practitioner teach the patient to report the symptoms such as irritability, agitation and suicidal ideation. Emergency hotline numbers should be given in case the patient symptoms emerge. Patient and family should be educated regarding the signs and symptoms and also what to do in this case.
References
