Generalized Anxiety Disorder / Insomnia / Major Depressive Disorder/ PTSD
Pt Name: L.G.D Age: 30 Years old.
Diagnosis: Generalized Anxiety Disorder / Insomnia / Major Depressive Disorder/ PTSD
Chief Complain: Still having panic attack. Pt is a 30 year old female, who presented to the clinic complaining that she is still having panic attack and that Fluoxetine is not helping her though it helped her to loss the weight she gained from taking Lexapro. She is having problem trying to impress people at work by trying to make them see her as a normal person which is affecting her performance. Her anxiety level is 8/10 while her depression level is 5/10. Pt denied any SI/HI/AU/VH intent. Pt uses Xanax in the morning to keep her anxiety level down and some times takes it in the afternoon. Pt's list of medications include Alprazolam (Xanax) 1 MG Oral Tablet Fluoxetine HCl (FLUoxetine HCl) 10 MG Oral Capsule Fluoxetine HCl (FLUoxetine HCl) 20 MG Oral Capsule. Pt's med was called in and pt is to follow up in a months time.
Fluoxetine was not providing adequate relief from her symptoms and she had also gained weight while taking Lexapro, leading to additional distress over being unable to "impress people at work" or perform as well as expected due to her mental health issues. Her self-reported level of anxiety was 8/10, while her level of depression was 5/10; however she denied any suicidal ideation (SI), homicidal ideation (HI), auditory hallucinations (AU) or visual hallucinations (VH).
To help manage her symptoms, L.G.D has been prescribed alprazolam 1mg oral tablet twice daily along with fluoxetine HCl 10 mg oral capsule once per day and fluoxetine HCl 20 mg oral capsule as needed for additional symptom relief. In order to monitor the efficacy of this treatment plan, it is recommended that L.GDs follow up in one month's time for an evaluation by either a psychiatrist or psychotherapist depending on individual need and preferences; additional medical consultations may be necessary if deemed appropriate by the clinician in charge of the case.
It is important that LGD remain compliant with all instructions given by healthcare providers during follow-up appointments in order to ensure optimal success with their current medications and treatment plan moving forward; this includes adhering strictly to all dosage guidelines provided on label directions whenever administering their antidepressant medications orally so as not risk overdosing or overdose related complications which could potentially be fatal if left untreated long enough before seeking professional assistance from a doctor or other qualified medical personnel immediately upon hosting such symptoms related tot he useof these drugs . Furthermore , it would also benefit LGD greatly if lifestyle modifications such as exercising regularly , eating healthier meals , reducing caffeine consumption etc are adopted alongside therapy sessions which could include cognitive behavioral therapy sessions designed specifically t ohelp individuals cope better with situations triggering negative responses associated directly with their respective mental health disorders .
In summation , LP should adhere strictly to both dosages instructions provided when taking his medications combined wit han overall healthy lifestyle change including regular exercise regimens combined wiht psychological support from individuals capable of providing specialized therapies tailored towards helping him improve his quality life significantly through improved control over thoughts associated directly within terms of his particular conditions . It is important for himt o checkout again inthe future wtihadvice from ahcealthcare provider afterhte initial set period fo rfurther checkupsto determinet he degree effeictivenessoftreatment sothatmore adequa te adjustment sotfhis regimesmaybemade accordingly .