Axiolysis

Running head: AXIOLYTIC THERAPY AND TREATMENT FOR ANXIETY DISORDER 1

AXIOLYTIC THERAPY AND TREATMENT FOR ANXIETY DISORDER 2

Anxiolytic Therapy and Treatment for Anxiety Disorder

Week 5

Anxiolytic Therapy and Treatment for Anxiety Disorder

Anxiolytic refers to the combination of medication that is prescribed for the patient with anxiety disorder (Bandelow, Michaelis, & Wedekind, 2017). Various medications fall into the category of anxiolytic and they may be pharmaceutical medications or CAM treatment approaches. serotonin reuptake inhibitors, benzodiazepines and barbiturates are among the pharmacological treatments for this condition. Anxiety disorder can manifest in several approaches that may include malaise, cerebral pain, acute chest pain, nausea and irregular heart rate (Knowles, et al. 2019). Subjective data that indicates anxiety disorder may manifest in persons with the anxiety disorder includes trembling, frequent sweating and emotional instability. Patients with anxiety disorder also experience a feeling of hopelessness and lack of purpose in life. Suicidal thoughts may also reign the thoughts of the patient. Healthcare providers should consider applying critical thinking when deciding the type of medication to provide to the patients with anxiety disorder. This paper discussion the decision of treatment for the patient presented in the case study. The rationale for the selected medication would in each of the three steps is also provided. A discussion of the expected results from using the medication is discussed.

Decision #1: Begin Zoloft 50 mg PO day

Rationale

The first decision of treatment option that is selected for this patient is Zoloft 50 mg PO day. Zoloft is one of the key priorities for the treatment of the most mental health conditions (Banks, 2017). The patient has been diagnosed with generalized anxiety disorder and thus one of the most effective medication from the provided options is Zoloft. Zoloft falls in the SSRI category of drugs. The therapeutic actions of Zoloft at most one week and thus will provide immediate action for the patient condition. Since Zoloft is one of the first line medication for the management mental health conditions, it is therefore necessary to consider it in the place of Buspirone and Imipramine. These two belong to the second line of the mental health treatment and thus may be considered in second priority.

Expected Results from using Zoloft

The optimal therapeutic effects of Zoloft can be experienced at least within the first two weeks. Within the first two (Banks, 2017). The frequency of hopelessness will reduce significantly while the heart rate is expected to gradually stabilize. The emotions of the patient will also be expected to stabilize while the nausea also reducing significantly. The chest tightness will also reduce significantly and the patient will be likely to experience specific treatment for the condition. The HAM-A scale measurement is also expected to drop after the first two weeks of using the medication (Bandelow, Michaelis, & Wedekind, 2017). A positive response to this Zoloft will also be expected to manifest in the reduced level of the patient weakness.

Difference Between the Outcome and the Expected Results

The process of developing Zoloft PO day, the patient reported various changes. Although the HAM-A scale, measurement had dropped, the patient did not attain the 15 scale reading that was expected within the four weeks’ period. The HAM-A scale measure during the return period was found to be 20, down from the initial 26. The patient reported to still experience episodes of chest tightness as compared to the expected complete recovery from this symptom. The patient also reported to experience breathing difficulty especially when he gets angered. The expectation for this symptom was to have the patient attain healthy breathing.

Decision #2: Increase Zoloft dose from 50mg to 75 mg PO daily

Rationale

The rationale for selecting this medication is due to the fact that the patient responded positively to the initial dose of the medication. Thus increasing the dose for this medication would contribute to further positive response to the medication. The maximum dose for Zoloft is 200mg PO day for patients with anxiety disorders. Adding 25mg PO day would likely improve the effectiveness of the medication (Bandelow, Michaelis, & Wedekind, 2017). The therapeutic response rate of Zoloft would be considered to be directly proportional to the effectiveness of the medication. Having 75mg orally would therefore be expected to yield therapeutic outcome within a shorter time than it was in the case of 50mg orally.

Expected outcome

The therapeutic impacts of the medication in this case would be expected to be at most two weeks. The HAM-A scale reading is expected to reduce to 12 at the end of the two weeks’ period. The mood swings are expected to disappear within the two weeks as well as the chest tightness. Breathing is also expected to be in the normal and the patient fear for uncertainties will also disappear. The patient condition would be associated with the implementation of effective features of concern.

Difference Between the Outcome and the Expected Results

The patient condition had further improved during the next visit after the four weeks’ period. The episodes of breathing difficulty had reduced significantly and the chest tightness had reduced to at most once every week. The HAM-A scale had reduced to 14 as opposed to the expected outcome of 10. The aspect of the breathing difficulty and chest tightness was expected to have disappeared during this last period. The emotional swings were also expected to have diminished but the patient still reported to experience the mood swings at least twice in the period of four weeks.

Decision #3: Maintain the dose of Zoloft 75mg PO day

Rationale

Considering that the patient condition had shown consistent positive response to the condition in the previous dose, it would therefore be wise to continue the dose. The symptoms had reduced by at least 60% over the last two months of prescription. These indications imply that the dose is effective and thus the rationale maintaining the dose.

Expected results

Within the next four weeks, the symptoms will be expected to have reduced by at least 90%. The patient will be expected to experience no chest tightness nor breathing difficulty by the 12th week. The mood swings are also expected to reduce by more than 90% as the patient is also expected to have suitable features of concern.

Difference Between the Outcome and the Expected Results

During the 12th week visit, most of the patient symptoms had significantly reduced and most of the expectations were met. The patient reported not experiencing any episode of breathing difficulties and no chest tightness. The patient reported having experienced one episode of mood swings. The symptoms could be considered to have reduced by at least 85%. The remaining symptoms could be reduced through behavioral therapy.

Ethical Consideration in the Treatment Plan

While providing treatment for the patient condition, it is important to consider adhering to ethics. Anxiolytic treatment for patients with mental health disorders should adhere to informed consent the patient autonomy (Ghafourian, Safaei, & Abbasi, 2018). These includes providing patient education on the type of medication regime provided to the patient. The patient would also be educated on why the provided medication is the most appropriate for him. The aspect of non-maleficence was also adhered to in the process of developing suitable features that would be associated with the improvement of the patient condition. These would ensure that the patient is consistently protected from harm.

Conclusion

The process of providing intervention to the patient health condition requires that the the healthcare providers employ critical thinking. This would help the healthcare providers to make up mind on the most appropriate treatment from the available options. The available most efficient medication should be considered in order to enable the best therapy. In the case study presented, the medication that is considered to be the most effective for the management of the anxiety disorder is Zoloft. Zoloft is among the best SSRI medication for managing mental health challenges. The dose for the medication was increased in the next visit in order to improve therapy. In the last visit the dose was maintained and the patient condition was effectively managed. The aspect of ethics is considered to be the most effective features of concern. These includes adhering to autonomy and informed consent.

References

Banks, L. (2017). Zoloft/Sertraline HCl.

Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in clinical neuroscience, 19(2), 93.

Ghafourian, M., Safaei, S., & Abbasi, M. (2018). Analyzing the Role of Patient Autonomy in Informed Consent. Bioethics Journal, 8(29), 43-51.

Knowles, K. A., Sripada, R. K., Defever, M., & Rauch, S. A. (2019). Comorbid mood and anxiety disorders and severity of posttraumatic stress disorder symptoms in treatment-seeking veterans. Psychological Trauma: Theory, Research, Practice, and Policy, 11(4), 451.

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