Week 3 discussion

Discussion: The Impact of Ethnicity on Antidepressant Therapy

Major depressive disorder is one of the most prevalent disorders you will see in clinical practice Treatment for this disorder, however, can vary greatly depending on client factors, such as ethnicity and culture As a psychiatric mental health professional, you must understand the influence of these factors to select appropriate psychopharmacologic interventions For this Discussion, consider how you might assess and treat the individuals in the case studies based on the provided client factors, including ethnicity and culture

Learning Objectives

Students will:

Assess client factors and history to develop personalized plans of antidepressant therapy for adult and geriatric clients

Analyze factors that influence pharmacokinetic and pharmacodynamic processes in adult and geriatric clients requiring antidepressant therapy

Analyze the impact of ethnicity on antidepressant therapy

Evaluate efficacy of treatment plans

Apply knowledge of providing care to adult and geriatric clients presenting for antidepressant therapy

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus

Required Readings

Note: All Stahl resources can be accessed through the Walden Library using this link This link will take you to a log-in page for the Walden Library Once you log into the library, the Stahl website will appear

Stahl, S M (2013) Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed) New York, NY: Cambridge University Press

Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter Be sure to read all sections on the left navigation bar for each chapter

Chapter 7, “Antidepressants”

Stahl, S M (2014b) The prescriber’s guide (5th ed) New York, NY: Cambridge University Press

Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication

Review the following medications:

amitriptyline

bupropion

citalopram

clomipramine

desipramine

desvenlafaxine

doxepin

duloxetine

escitalopram

fluoxetine

fluvoxamine

imipramine

ketamine

mirtazapine

nortriptyline

paroxetine

selegiline

sertraline

trazodone

venlafaxine

vilazodone

vortioxetine

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (5th ed) Washington, DC: Author

Note: Retrieved from Walden Library databases

Howland, R H (2008a) Sequenced treatment alternatives to relieve depression (STAR*D) Part 1: Study design Journal of Psychosocial Nursing and Mental Health Services, 46(9), 21–24 doi:103928/02793695-20080901-06

Note: Retrieved from Walden Library databases

Howland, R H (2008a) Sequenced treatment alternatives to relieve depression (STAR*D) Part 2: Study outcomes Journal of Psychosocial Nursing and Mental Health Services, 46(19), 21–24 doi:103928/02793695-20081001-05

Note: Retrieved from Walden Library databases

Yasuda, SU, Zhang, L & Huang, S-M (2008) The role of ethnicity in variability in response to drugs: Focus on clinical pharmacology studies Clinical Pharmacology & Therapeutics, 84(3), 417–423 Retrieved from https://webarchiveorg/web/20170809004704/https://wwwfdagov/downloads/Drugs/ScienceResearch//UCM085502pdf

To prepare for this Discussion:

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number

Case 1: Volume 1, Case #1: The man whose antidepressants stopped working

Case 2: Volume 1, Case #7: The case of physician do not heal thyself

Case 3: Volume 1, Case #29: The depressed man who thought he was out of options

Review this week’s Learning Resources and reflect on the insights they provide

Go to the Stahl Online website and examine the case study you were assigned

Take the pretest for the case study

Review the patient intake documentation, psychiatric history, patient file, medication history, etc As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office

Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (ie, family members, teachers, nursing home aides, etc)

Consider whether any additional physical exams or diagnostic testing may be necessary for the patient

Develop a differential diagnoses for the patient Refer to the DSM-5 in this week’s Learning Resources for guidance

Review the patient’s past and current medications Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient

Review the posttest for the case study