course material

1. Assignment on Psychopharmacologic Approaches to Treatment of
Psychopathology
Therapy for Patients With Major Depressive Disorder (MDD)Mood disorders can impact
every facet of a human being’s life, making the most basic activities difficult for patients and
their families. This was the case for 13-year-old Jeanette, who was struggling at home and at
school. For more than 8 years, Jeanette suffered from temper tantrums, impulsiveness,
inappropriate behavior, difficulty in judgment, and sleep issues.As a PNP working with
pediatric patients, you must be able to assess whether these symptoms are caused by
psychological, social, or underlying growth and development issues. You must then be able
recommend appropriate therapies.This week, as you examine antidepressant therapies, you
explore the assessment and treatment of three populations: pediatrics, adults, and
geriatrics. The focus of your assessment tool, a decision tree, will specifically center on one
of the most vulnerable populations, pediatrics. Please remember, you must also consider
the ethical and legal implications of these therapies. You will also complete a Quiz on the
concepts addressed throughout this module.Learning ObjectivesStudents will:· Assess
patient factors and history to develop personalized plans of antidepressant therapy across
the lifespan· Analyze factors that influence pharmacokinetic and pharmacodynamic
processes in pediatric, adult, and geriatric patients requiring antidepressant therapy·
Synthesize knowledge of providing care to pediatric, adult, and geriatric patients presenting
for antidepressant therapy· Analyze ethical and legal implications related to prescribing
antidepressant therapy to patients across the lifespan Learning ResourcesBaek, J. H.,
Nierenberg, A. A., & Fava, M. (2016). Pharmacological approaches to treatment-resistant
depression. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts
General Hospital psychopharmacology and neurotherapeutics (pp. 44–47). Elsevier.Fava,
M., & Papakostas, G. I. (2016). Antidepressants. In T. A. Stern, M. Favo, T. E. Wilens, & J. F.
Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and
neurotherapeutics (pp. 27–43). Elsevier.American Psychiatric Association. (2013).
Diagnostic and statistical manual of mental disorders (5th ed.).
https://doi.org/10.1176/appi.books.9780890425596Howland, 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.
https://doi.org/10.3928/02793695-20080901-06Howland, R. H. (2008b). Sequenced
Treatment Alternatives to Relieve Depression (STAR*D). Part 2: Study outcomes. Journal of

2. Psychosocial Nursing and Mental Health Services, 46(10), 21–24.
https://doi.org/10.3928/02793695-20081001-05Lorberg, B., Davico, C., Martsenkovskyi,
D., & Vitiello, B. (2019). Principles in using psychotropic medication in children and
adolescents. In J. M. Rey & A. Martin (Eds.), IACAPAP e-textbook of child and adolescent
mental health. https://iacapap.org/content/uploads/A.7-Psychopharmacology-
2019.1.pdfMagellan Health. (2013). Appropriate use of psychotropic drugs in children and
adolescents: A clinical monograph.
http://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-
0203141.pdfPoznanski, E. O., & Mokros, H. B. (1996). Child depression rating scale—
Revised. Western Psychological Services.Rao, U. (2013). Biomarkers in pediatric depression.
Depression & Anxiety, 30(9), 787–791. https://doi.org/10.1002/da.22171Yasuda, S. U.,
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.
https://web.archive.org/web/20170809004704/https://www.fda.gov/downloads/Drugs/
ScienceResearch/…/UCM085502.pdfNote: To access the following medications, use the IBM
Micromedex resource. Type the name of each medication in the keyword search bar. Be
sure to read all sections on the left navigation bar related to each medication’s result page,
as this information will be helpful for your review in preparation for your
Assignments.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· vortioxetineRequired Media (click to
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_container_1716881496-accordion_copy_copy_2106378025-448Case Study: An African
American Child Suffering from Depression // Pediatric depressionTherapy for Pediatric
Clients with Mood DisordersAn African American Child Suffering From
DepressionBACKGROUND INFORMATIONThe client is an 8-year-old African American male
who arrives at the ER with his mother. He is exhibiting signs of depression.· Client
complained of feeling “sad”· Mother reports that teacher said child is withdrawn from
peers in class· Mother notes decreased appetite and occasional periods of irritation· Client
reached all developmental landmarks at appropriate ages· Physical exam
unremarkable· Laboratory studies WNL· Child referred to psychiatry for
evaluation MENTAL STATUS EXAMAlert & oriented X 3, speech clear, coherent, goal
directed, spontaneous. Self-reported mood is “sad”. Affect somewhat blunted, but child
smiled appropriately at various points throughout the clinical interview. He denies visual or
auditory hallucinations. No delusional or paranoid thought processes noted. Judgment and
insight appear to be age-appropriate. He is not endorsing active suicidal ideation, but does
admit that he often thinks about himself being dead and what it would be like to be

3. dead.You administer the Children’s Depression Rating Scale, obtaining a score of 30
(indicating significant depression) RESOURCES§ Poznanski, E., & Mokros, H. (1996). Child
Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.Decision
Point OneSelect what you should do: Begin Zoloft 25 mg orally dailyBegin Paxil 10 mg orally
dailyBegin Wellbutrin 75 mg orally BIDOptional Resources (click to
expand/reduce) Assignment: Assessing and Treating Pediatric Patients With Mood
DisordersWhen pediatric patients present with mood disorders, the process of assessing,
diagnosing, and treating them can be quite complex. Children not only present with
different signs and symptoms than adult patients with the same disorders, they also
metabolize medications much differently. Yet, there may be times when the same
psychopharmacologic treatments may be used in both pediatric and adult cases with major
depressive disorders. As a result, psychiatric nurse practitioners must exercise caution
when prescribing psychotropic medications to these patients. For this Assignment, as you
examine the patient case study in this week’s Learning Resources, consider how you might
assess and treat pediatric patients presenting with mood disorders.To prepare for this
Assignment:· Review this week’s Learning Resources, including the Medication Resources
indicated for this week.· Reflect on the psychopharmacologic treatments you might
recommend for the assessment and treatment of pediatric patients requiring
antidepressant therapy.The Assignment: 5 pagesExamine Case Study: An African American
Child Suffering From Depression. You will be asked to make three decisions concerning the
medication to prescribe to this patient. Be sure to consider factors that might impact the
patient’s pharmacokinetic and pharmacodynamic processes.At each decision point, you
should evaluate all options before selecting your decision and moving throughout the
exercise. Before you make your decision, make sure that you have researched each option
and that you evaluate the decision that you will select. Be sure to research each option using
the primary literature.Introduction to the case (1 page)· Briefly explain and summarize the
case for this Assignment. Be sure to include the specific patient factors that may impact
your decision making when prescribing medication for this patient.· Decision #1 (1 page)·
Which decision did you select?· Why did you select this decision? Be specific and support
your response with clinically relevant and patient-specific resources, including the primary
literature.· Why did you not select the other two options provided in the exercise? Be
specific and support your response with clinically relevant and patient-specific resources,
including the primary literature.· What were you hoping to achieve by making this decision?
Support your response with evidence and references to the Learning Resources (including
the primary literature).· Explain how ethical considerations may impact your treatment
plan and communication with patients. Be specific and provide examples.· Decision #2 (1
page)· Why did you select this decision? Be specific and support your response with
clinically relevant and patient-specific resources, including the primary literature.· Why did
you not select the other two options provided in the exercise? Be specific and support your
response with clinically relevant and patient-specific resources, including the primary
literature.· What were you hoping to achieve by making this decision? Support your
response with evidence and references to the Learning Resources (including the primary
literature).· Explain how ethical considerations may impact your treatment plan and

4. communication with patients. Be specific and provide examples.· Decision #3 (1 page)·
Why did you select this decision? Be specific and support your response with clinically
relevant and patient-specific resources, including the primary literature.· Why did you not
select the other two options provided in the exercise? Be specific and support your
response with clinically relevant and patient-specific resources, including the primary
literature.· What were you hoping to achieve by making this decision? Support your
response with evidence and references to the Learning Resources (including the primary
literature).· Explain how ethical considerations may impact your treatment plan and
communication with patients. Be specific and provide examples.· Conclusion (1
page)Summarize your recommendations on the treatment options you selected for this
patient. Be sure to justify your recommendations and support your response with clinically
relevant and patient-specific resources, including the primary literature.Note: Support your
rationale with a minimum of five academic resources. While you may use the course text to
support your rationale, it will not count toward the resource requirement. You should be
utilizing the primary and secondary literature.Reminder : The College of Nursing requires
that all papers submitted include a title page, introduction, summary, and references.