psych________q2 - dep

[ArchivalUser]

You have been following a 72-year-old white male for depressed mood after his wife's death 7 months ago. Apart from a weight loss of 13lb(5.9kg), the patient also complains of lethargy and episodes of tearfulness. After attending 2 sessions of supportive psychotherapy, he continues to feel depressed, with added complaints of insomnia. He is plagued with thoughts of guilt about his wife™s death, and intermittent suicidal ideation. Based on this information, what step would you take next?


A. Start amitriptyline and alprazolam
B. Start sertraline
C. Increase psychotherapy sessions to twice weekly
D. Begin electroconvulsive therapy
E. Reassurance and continue cognitive therapy

[ArchivalUser]

ddd

[ArchivalUser]

i ll go for b

[ArchivalUser]

@natad..yes ans is B but can u explain it..why not D?pt is suicidal he needs ECT

[ArchivalUser]

In spite of treating the pt with Psychotherapy there are no improvement in symptoms.
The next step will be giving an SSRI.
Pt has suicidal thoughts but there is no immediate plan or imminent danger to life right away

[ArchivalUser]

thank you Axiom

if any one can recall me when to use ECT what about it side effect

[ArchivalUser]

remind in depression , questions regarding suicidal thought is very immportamt

[ArchivalUser]

pt has insomnia.how can we treat him with SSRI.The major side effect of SSRI is insomnia.

[ArchivalUser]

if we try trazodone