Advances in genetics and epigenetics have significantly impacted our understanding of mood disorders and have led to the development of new evidence-based practices for assessment and treatment. As a psychiatric mental health nurse practitioner, it is crucial to stay up to date with these advancements in order to provide the best possible care for clients with mood disorders.
Depressive disorders, commonly referred to as major depressive disorder (MDD) or clinical depression, are characterized by persistent feelings of worthlessness, hopelessness, and unhappiness, as well as a loss of interest in previously enjoyed activities (Unützer & Park, 2012). It is crucial to address depression in older men, as they are less likely than older women to receive proper treatment for depression and are also more likely to die by suicide (Flint, 2013).
Late-life depression (LLD) refers to depression that either recurs in old age, after starting earlier in life, or develops for the first time in old age. LLD is associated with cognitive impairment, functional impairment, and an increased risk of developing Alzheimer’s disease and vascular dementia (Diniz & Reynolds, 2014). Therefore, it is crucial to effectively assess and treat depression in older adults to prevent further decline in their cognitive and functional abilities.
When making decisions about medication therapy for clients with mood disorders, there are several factors that must be considered. One important consideration is the client’s pharmacokinetic processes. Pharmacokinetics refers to how the body absorbs, distributes, metabolizes, and excretes drugs (Mangoni, 2004). Factors such as age, liver and kidney function, and the presence of comorbid conditions can all impact a client’s pharmacokinetic processes. Therefore, medication dosages may need to be adjusted to ensure optimal effectiveness and minimize the risk of adverse effects.
Another factor to consider is the client’s pharmacodynamic processes. Pharmacodynamics refers to how drugs interact with their molecular targets in the body to produce a therapeutic effect (Mangoni, 2004). Each medication has specific mechanisms of action, and these mechanisms can vary depending on the drug. It is important to understand how a specific medication works and how it will interact with the client’s body in order to achieve the desired therapeutic outcome.
In the case of the provided patient, the decision is made to prescribe Wellbutrin 150mg XL. Wellbutrin is an antidepressant medication that acts as a norepinephrine-dopamine reuptake inhibitor (NDRI). By inhibiting the reuptake of these neurotransmitters, Wellbutrin helps to increase their availability in the brain, which can improve mood and reduce symptoms of depression (NAMI, 2017).
The expected results of prescribing Wellbutrin 150mg XL for this patient include an improvement in symptoms within two weeks. Signs of improvement may include enhanced performance at work, increased engagement in exercise and hobbies, enhanced intellectual pursuits, and improved sleep (Laureate Education, 2016). It is essential to closely monitor the patient’s progress and adjust the medication dosage or consider alternative medications if the desired therapeutic effect is not achieved.
In conclusion, it is crucial for psychiatric mental health nurse practitioners to stay updated on advances in the understanding and treatment of mood disorders. When making decisions about medication therapy for clients with mood disorders, factors impacting pharmacokinetic and pharmacodynamic processes should be considered. In the case of the provided patient, the decision to prescribe Wellbutrin 150mg XL is based on its effectiveness as an antidepressant medication. Close monitoring and adjustment of the medication therapy are essential for optimal patient outcomes.