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July 12, 2018


The client is a 68-year-old female who presents herself at the clinic. Her major symptoms include; disturbed sleep pattern, difficulty concentration, anhedonia, low self-esteem, guilty, decreased appetite, and disordered thought process. After careful assessment of the symptoms, the client is diagnosed with a major depressive disorder. The likely appropriate medication for the client is fluoxetine (Prozac) because research indicates that it is one of the most effective antidepressants for patients aged 65 and above (Kashani et al., 2017). Fluoxetine is a selective serotonin reuptake inhibitor (SSRIs) and doctors prefer to prescribe them to patients with major depressive disorder since it is safe and has fewer side effects compared to other antidepressants.

          When administering fluoxetine to a client, the nurse should inform her about the expected side effects from the use of the medication such as headaches, dizziness, upset stomach, and vomiting. The patient should report back to the clinic if there worsening or new symptoms. Also, the patient needs to comply with the medication directions including dosage and taking the medication at the right time. After using fluoxetine for 2 months, it is expected that the symptoms will improve both in frequency and severity. As the body gets used to fluoxetine, some of the side effects will improve gradually. If the client does not respond to the medication prescribed, a combination of medication and psychotherapy such as cognitive-behavioral therapy (CBT). If the condition persists, brain stimulation therapies such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) can be suggested. ECT and TMS are used if a patient is not responding to medication (Livingston et al., 2016). In ECT, an electrical current is used to impact the functioning of the brain and relieve depression while for TMS treatment coil is placed on the scalp to send magnetic pulses and stimulate nerves in the brain that controls mood and depression.

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