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While Mr. Bender did demonstrate some symptoms of depression
following his appendectomy and also following the birth of his
son, you are not certain if he met the criteria for MDD during
those times. However, you recall that at one point his physician
felt he required medication for his insomnia. You discuss the
options of maintaining Mr. Bender on his SSRI versus
discontinuing the SSRI with close follow-up. You ask Mr. Bender
to retake the Zung Questionairre to objectively measure his
depression, and he scores in the normal (i.e., “no depression)
range. He opts to taper and discontinue the SSRI, and agrees to
see his counselor twice a month. You review the *SIG E CAPS symptoms of depression with Mr. and Mrs. Bender, and instruct them to follow-up with you if either of them notices a return of any *SIG E CAPS symptoms. Both Mr. and Mrs. Bender are pleased with the plan at this point. As they leave the exam room, you remind Mr. Bender to call your office if he has any questions, and wish him good luck at his upcoming basketball game. For more information on depression: National Foundation for Depressive Illness, Inc. National Depressive and Manic-Depressive Association National Mental Health Association |
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Sources:
Alternate-Site Anesthesia: Clinical Practice Outside the Operating Room. Garfield B. Russell, M.D., editor. Chapter 13, Donald E. Martin and Paul Kettl. Butterworth-Heinemann. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR). American Psychiatric Association, 2000. Diagnosis and Management of Mood Disorders. American Academy of Family Physicians Monograph. 2004. Essential Psychopharmacology, Neuroscientific Basis and Practical Applications. Stephen M. Stahl, MD, PhD. Cambridge University Press, 2000. Handbook of Psychiatric Drug Therapy. Third Edition. Steven E. Hyman, George W. Arana, Jerrold F. Rosenbaum. Little, Brown and Company, 1995. Interview Guide for Evaluating DSM-IV Psychiatric Disorders and the Mental Status Examination. Mark Zimmerman, M.D. Psych Products Press, 1994. Kaplan and Sadock's Synopsis of Psychiatry. Eighth Edition. Harold I. Kaplan, M.D. and Benjamin J. Sadock, M.D. Williams and Wilkins, 1998. Massachusetts General Hospital Handbook of General Hospital Psychiatry. Fourth Edition. Ned H. Cassem, Theodore A. Stern, Jerrold F. Rosenbaum, Michael S. Jellinek. Mosby, 1997. Physician’s Desk Reference. Fiftieighth Edition. Thomson PDR. 2004. Psychopharmacology of Antidepressants. Stephen M. Stahl, MD, PhD. Martin Duntz, Ltd. 1998 Treating Depression in Primary Care, A Special Report. Postgraduate Medicine. McGraw-Hill Companies, Inc. 2003. Authors: Case composed: October 2000 Case Composer:
Reviser/ Editor:
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