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This week, you will begin to learn about “antidepressants.” You will find these medications are often
prescribed for other conditions besides depression. You will begin to explore the most commonly
prescribed antidepressant medications, SSRIs and SNRIs. You will also begin to critically consider the
implications of prescribed medications for specific patients.
What’s Happening This Week?
This week, you will begin your exploration of antidepressants. Through your exploration, you will
construct a patient guide to connect the patient with the prescribed medication(s).
LEARNING OBJECTIVES
Students 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 older adult patients requiring antidepressant therapy
▪ Synthesize knowledge of providing care to pediatric, adult, and older adult patients presenting
for antidepressant therapy
▪ Analyze ethical, legal, and social determinates of health implications related to prescribing
antidepressant therapy to patients across the lifespan
Learning Resources and Readings

• Goldin, D. S. (2023). Fast facts for psychopharmacology for nurse practitioners. Springer
  Publishing.
  o Chapter 5, “Antidepressants” (pp. 66–82)
• Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical
  applications (5th ed.). Cambridge University Press.
  o Chapter 7, “Treatments for Mood Disorders: So-Called “Antidepressants” and “Mood
  Stabilizers” ” (pp. 284–353)
• American Psychological Association. (2019). Clinical practice guideline for the treatment of
  depression across three age cohortsLinks to an external site.
• Healthy People 2030. (n.d.). Social determinants of healthLinks to an external site.
• Drugs.comLinks to an external site.. (2023).
  Note: Please use the following resource to check the most up-to-date box warnings, FDA
  approvals and indications, recommendations for follow-up evaluations. changes, etc.
• Antidepressant Medication Table
  Note: Utilize this medication table to familiarize yourself with the medications aligned with the topics
  presented this week.
  Citalopram Escitalopram Paroxetine Fluoxetine Fluvoxamine Sertraline
  Vortioxetine Vilazodone Duloxetine Venlafaxine Levomilnacipran Desvenlafaxine
  Amoxapine Amitriptyline Desipramine Nortriptyline Doxepin Trimipramine
  Imipramine Protriptyline Mirtazapine Bupropion Selegiline Isocarboxazid
  Phenelzine Tranylcypromine
  Patient Guide
  Understanding that prescribing medication is not the same for all individuals is imperative to
  becoming a safe and effective psychiatric nurse practitioner. In clinical practice, you will see many
  patients in different stages of their lives and need to consider these in developing your prescribing
  treatment plan.
  For this Assignment, you will choose a vulnerable patient and develop a 2- to 3-page Medication
  Guide for them and their family. In your guide, you will consider their ages, birth-assigned sex, FDA
  approvals, and considerations for increased or decreased risk for side effects. You will choose the
  most appropriate medication for each of these individuals. Support your answers with evidence-based,
  peer-reviewed scholarly literature. APA style format title page, citations and references will apply.
  Note: You will not set up this Medication Guide as a paragraph-formatted paper but, instead, as a
  creative, visually appealing guide.
  To prepare for this Assignment:
• Select a vulnerable patient from the list provided.
• Consider age, birth-assigned sex, FDA approvals, and risk and side-effect consideration.
• Select the most appropriate medication for your selected patient based upon the information
  provided.
• Review the textbook for commonly prescribed antidepressants, Fast Facts for
  Psychopharmacology for Nurse Practitioners.
• Review the textbook Stahl’s essential psychopharmacology: Neuroscientific basis and
  practical applications (5th ed.). Chapters assigned
• Conduct research through the FDA websiteLinks to an external site..
• Review prescriber information for professionals of the medications.
  Note: These can be located free online with web search.
• Review national guidelines for prescribing for these vulnerable individuals:
  o Depression Treatments for AdultsLinks to an external site.
  o Depression Treatments for Older AdultsLinks to an external site.
  o Depression Treatments for Children and AdolescentsLinks to an external site.
  THE ASSIGNMENT
  Step 1: Choose one of the following vulnerable patients to create a Medication Guide for the patient:
• Patient 1: 26-year-old female with a diagnosis of major depressive disorder and social
  anxiety disorder who is increasing in isolation and poor self-care. She is in her third trimester
  of pregnancy.
• Patient 2: 16-year-old male with a diagnosis of major depressive disorder, severe. He has
  seen a therapist weekly for the past 6 months and has had minimal change in symptoms. He
  has expressed thoughts of wanting to die.
• Patient 3: 72-year-old male with diagnosis of major depressive disorder and panic disorder.
  He has cardiac history and takes antihypertensive medications.
• Patient 4: 8-year-old Asian female with a diagnosis of severe depressive disorder presents to
  the office with a report of worsening symptoms. She has never taken psychotropic medication
  before.
  Step 2: Create a Medication Guide for a patient. In your guide, you should provide the following
  specific instructions for the patient:
• Describe the chosen classification of medications, from the classification category, for your
  chosen vulnerable patient. Explain your rationale for your choice.
• Explain what dose you would start the chosen medication with and the frequency.
• Discuss how the medication works to treat their symptoms.
• Explain how long they should take the medication.
• Discuss the typical or common side effects of the medication.
• Explain the urgent or emergent considerations for the patient taking the medication.
  The Medication Guide should also include:
• Directions you would provide the patient on how to take the prescribed medication
• Instructions on what the patient should do if a medication dose is missed
• List of any other medications, over-the-counter medications, and/or supplements/herbals the
  patient should avoid while taking the prescribed medication
• List of foods the patient should avoid when taking this medication
• Date when the patient should return for follow-up visit with you
• Discussion about the legal and ethical considerations for the medication being prescribed
• Answers in consideration of Social Determinants of Health on how you would:
  o Assist the patient who cannot not afford to pay financially for the medication you are
  recommending/prescribing; and/or
  o Has difficulty with transportation that impacts their ability to present for regular
  appointments with you
• Discuss how financial hardship and lack of transportation could relate to Social Determinants
  of Health, as well as why they are important considerations for you as a prescriber

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