Assignment: Assessing and Treating Pediatric Patients With Mood Disorders

12/12/21, 6:50 PM Psychopharmacologic Approaches to Treatment of Psychopathology

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Therapy for Pediatric Clients with Mood Disorders An African American Child Su�ering From Depression

Decision Point One

Begin Zoloft 25 mg orally daily

12/12/21, 6:50 PM Psychopharmacologic Approaches to Treatment of Psychopathology

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RESULTS OF DECISION POINT ONE � Client returns to clinic in four weeks

� Slight increase in mood

� No HAM-D results

� No adverse events reported

Decision Point Two

Increase dose to 50 mg orally daily

RESULTS OF DECISION POINT TWO � Client returns to clinic in four weeks

� Depressive symptoms decrease by 50%. Client tolerating well

Decision Point Three

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Maintain current dose

Guidance to Student

At this point, su�cient symptom reduction has been achieved. It is considered a full response to

therapy when symptoms are reduced by 50% or more on the HAM-D. Do not confuse this with full

symptom resolution which would be a 100% reduction in symptoms as measured on the HAM-D. It

would be in the best interest of the patient to continue with the current dose of medication and re-

assess in 4 weeks. Remember, any change in dose resets the "clock" for a full assessment of

therapy e�cacy. Waiting an additional 4 weeks (8 weeks total from dose change) would allow

additional bene�t to be recognized. An increase in dose would not be warranted at this point in

time as it would lead to an increased potential for adverse events. This could fracture the

therapeutic alliance created with your patient and lead to loss to follow-up, loss of symptom

control, and other negative consequences to the patient. There is no indication that the drug

therapy should be changed to an SNRI at this point as the client is clearly responding to this

therapy.

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