Posted: September 4th, 2023

Week 5: Anxiolytic Therapy & PTSD Treatment

Week 5: Anxiolytic Therapy & PTSD Treatment

“I’m no longer at the mercy of my PTSD, and I would not be here today had I not had the proper diagnosis and treatment. It’s never too late to seek help.”

—P.K. Philips, PTSD patient

For individuals suffering from posttraumatic stress disorder (PTSD) and other anxiety disorders, everyday life can be a constant challenge. Clients requiring anxiolytic therapy may present with anxiousness, depression, substance abuse issues, and even physical symptoms related to cardiovascular, respiratory, and gastrointestinal ailments. As a psychiatric mental health nurse practitioner, you must be prepared to address the many needs of individuals seeking treatment for PTSD and other anxiety disorders.

This week, as you study anxiolytic therapies and PTSD treatments, you examine the assessment and treatment of clients with PTSD and other anxiety disorders. You also explore ethical and legal implications of these therapies.
Assignment: Assessing and Treating Clients With Anxiety Disorders

Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt clients to seek care from their primary care providers or emergency departments. Once it is determined that there is no organic basis for these symptoms, clients are typically referred to a psychiatric mental health practitioner for anxiolytic therapy. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with anxiety disorders.
Learning Objectives
Students will:

Assess client factors and history to develop personalized plans of anxiolytic therapy for clients
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring anxiolytic therapy
Evaluate efficacy of treatment plans
Analyze ethical and legal implications related to prescribing anxiolytic therapy to clients across the lifespan

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Note: All Stahl resources can be accessed through this link provided.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

Chapter 9, “Anxiety Disorder and Anxiolytics”

Stahl, S. M., & Grady, M. (2010). Stahl’s illustrated anxiety, stress, and PTSD. New York, NY: Cambridge University Press.

To access the following chapters, click on the Illustrated Guides tab and then the Anxiety, Stress, and PTSD tab.

Chapter 4, “First-Line Medications for PTSD”
Chapter 5, “Second-Line, Adjunct, and Investigational Medications for PTSD”

Strawn, J. R., Wehry, A. M., DelBello, M. P., Rynn, M. A., & Strakowski, S. (2012). Establishing the neurobiologic basis of treatment in children and adolescents with generalized anxiety disorder. Depression and Anxiety, 29(4), 328-339. doi:10.1002/da.21913

Hamilton, M. (1959). Hamilton Anxiety Rating Scale. PsycTESTS, doi:10.1037/t02824-0

Required Media

Laureate Education. (2016b). Case study: A middle-aged Caucasian man with anxiety [Interactive media file]. Baltimore, MD: Author.

Note: This case study will serve as the foundation for this week’s Assignment.

Optional Resources

Lupi, M., Martinotti, G., Acciavatti, T., Pettorruso, M., Brunetti, M., Santacroce, R., & … Di Giannantonio, M. (2014). Pharmacological treatments in gambling disorder: A qualitative review. Biomed Research International, 2014. doi:10.1155/2014/537306

To prepare for this Assignment:

Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.

The Assignment

Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients.

______________________-:

Decision #1

I selected the decision to prescribe sertraline (Zoloft). This is a selective serotonin reuptake inhibitor (SSRI), which is a first-line medication for the treatment of anxiety disorders. SSRIs work by increasing the levels of serotonin in the brain, which is a neurotransmitter that plays a role in mood, anxiety, and sleep.

I selected this decision for several reasons. First, sertraline is a well-studied and effective medication for anxiety disorders. It has been shown to be effective in reducing symptoms of anxiety, such as worry, nervousness, and restlessness. Second, sertraline has a good safety profile. It is generally well-tolerated and has few side effects. Third, sertraline is a relatively inexpensive medication.

I was hoping to achieve several things by making this decision. First, I wanted to reduce the client’s symptoms of anxiety. Second, I wanted to improve the client’s quality of life. Third, I wanted to prevent the client from developing other mental health problems, such as depression or substance abuse.

The results of this decision were positive. The client’s symptoms of anxiety decreased significantly after starting sertraline. The client also reported an improvement in their quality of life. The client was able to return to work and spend more time with their family and friends.

Decision #2

I decided to increase the dosage of sertraline from 50 mg to 100 mg. This was because the client was still experiencing symptoms of anxiety after taking 50 mg of sertraline for six weeks. I wanted to increase the dosage to see if it would help to reduce the client’s symptoms further.

I made this decision because I was concerned about the client’s symptoms of anxiety. The client was still reporting significant levels of worry, nervousness, and restlessness. I was also concerned about the potential for the client to develop other mental health problems, such as depression or substance abuse.

The results of this decision were positive. The client’s symptoms of anxiety decreased significantly after increasing the dosage of sertraline to 100 mg. The client reported that they were feeling much better and that they were able to function better in their daily life.

Decision #3

I decided to add cognitive behavioral therapy (CBT) to the client’s treatment plan. CBT is a type of psychotherapy that can be effective in the treatment of anxiety disorders. CBT helps clients to identify and change the negative thinking patterns that contribute to their anxiety.

I made this decision because I wanted to provide the client with the best possible treatment for their anxiety disorder. CBT is a well-researched and effective treatment for anxiety disorders. It has been shown to be effective in reducing symptoms of anxiety, such as worry, nervousness, and restlessness. CBT can also help clients to improve their coping skills and to manage their anxiety in a more healthy way.

The results of this decision were positive. The client reported that they were benefiting from CBT. They were able to identify and change some of the negative thinking patterns that were contributing to their anxiety. The client also reported that they were learning new coping skills that were helping them to manage their anxiety.

Ethical considerations

There are a number of ethical considerations that I took into account when making these decisions. First, I was mindful of the client’s right to informed consent. I explained the risks and benefits of all of the treatment options to the client and I obtained their informed consent before making any decisions.

Second, I was mindful of the client’s right to privacy. I kept all of the client’s information confidential and I only shared it with other healthcare professionals who were directly involved in the client’s care.

Third, I was mindful of the client’s best interests. I made these decisions based on what I believed was in the best interests of the client. I considered the client’s symptoms, their medical history, and their treatment goals.

I believe that I made the best decisions possible for this client. I was able to reduce the client’s symptoms of anxiety, improve the client’s quality of life, and prevent the client from developing other mental health problems. I also believe that I was able to uphold the client’s rights to informed consent, privacy, and best interests.

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