Margo is a 49-year-old divorced woman who works as a bank teller. She tells her primary care provider (PCP) that she feels tired all the time and that she is gaining weight because she has no interest in her usual exercise activities, and that she has been overeating, even though she is often not really hungry. She notices that she has difficulty falling asleep at night and awakens around 4 a.m. most mornings, without her alarm, and cannot go back to sleep even though she still feels tired. She finds little joy in her life but cannot pinpoint any particular concern or event causing this problem. The PCP asks Angela to fill out a Beck’s Depression Scale, which indicates she has moderate depression.
Choose a pharmacologic intervention for Margo.
Provide Margo with written education regarding her prescriiption. (Include what she should expect when first taking the drug, appropriate activity warnings, when to expect improvement, side effects she may experience, and anything she should report to the provider).
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Pharmacologic Intervention: Sertraline (Zoloft) 50 mg once daily
Rationale:
Sertraline is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for moderate depression. It helps balance serotonin levels in the brain, improving mood, energy levels, and sleep patterns.
Patient Education for Sertraline (Zoloft)
Dear Margo,
Your provider has prescribed Sertraline (Zoloft) 50 mg once daily to help manage your symptoms of depression. Below is important information to help you understand what to expect while taking this medication.
1. What to Expect When Starting Sertraline
- It may take 2 to 4 weeks to start feeling improvements in mood and energy.
- Full benefits may take up to 6 to 8 weeks of consistent use.
- You may experience mild side effects initially, which often improve within a few days to weeks.
2. How to Take Your Medication
- Take one tablet (50 mg) once daily, preferably in the morning or evening.
- You can take it with or without food, but taking it with food may help reduce nausea.
- Take it at the same time each day to maintain stable levels in your body.
3. Possible Side Effects
Some side effects may occur but often go away with time. These include:
Nausea or upset stomach
Dizziness or lightheadedness
Dry mouth
Sleep disturbances (either drowsiness or difficulty sleeping)
Mild headache
Increased sweating
If these symptoms persist or become bothersome, contact your provider.
4. Activity Warnings
Avoid alcohol while taking Sertraline, as it may increase drowsiness and impair judgment.
Use caution when driving or operating machinery until you know how the medication affects you.
If you feel dizzy when standing up, rise slowly from a sitting or lying position.
5. When to Expect Improvement
- First few weeks: Possible mild improvement in sleep and appetite.
- 2-4 weeks: Gradual improvement in energy and interest in daily activities.
- 4-8 weeks: Full effects on mood and overall well-being.
6. When to Contact Your Provider
Call your provider if you experience:
- Worsening depression or anxiety
- Thoughts of self-harm or suicidal thoughts (Seek immediate help)
- Severe nausea, vomiting, or diarrhea
- Unusual bleeding or bruising
- Increased restlessness or agitation
- Signs of serotonin syndrome (fast heartbeat, fever, confusion, muscle stiffness)
7. Do Not Stop Abruptly
- Do not stop taking Sertraline suddenly, as it may cause withdrawal symptoms (dizziness, irritability, flu-like symptoms).
- If you wish to stop, consult your provider for a gradual tapering plan.
If you have any questions or concerns, please reach out to your provider. We are here to support you!
Wishing you good health,
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