Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Introduction:

This case study is about a 33-year-old Puerto Rican woman who has been experiencing depression, anxiety, and cocaine addiction for the past 10 years. The patient reports that her addiction began after she started using cocaine recreationally with friends. She has a history of physical and sexual abuse, and she has not been taking any medications for her mental health concerns. In this assignment, I will assess and treat this patient by making three decisions concerning medication prescribing.

Factors that may impact my decision-making when prescribing medication for this patient include the patient’s comorbid addiction and mental health concerns, as well as her age, gender, ethnicity, and history of abuse. I will also need to consider the patient’s pharmacokinetic and pharmacodynamic processes, including her liver and kidney function, possible drug interactions, and the potential side effects of the medication.

Decision #1:

I selected the decision to prescribe fluoxetine 20mg/day for this patient. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) that is commonly used to treat depression, anxiety, and other mental health concerns. This medication has been shown to be effective in treating addiction as well. Studies have demonstrated that fluoxetine reduces cocaine use and craving and can improve treatment outcomes for individuals with cocaine dependence (Shoptaw et al., 2002).

I did not select the other two options provided in the exercise because bupropion is contraindicated in individuals with a history of seizures, and naltrexone is not indicated for the treatment of depression or anxiety. While both of these medications may be useful in treating addiction, they are not appropriate for this patient’s comorbid mental health concerns.

My goal in prescribing fluoxetine is to reduce the patient’s symptoms of depression and anxiety, which may contribute to her addiction. Fluoxetine may also help to reduce the patient’s cravings for cocaine and improve her treatment outcomes.

Ethical considerations may impact my treatment plan and communication with patients. For example, I will need to ensure that the patient understands the potential risks and benefits of the medication and that she provides informed consent. I will also need to respect the patient’s autonomy and right to make decisions about her treatment.

Decision #2:

I selected the decision to prescribe disulfiram 250mg/day for this patient. Disulfiram is an aversive agent that is used to treat alcohol addiction by causing unpleasant physical effects when alcohol is consumed. While disulfiram is not indicated for the treatment of cocaine addiction, it may be useful in reducing the patient’s overall substance use and promoting abstinence.

I did not select the other two options provided in the exercise because they are not appropriate for this patient’s comorbid addiction and mental health concerns. While clonidine may be useful in treating withdrawal symptoms in individuals with opioid addiction, it is not indicated for the treatment of cocaine addiction. Similarly, acamprosate is indicated for the treatment of alcohol addiction and may not be effective in treating the patient’s cocaine addiction.

My goal in prescribing disulfiram is to reduce the patient’s overall substance use and promote abstinence. By using an aversive agent, the patient may be more motivated to abstain from substance use and may be less likely to relapse.

Ethical considerations may impact my treatment plan and communication with patients. For example, I will need to ensure that the patient understands the potential risks and benefits of disulfiram and that she provides informed consent. I will also need to respect the patient’s autonomy and right to make decisions about her treatment.

Decision #3:

I selected the decision to refer the patient to a substance abuse treatment program. While medication can be useful in treating addiction, it is often most effective when used in conjunction with behavioral interventions, such as counseling and support groups. Substance abuse treatment