Assignment: MAOIs and Ethnicities

Want create site? With you can do it easy.

Assignment: MAOIs and Ethnicities

Assignment: MAOIs and Ethnicities

Don't use plagiarized sources. Get Your Custom Essay on
Assignment: MAOIs and Ethnicities
Just from $13/Page
Order Essay

With many MAOIs, hypertensive crisis is a major concern for nay race. Since minorities are diagnosed with hypertension at higher rates, this causes a greater concern. This is the reason for a tyramine restricted diet.  Foods such as aged chees, yeast and tap beer should be avoided ()

Changes in Therapy

After review of further data with this patient, changes would not be made to the suggested treatment.

Lessons Learned

Throughout this case study many lessons were present.  The lesson of medication compliance was the first lesson learned. Another lesson learned was the lesson of proper medication selection in a patient, especially after a recurrent episode of depression.  Assessment and presentation of psychiatric treatment for patients was another lesson learned from this case study.


In conclusion, this case study involved a 63-year-old male with recurrent depression. The patient has had success and failures with medication and treatment. These failures may be due to medication compliance or improper cessation of medications from a physician. After two years, the patient is finally on the right track. Hopefully, this will continue.


Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins. (2018).  Isocarboxazid. Retrieved from http:/ ttps://

Serra, F., Spoto, A., Ghisi, M., & Vidotto, G. (2015). Formal Psychological Assessment in Evaluating Depression: A New Methodology to Build Exhaustive and Irredundant Adaptive Questionnaires. PLoS ONE, 10(4), e0122131.

Smith, K. M., Renshaw, P. F., & Bilello, J. (2013). The diagnosis of depression: current and emerging methods. Comprehensive Psychiatry, 54(1), 1–6.

Stahl, S. M. (2008). Essential Psychopharmacology Online. Retrieved September 11, 2018 from

Zaninotto, L., Solmi, M., Veronese, N., Guglielmo, R., Ioime, L., Camardese, G., & Serretti, A. (2016). A meta-analysis of cognitive performance in melancholic versus non-melancholic unipolar depression. Journal of affective disorders, 201, 15-24.


Three questions that I might ask our patient are:

Tell me when you take your medication? [The reason for this question is to establish his adherence to his medication. Tachyphylaxis aka poop out, may occur due to medication nonadherence. It is therefore important to assess if the client is experiencing tachyphylaxis related to medication nonadherence] (Targum, 2014).
Do you feel a lack of motivation about life? [The Rothschild Scale for Antidepressant Tachyphylaxis suggests a conceptualization of antidepressant tachyphylaxis that is characterized by symptoms of apathy.] (Targum, 2014).
Are you experiencing patterns of sleep disturbance? [This is also a symptom of poop out. It is important to assess these symptoms in order to proceed with his plan of care. Another important question is to assess the client for is substance abuse which was already addressed within the case study.)
According to our case study, our client is a 69-year-old retired male who is married with children and grandchildren. In my opinion, it would be most important to speak to those that are the closest to him (his wife) who can observe him for any signs of activation of bipolar disorder such as: lack of impulse control, irritable and agitated mood lasting longer than a week (Bail, Dains, Flynn, Solomon, & Stewart, 2015). Activation of bipolar disorder would require his antidepressant to be discontinued and switched to a mood stabilizer (Stahl, 2013).

Physical exams and diagnostic tests relevant to our client’s care would be testing his blood pressure before/during initiating treatment and testing for plasma levels of O-desmethylvenlafaxine (ODV) which is an active metabolite of venlafaxine formed as a result of CYP450 2D6 (Stahl, 2013). Plasma levels of ODV will determine if the provider may safely increase his dose based on results. It is imperative to assess our client’s blood pressure related to the effects of the norepinephrine in the SNRI. Based on the check points for his first follow up, I would have changed his phone follow up to a face to face follow up to assess our client better and would have ordered his plasma ODV sooner to properly assess the effectiveness of his medication therapy.

According to the American Psychiatric Association (2013), three differential diagnoses that I am giving our client are: 1. mood disorder due to another medical condition 2. Sadness 3. Adjustment disorder with depressed mood. The one that I think is more likely is sadness. My thought is sadness because our client’s history from the case study reveals a long, waxing and waning major depressive episode where he feels like he is out of options (Stahl, 2013).

Assignment: MAOIs and Ethnicities

Assignment: MAOIs and Ethnicities

Two pharmacologic agents that would be appropriate for our client’s therapy would be Mirtazapine 15 mg PO nightly or Bupropion 75 mg PO BID. Bupropion is an NDRI which is a good augmenting combination with Venlafaxine. It is a powerful enhancer of noradrenergic action. Mirtazapine is a dual serotonin and norepinephrine combination which also works well with Venlafaxine but it may further increase his high cholesterol; for this reason, I would choose the Bupropion.

Lessons that I learned from this case study are certain drugs may not be as effective due to noncompliance, pharmacokinetic failures or even genetic variants. I have also learned the seriousness of how severe depression can be and the importance of knowing not necessarily all of the drugs out on the market for depression but more so the pharmacokinetics and pharmacodynamics of how they work.



Targum, S. D. (2014). Identification and treatment of antidepressant tachyphylaxis. Innovations in Clinical Neuroscience, 11(24), 3-4. Retrieved from

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to     physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

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

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Retrieved from Walden Library databases.

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

Did you find apk for android? You can find new and apps.


Calculate The Price Of Your Paper

{{total || ""}}

Why Choose Us

Top Quality and Well-Researched Papers

We always make sure that writers follow all your instructions precisely. You can choose your academic level: high school, college/university or professional, and we will assign a writer who has a respective degree.

Professional and Experienced Academic Writers

We have a team of professional writers with experience in academic and business writing. Many are native speakers and able to perform any task for which you need help.

Free Unlimited Revisions

If you think we missed something, send your order for a free revision. You have 10 days to submit the order for review after you have received the final document. You can do this yourself after logging into your personal account or by contacting our support.

Prompt Delivery and 100% Money-Back-Guarantee

All papers are always delivered on time. In case we need more time to master your paper, we may contact you regarding the deadline extension. In case you cannot provide us with more time, a 100% refund is guaranteed.

Original & Confidential

We use several writing tools checks to ensure that all documents you receive are free from plagiarism. Our editors carefully review all quotations in the text. We also promise maximum confidentiality in all of our services.

Customer Support 24/7

Our support agents are available 24 hours a day 7 days a week and committed to providing you with the best customer experience. Get in touch whenever you need any assistance.

Our FREE services
Every order comes with these awesome features.
Order Now
Money Back Guarantee
FREE Best essay writer across your subject
FREE Cover page and bibliography
FREE APA/MLA/Chicago formatting
FREE Free Revisions
FREE 24/7 customer support hotline and chat


Essay Writing Services

No matter what kind of academic paper you need and how urgent you need it, you are welcome to choose your academic level and the type of your paper at an affordable price. We take care of all your paper needs and give a 24/7 customer care support system.


Admission and Business Papers

An admission essay is an essay or other written statement by a candidate, often a potential student enrolling in a college, university, or graduate school. You can be rest assurred that through our service we will write the best admission essay for you.


Editing and Proofreading

Our academic writers and editors make the necessary changes to your paper so that it is polished. We also format your document by correctly quoting the sources and creating reference lists in the formats APA, Harvard, MLA, Chicago / Turabian.


Revision Support

If you think your paper could be improved, you can request a review. In this case, your paper will be checked by the writer or assigned to an editor. You can use this option as many times as you see fit. This is free because we want you to be completely satisfied with the service offered.