Discussion Part Three
You decide to begin the patient on bupropion.
At what dose should she be started on bupropion, and how does bupropion differ from other
commonly prescribed antidepressants, such as fluoxetine,
...
Discussion Part Three
You decide to begin the patient on bupropion.
At what dose should she be started on bupropion, and how does bupropion differ from other
commonly prescribed antidepressants, such as fluoxetine, venlafaxine, and nortriptyline?
Why would this be the best option for this patient given her symptoms and lifestyle? In your
answer, be sure to compare and contrast bupropion with each medication mentioned above
(fluoxetine, venlafaxine, and nortriptyline).
Subjective
39 year old female with adhedonia and depressed mood the past several months
Objective
Pertinent positives –
Barbara is a married female, smokes 1 pack/day, experiencing fatigue, feelings of
worthlessness, appetite disturbances, weight gain, lack of concentration, insomnia, and
psychomotor disturbances.
Weight 180lbs (overweight, possibly obese) height needed
Anhedonia – lack of interest or pleasure in normal activities
Pertinent negatives – no children, has not needed therapy for 20 years
Pertinent + in RED
Pertinent – in BLUE
Assessment
Major Depression Disorder
Current Plan
Bupropion 100 mg PO BID for 3 days, may increase to 100 mg PO TID; MAX dose is 450 mg/day given as
150 mg PO TID OR 100 mg PO 4 times daily; separate all doses by at least 6 hours; MAX single dose is
150 mg (DynaMed Plus, 2016).
Mechanism of Action - this aminoketone class antidepressant blocks neuronal uptake of dopamine. This
medication has no effect on monoamine oxidase or serotonin uptake. Smoking cessation properties are
believed to be associated with dopaminergic action of bupropion (DynaMed Plus, 2016).
Clinical Use - depression, seasonal affective disorders, major depression, and smoking cessation
assistance (initial treatment while still smoking).
Efficacy - improvement in signs
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