The 48-year-old Caucasian male patient was prescribed Depakote 750mg BID and Xanax 0.5mg PRN for post-traumatic stress disorder (PTSD) and mood issues respectively. The notable alternative medication for Depakote is Sertraline (Zoloft), a selective serotonin reuptake inhibitor (SSRI) with a recommended dosage of 50-200 mg/day CITATION Ann12 \l 1033 (Schwartz & Rothbaum, 2012). Sertraline provides benefits such as boosting the level of serotonin neurotransmitter which, in conjunction with its proven efficacy makes it a preferable alternative for PTSD, OCD, mood disorders and panic attacks CITATION Ann12 \l 1033 (Schwartz & Rothbaum, 2012). In Reismans (2016) research to ascertain first-line medications for PTSD among military veterans, researchers identified Sertraline as a medication with lowered lethality risks in case of an overdose and enhance tolerability. Such attributes make it a good alternative for the 48-year-old patient. Alexander (2012) confirms Sertraline's efficacy citing that the drugs relatively reduced impact on cytochrome enzyme (P450) system and favourable tolerability makes it be a preferable first-line PTSD medication. American Psychiatric Association (2013) in its DSM-5 manual advocates for the use of selective serotonin reuptake inhibitor (SSRI) such as Sertraline because of their efficiency in treating psychiatric disorders associated with PTSD like obsessive-compulsive disorder, social phobia, panic disorder and depression.
The sole purpose of Xanax 0.5mg PRN was to address anger and mood issues. The best alternative for the medication is Klonopin (Clonazepam), a benzodiazepine for treating anxiety, mood and anger disorders. The dosage for Klonopin is 0.25-1 mg PO q12hr CITATION Iva16 \l 1033 (Kacirova, Grundmann, Silhan, & Brozmanova, 2016). Other than the efficacy of the drug, the choice of Clonazepam as an alternative for Xanax follows Its superior safety profile compared to other benzodiazepines. Wang et al. (2016) confirm that side effects and withdrawal symptoms after taking Clonazepam compared to other benzodiazepines such as lorazepam and alprazolam. Through the combination of Sertraline and Clonazepam, there is augmented likelihood of ameliorating the three common cluster symptoms of anxiety and mood disorders namely hyperarousal, avoidance and re-experiencing.
BIBLIOGRAPHY Alexander, W. (2012). Pharmacotherapy for Post-traumatic Stress Disorder In Combat Veterans. Journal of Managed Care and Hospital Formulary Management, 37(1): 3238.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, ed. 5 (DSM-5:304.1 (F13.1). Arlington, VA: APA Press.
Kacirova, I., Grundmann, M., Silhan, P., & Brozmanova, H. (2016). A Case Report of Clonazepam Dependence. Medicine, 95(9): e2881. DOI: 10.1097/MD.0000000000002881.
Reisman, M. (2016). PTSD Treatment for Veterans: Whats Working, Whats New, and Whats Next. Journal of Managed Care and Hospital Formulary Management, 41(10): 623-634.
Schwartz, A., & Rothbaum, B. (2012). Review of sertraline in post-traumatic stress disorder. Expert Opinion on Pharmacotherapy, 5(2): 1489-1499.
Wang, S.-M., Kim, J.-B., Sakong, J. K., Suh, H.-S., Oh, K. S., Woo, J.-M., . . . Lee, S.-Y. (2016). The Efficacy and Safety of Clonazepam in Patients with Anxiety Disorder Taking Newer Antidepressants: A Multicenter Naturalistic Study. Clin Psychopharmacology and Neuroscience, 14(2): 177183. DOI: 10.9758/cpn.2016.14.2.177.
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