Psychopharmacology case study

Case Study 3 Brady is an 11yo boy who was recently discharged after being in the hospital on an inpatient psychiatric unit for 3 weeks. He was admitted for suicidal ideation and suicidal gesture of tying a rope around the rafter in his house and standing on a chair with the noose around his neck when his mother found him. She called 911 and he was taken to the hospital. He remained at the hospital for an extended period of time as he continued to tell the treatment team there that he had active thoughts of wanting to die and had no intention of being safe when he got home. He pleaded with them to just “let me go home and die.” He lives at home with his parents and twin brother. Brady has been diagnosed with Major Depression, Generalized Anxiety, ADD, and is also on the Autism Spectrum. This most recent hospitalization was the 3rd in the past 2 years, though this was the longest. This is the first time that he has been so vocal about his depression. Today, Brady says that he still feels hopeless, worthless, wants to die, and that he has constant intrusive thoughts of harming himself. He tells you that he doesn’t have a plan and is able to create a safety plan, but it is hard to engage him in doing this activity. He is scheduled to see his prescriber in the coming weeks. At the current time he is taking: Luvox 50mg at bedtime Wellbutrin XL 150mg in the morning Vyvanse 30mg in the morning Melatonin 5mg at bedtime He was previously taking Prozac, but that was discontinued in the hospital. Brady’s mother is fearful of him harming himself and she is staying home with him as she is on leave from work. While this is helpful for safety and monitoring, it does increase some of the financial stress that the family is feeling right now. Brady’s father is not as supportive and doesn’t seem to understand or believe that there is any mental health issue with Brady and feels that his wife is “just babying and making excuses for him.” In reviewing the record and assessments from the hospital, you learn that Brady’s father is suspected of being on the Autism Spectrum. He was not really involved in Brady’s care at the hospital and doesn’t seem to be very involved in his care on an outpatient basis from what you can see in the notes. Areas to be addressed: 1) What is your clinical impression of Brady? 2) How would you go about supporting Brady while also working with his parents? 3) Why do you think the Prozac was discontinued in the hospital? 4) Why is he taking both Wellbutrin and Vyvanse? 5) What information would like to get from the prescriber? From the family? 6) How would you work with Brady’s father and develop a rapport with him? All papers are expected to be in APA format including a title page, running head and reference page. You must use a minimum of 3 reputable sources and papers should be at least 4 pages long. The title page does not count as one of the pages.

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