History of generalized anxiety disorder and congestive heart

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The PMHNP is seeing a 59 y/o Caucasian female with a history of generalized anxiety disorder, congestive heart failure and recently was hospitalized for pulmonary embolism 6 months ago. She has been taking Xarelto daily since discharge and recovering without physical complaints. The patient was referred to PMHNP from primary care provider, who initiated Zoloft 75 mg daily. The patient reports that she has experienced partial remission of anxiety on current dose of Zoloft since initiating the medication one month ago. However, she is experiencing an increase in bruising bilaterally on forearms. The next best action of the PMHNP is a. Taper and discontinue Zoloft, exploring alternative antidepressant medication b. Increase dose of Zoloft due to partial response of anxiety without side effects c. Initiate adjunct, temporary 0.5mg once daily as needed of Ativan for approximately 2 weeks d. Decrease Zoloft to 50 mg due to potential for side effects secondary to polypharmacy.

Reference no: EM133712445

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