Mental Health Case Study

AL is a 27 year old female diagnosed with major depression 6 years ago.  She had difficulty concentrating, reduced motivation, and anxiety in social situations.  She was initially self -medicating with alcohol, and has seen several psychiatrists.  AL’s psychiatrist has prescribed her several antidepressants including Fluoxetine (Prozac) and Lurasidone, and Paroxetine (Paxil) which she was intermittently compliant with.  She is now taking Sertraline 100mg daily by mouth Aripiprazole (Abilify) 2mg by mouth daily.  She is worried about the side effects and here for follow up.

  1. What type of antipsychotic is Aripiprazole, and what labs should be monitored when taking this medication?
  2. Sertraline is an antidepressant.  How can we assess if the medication is working?  What are some of the adverse effects we need to warn the patient about? 
  3. What is a major benefit of Sertraline (Zoloft) over Venlafaxine (Effexor)?
  4. Would you change the patient to Valproate (Depakote) and why or why not?

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