Management | Health Spectrum Jess

When a patient is experiencing an inadequate response to their treatment plan, clinicians can draw on a range of MDD management strategies.
Given the many potential treatment pathways, consulting an evidence-based algorithm for managing an inadequate response is helpful.
Pharmacologic approaches to the treatment of residual symptoms following an adequate trial of an antidepressant include increasing the dose, switching to an agent of another class, or augmentation (ie, adding a medication to the current treatment regimen).
When determining whether to switch or add an adjunctive medication, it is helpful to consider several key factors, including patient preference, how many antidepressants have already been trialed, and how well the current medication is working and being tolerated.
In Jonathan’s case, the patient has expressed a preference for continuing with the agents he has been prescribed, as he has seen some benefit. Thus, the most appropriate next steps might include increasing the dose of his current medications or augmenting with a third medication.
The addition of non-pharmacologic interventions (eg, talk therapy, exercise, diet, meditation) is another important option for Jonathan, and one he was open to.

When a patient is experiencing an inadequate response to their treatment plan, clinicians can draw on a range of MDD management strategies.
Given the many potential treatment pathways, consulting an evidence-based algorithm for managing an inadequate response is helpful.
Pharmacologic approaches to the treatment of residual symptoms following an adequate trial of an antidepressant include increasing the dose, switching to an agent of another class, or augmentation (ie, adding a medication to the current treatment regimen).
When determining whether to switch or add an adjunctive medication, it is helpful to consider several key factors, including patient preference, how many antidepressants have already been trialed, and how well the current medication is working and being tolerated.
In Jonathan’s case, the patient has expressed a preference for continuing with the agents he has been prescribed, as he has seen some benefit. Thus, the most appropriate next steps might include increasing the dose of his current medications or augmenting with a third medication.
The addition of non-pharmacologic interventions (eg, talk therapy, exercise, diet, meditation) is another important option for Jonathan, and one he was open to.

The goal of HAE management is to help patients achieve total control of the disease and to live a normal life (5,6).
Evaluating Jessica’s perceived burden of disease and QoL is essential for assessing and modifying her comprehensive management plan.
QoL can be evaluated using tools developed for patients with HAE (4).
All patients should have immediate access to an on-demand therapy for acute attacks (5,6).
Health care providers should offer recommendations about dosing on-demand medication and when to seek medical attention for symptoms, especially airway involvement that does not respond to standard doses of HAE medications (5).
Short-term prophylaxis should be considered for Jessica before exposure to potential triggers such as medical, surgical, or dental procedures (6).
The appropriateness of long-term prophylaxis should be evaluated at every visit, at least once a year (6).
Shared decision-making should be used to develop an individualized management plan for all patients (4-6).