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Can you help me respond to this discussion post using high level references from the last 5 years? The FNP is conducting a routine follow-up on a patient with depression. The patient reports she is feeling like she can’t go on anymore. The FNP learned that this patient discontinued her medication 3 weeks ago because she couldn’t afford it. What should the FNP do in this situation? The NP should assess if the patient wants to harm herself and if she has a plan to do so. If the patient wants to harm herself, then there is a mandate to report and the patient should be referred to the hospital for psychiatric evaluation and a hold to prevent self-harm. If the patient is not suicidal, then education and support is needed. The NP should assess why the patient stopped taking her medication and address the issue. Antidepressant medications take 4- 6 weeks to get full effect. Depending on how long the patient has been on the medication and what the diagnosis is, the patient may need to restart the medication, a medication change or added therapy. Several patients require treatment with at least two antidepressant medications. As many as half of all patients on antidepressant therapy may not have full results on two antidepressant medications. Providers should evaluate dose for full effectiveness, change medications or add nontraditional medications like ketamine (Saelens et al., 2024). The patient can be referred to a mental health therapist for psychotherapy. Some antidepressant medications can cause side effects like sexual dysfunction, emotional issues and other physical side effects that contribute to depression. Speaking with a mental health professional can help the patient work through problems contributing to the depression as well as identify side effects from medications and other lifestyle modifications that can help with overall mental health improvement (Chiesa, 2024). References Chiesa, M. (2024). Antidepressant medication and psychotherapy: Why it matters. British Journal of Psychotherapy, 41(1), 65-87. Retrieved June 8, 2025, from https://doi.org/10.1111/bjp.12938 Saelens, J., Gramser, A., Watzal, V., Zarate, C. A., Lanzenberger, R., & Kraus, C. (2024). Relative effectiveness of antidepressant treatments in treatment-resistant depression: A systematic review and network meta-analysis of randomized controlled trials. Neuropsychopharmacology, 50(6), 913-919. Retrieved June 8, 2025, from https://doi.org/10.1038/s41386-024-02044-

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