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This visit aimed to assess critical issues that may have arisen and any progress within the timeline from the previous visit till now. It would help to ascertain the level of medication efficacy and advancement of ailment manifestation. After evaluation, the patient showed considerable attentiveness and focused with good coordination and general signs of normalcy. The patient was even actively engaging and expressing their feelings and thinking. The last visit was prompted by a distress call over mounting anxiety described as “mini panic attacks”, suggesting increased stressors. Upon further scrutiny, we realized a considerable upsurge in life events might contribute considerably to the patient’s stress levels. These include her workplace issues with the boss, parenting issues for a single mother, and the gain and loss of relatives, a roller coaster of emotional variation. Realizing that her newfound sister experienced the same mental challenges as her was intriguing and emotive.

           For the record, the patient denied abusing any mind-altering substances, including recreational drugs and alcohol. She also revealed no past traumas or issues with nutrition and weight. Reportedly, her Trazadone medication effetely gets her to sleep but with side effects of lethargy that discourage regular use. The same apprehension is held for her PRN Ativan medication unless in severe cases of panic attacks. Standard procedure was followed in assessing life stressors and coping mechanisms, validating feelings and thoughts, and discussing medication use. For medication, she was open to trying PRN Trazadone in case of an upsurge in anxiety, with the bedtime dosage maintained at 6 hours as required. Additional medication alternatives discussed with the patient were toward assisting with lessening anxiety and mood adjustment for more positivity. For this outcome, it was agreed that the patient would get on a Neurontin trial basis with support from a Zoloft prescription to help smoothen the experience. Neurontin is expected to supplement Zoloft and its impact, with the outcome being optimized anxiety symptoms. 100g of Neurontin will be good for a start, with risk and benefits analyzed for potential side effects and impactful results.

           On the first upcoming visit, there was general contentment with the positivity in her life with a new housing situation convenient for work, keeping her in good spirits. There were fewer panic attacks, and she showed openness to medication adjustments to include   PRN Ativan D/C even when using Neurontin with PRN Trazadone maintained while the Neurontin gets to work. The patient was actively involved and voiced comprehension with affirmed treatment plan approval.




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