24 Feb Nia Omari, a 35-year-old female client (DOB: 7/7/1989), presents to the clinic complaining of reduced libido, weight gain, and insomnia for the past three months after starting sertraline (Zoloft) six months ago. While her anxiety has decreased, the side effects are unpleasant, and Nia wonders if other medications might be equally effective with fewer side effects. The provider’s physical exam is unremarkable.

Nia Omari Image Description
Nia Omari, a 35-year-old female client (DOB: 7/7/1989), presents to the clinic complaining of reduced libido, weight gain, and insomnia for the past three months after starting sertraline (Zoloft) six months ago. While her anxiety has decreased, the side effects are unpleasant, and Nia wonders if other medications might be equally effective with fewer side effects. The provider’s physical exam is unremarkable. The provider considers what medications may be appropriate. 
Past Medical History: Generalized Anxiety Disorder (GAD) 
Allergies: Penicillin
Medications: sertraline (Zoloft) 50 mg PO once daily 
Social History: She has never smoked cigarettes and does not drink alcohol. 
Physical Exam:
• Height: 5 feet 4 inches
• Weight: 134 lbs
• Body Mass Index (BMI): 23
• Blood Pressure (BP): 118/78
• Heart Rate (HR): 88 
• Respiratory Rate (RR): 16
• Oxygen Saturation (O2 Sat): 100% on RA
• Temperature (TEMP): 98.6 oral
Write an appropriate prescription for this client in the activity below. Click the “Show Answers” option that will appear once all fields are complete to compare your response with the correct answer. 

Patient Prescription Transcript
An appropriate prescription for Nia is:
Name: Nia Omari
Date Of Birth: 7/7/1989
Date Prescribed: Current Date
Rx: escitalopram (Lexapro) 10 mg 
Disp: 30
Sig: Take one tablet by mouth once daily. 
Refills (O-4): 4
Dispense as Written:
Generic Substitution Permitted: 
• Either Dispense as Written or Generic Substitution Permitted should be checked on every written prescription depending on what is best for each client.  Refer to the week 1 lesson for criteria.  
Rationale: Nia has been experiencing adverse effects from taking sertraline. The CPG recommends transitioning the client to another SSRI. While many other SSRIs have more favorable side effect profiles, escitalopram is one of the medications that may help reduce the client’s symptoms while still improving anxiety. Escitalopram is dosed, beginning at 10 mg once daily. The provider should ensure that the client stops taking sertraline when beginning escitalopram to avoid serotonin syndrome. The provider should schedule a follow-up visit with the client to ensure the medication works after several weeks (Luu et al., 2021; NICE, 2023; Rosenthal & Burchum, 2021).

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