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Case Study: A Caucasian Man with Hip Pain “The patient is a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client repor $12.49   Add to cart

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Case Study: A Caucasian Man with Hip Pain “The patient is a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client repor

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Case Study: A Caucasian Man with Hip Pain “The patient is a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client reports that his family doctor sent him for ps...

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  • December 28, 2019
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  • 2019/2020
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Case Study: A Caucasian Man with Hip Pain

Amanda Briand

Date:12/28/2019

NURS 6630: Psychopharmacologic Approaches to Treatment of Psychopathology

Walden University

, Case Study: A Caucasian Man with Hip Pain

“The patient is a 43-year-old white male presents at the office with a chief complaint of

pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical

interview, the client reports that his family doctor sent him for psychiatric assessment because

the doctor felt that the pain was “all in his head.” He further reports that his physician believes he

is just making stuff up to get “narcotics to get high.”The client reports that his pain began about

7 years ago when he sustained a fall at work. He states that he landed on his right hip.He reports

that he does get “down in the dumps” from time to time when he sees how his life has turned out,

but emphatically denies depression.” (Laureate Education, 2016a).

Decision #1

My first decision was to start this patient on Amitriptyline 25mg po QHS and titrate

upward weekly by 25g to a max dose of 200mg per day (Laureate Education, 2016a). This is a

serotonin and norepinephrine/noradrenaline reuptake inhibitor that can be prescribed for

neuropathic pain/chronic pain, fibromyalgia and for a wide variety of pain syndromes (Stahl,

2013). It boosts neurotransmitters serotonin and norepinephrine/noradrenaline and presumably

desensitizes both serotonin 1A receptors and beta adrenergic receptors (Stahl, 2013).I did not

choose Savella because it is a selective serotonin-norepinephrine reuptake inhibitor (SNRI),

similar to some drugs used for the treatment of depression and other psychiatric disorders

(Wolters Kluwer Clinical Drug Information, 2018b). It is also used for fibromyalgia but I did not

feel it was appropriate to start this patient on a medication for psychiatric disorders when he has

chronic pain in his hip. I did not choose Neurontin because it is commonly prescribed for

neuropathic pain and posttherpetic neuralgia (Stahl, 2013). I did not think it would be an

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