Mr. Strovio is a 42 year old , married, father of 2 young children, Italian man who comes to your outpatient practice complaining of anxiety. He reports losing his executive position when the company closed 2 years ago. At that time his PCP ordered Prozac for him and this helped to move him out of a depression. At that time he was sleeping excessively, crying and unable to motivate himself to job hunt. He stopped the Prozac independently about a year ago. Now he has obtained a new position at a new business, but at a lower salary. He is having difficulty focusing in meetings due to his symptoms of trembling and constantly worrying if he will perform adequately in this job. His sleep is mildly disturbed with difficulty falling asleep due to worrying., but then usually sleeps 6-8 hours without interruption.

He denies the use of any substances and only takes a multiple vitamin daily. He denies any physical problems but has noticed some difficulty urinating (interrupted stream) and has mild hypertension.

Respond to the following :

1. What additional information would you collect and why.
2. Discuss symptoms he is experiencing now, circuits and neurotransmitters involved
3. Discuss possible medications to relieve the symptoms. Include the neurotransmitters and circuits the medications influence including therapeutic as well as side effects. Provide evidence for your decision about meds, including level of evidence.
4. Present other considerations for treatment of this clientinclude teaching, relationship, other possible treatments etc.