CASE STUDY:
Hassan Ayad, a 16-year-old male client (DOB: 8/20/2008), presents with his mother, complaining of persistent sadness, hopelessness, anger, and a loss of interest in his usual activities. He was the star of his basketball team, and since his dad died last year, he has had these symptoms. His mother states he has been going to cognitive behavioral therapy for ten months without relief. Hassan recently stated his desire to quit the basketball team, causing his mother to worry and request medication for depression. His physical assessment is unremarkable and medications are considered for this client.
Past Medical History: Depression
Allergies: Peanuts
Medications: None
Social History: He has never smoked cigarettes or drank alcohol.
Physical Exam:
• Height: 5 feet 9 inches
• Weight: 160 lbs
• Body Mass Index (BMI): 23.6
• Blood Pressure (BP): 110/70
• Heart Rate (HR):  64
• Respiratory Rate (RR): 17 
• Oxygen Saturation (O2 Sat): 97% on RA
• Temperature (TEMP): 98.7 oral
An appropriate prescription for Hassan is:
Name: Hassan Ayad
Date Of Birth: 8/20/2008
Date Prescribed: Current Date
Rx: fluoxetine (Prozac) 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: This client has tried cognitive behavioral therapy to manage his depression, as the CPG recommends. Despite this non-pharmacologic intervention, the client is not experiencing relief and is requesting medication. According to the CPG, fluoxetine is recommended as a first-line treatment for adolescents (escitalopram, sertraline, and citalopram are also appropriate). The starting dose for adolescents is 10 mg. The provider must ensure the client and his mother are aware that this medication could take several weeks to work and monitor for signs of increasing depression or suicidality, as these symptoms can occur during initial treatment in adolescents. Frequent follow-up appointments should be scheduled to ensure the medication is effective and side effects are absent (APA, 2019; Luu et al., 2021; Rosenthal & Burchum, 2025).

Step 1: Assess the client’s case, the applicable clinical practice guideline (CPG), and the prescription information provided.
Step 2: Answer the discussion prompts below with explanation and detail, providing complete references for all citations. Refer to the lesson for client information.
Include the following sections:
1. Application of Course Knowledge: Answer all questions/criteria with explanations and detail.
a. Describe your assigned client’s situation. Why are they presenting to the clinic? What medications are they currently taking?
b. Assess the applicable clinical practice guideline (CPG) for your assigned client linked on the same page in the lesson where the client case is located. What treatment is recommended by the CPG for your client’s situation?
c. Discuss your personal professional assessment of the client’s situation provided in the scenario. What pharmacological treatment is necessary and why?
d. Reflect on additional questions you have about your assigned client that may influence treatment. What else do you need to know? What follow-up assessments, labs, or conversations are required to ensure optimal health outcomes?