Patient Intake The patient is a 29-year-old female who works

Patient Intake The patient is a 29-year-old female who works as a clinical laboratory technologist She first experienced panic attacks (spontaneous) in high school and generalized anxiety disorder symptoms during her first year of college, at a large University, located 2 hours from her parents. She worries about her work performance (despite evaluations that suggest excellent function), worries about her finances, worries about her parents’ health, worries that she may have made errors at work, worries about her co-workers’ impressions of her and also describes a general sense of dread, noting that she “always worries that the worst things possible will happen.” As an example, she will worry about terrorist attacks, bridges collapsing, being pulled over, etc. She has irritable bowel syndrome for which she takes hyoscyamine 0.125 mg QID PRN abdominal cramping. She was seen in individual psychotherapy for 12 appointments in high school and saw a counselor 2 years ago for 3-4 sessions, but this was stopped “because the coping strategies didn’t help.” Prior medication trials have included fluoxetine 40 mg daily, duloxetine 120 mg daily and sertraline 150 mg with minimal to no improvement. She currently takes escitalopram 30 mg daily with partial improvement, but as above, continues to experience significant anxiety. Trials of buspirone 15 mg TID and hydroxyzine 50 mg BID PRN for anxiety produced dizziness and sedation respectively. She denies alcohol use and marijuana as well as other illicit substances. She does not drink coffee as it “makes me shaky.” She is a non-smoker. She has no history of suicidal ideations or self-injury attempts. Patient History Family History: Father: generalized anxiety disorder (GAD) Mother: panic disorder No family history of substance uses disorders or endocrinopathy Work History: She works as a clinical laboratory technologist. She was a straight ‘A’ student in high school and has always had a small group of friends. She rarely dates and her last date was more than a year ago–with a gentleman that she met using an online dating app. Current Symptoms: She reports constant worrying, difficulty concentrating, initial insomnia with a sleep latency of 2-3 hours, muscle tension and a feeling of constant dread at work, at home and even when she has attempted to go out with friends. No reports of depressed mood, guilt anhedonia or suicidal ideation. Vital signs are within normal limits and there are no reports of heat or cold intolerance, recent weight loss or dysmenorrhea. She also denies cardiac symptoms including palpitations. Current Medication: escitalopram 30 mg daily. hyoscyamine 0.125 mg TID PRN cramping 2. What would you do next? A. Laboratory screening for hyperthyroidism B. Pharmacogenetic testing for pharmacokinetic genes C. QIDS (Quick Inventory of Depressive Symptoms D. Augmentation of her escitalopram with clonazepam 0.5 mg BID

******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."