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Running head: COMPLEX REGIONAL PAIN DISORDER1Complex Regional Pain DisorderQuinta TangohWalden University
COMPLEX REGIONAL PAIN DISORDER2Complex Regional Pain DisorderClient is a 43-year-old male who presents to the clinic with complaints of leg pain and uses a set of crutches to assist with ambulation. The client was referred for psychiatric evaluationand pain management. The client reports that pain began seven years ago following a fall at workand multiple diagnostic test have been completed, including an x-ray, CT scans, and MRIs. During the course of his diagnosis and treatment, he reported he was diagnosed with reflex sympathetic dystrophy and was treated with hydrocodone but stopped taking medication becauseof constipation and sleepiness (Laureate Education, 2016a).Client is alert and oriented to person, place, time, and situation. He is dressed appropriately for the weather and season. He denies any visual/auditory hallucination, delusion, or paranoid thoughts. He denies suicidal/homicidal ideation or attempt. To develop a treatment plan for the client, PMHNP completed a physical and psychiatric assessment for the treatment of reflex sympathetic dystrophy (RSD) (Laureate Education, 2016a).Reflex sympathetic dystrophy, also known as complex regional pain syndrome is a sympathetic nervous system disorder that is characterized by chronic severe pain. It is diagnosed through clinical evaluation that includes a comprehensive physical examination, x-ray, and bone scans where a positive response to sympathetic blockage is considered to be positive of RSD (Bush, 2010; Brandner, 2018)Decision Point OneTreatment plan; the client, will be started on Amitriptyline 25 mg oral at bedtime and titrate upward weekly by 25 mg to a max dose of 200 mg per day. Amitriptyline is a norepinephrine multi-modal (SN-MM), a Tricyclic antidepressant (TCA) and Serotonin and norepinephrine/noradrenaline reuptake inhibitor used for the treatment of depression, including
COMPLEX REGIONAL PAIN DISORDER3treatment-resistant depression, anxiety, and insomnia. However, it is also used to treat

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