Outcome Letter

Mr Arthur Pendelton 42 Elmwood Avenue, Manchester, M20 2WQ

24/10/2023

Dear Dr Carter,

Re: Mr Arthur Pendelton, DOB 14/05/1978, NHS 482 910 3847 - Psychiatric Outpatient Outcome Letter

I am writing to update you on the patient's recent consultation and its outcome.

Mr Pendelton attended the clinic today for a review of a 3-month history of persistent low mood, anhedonia, and early morning wakening, on a background of recurrent depressive disorder. A full Mental State Examination (MSE), Patient Health Questionnaire (PHQ-9), and Generalized Anxiety Disorder Assessment (GAD-7) were performed during the consultation, alongside a review of his recent baseline blood tests. On MSE, the patient appeared kempt with psychomotor retardation, flat affect, and low mood, though he denied any suicidal ideation or psychotic symptoms; his PHQ-9 score was 19/27, GAD-7 was 11/21, and routine bloods including TFTs and FBC were NAD. The clinical impression is a moderate-to-severe relapse of recurrent depressive disorder. We agreed to switch his antidepressant therapy due to the suboptimal response to citalopram, alongside providing sleep hygiene advice and crisis contact numbers. He has been prescribed sertraline (Lustral®) 50 mg PO OD, with instructions to cross-taper by reducing citalopram 20 mg PO OD to 10 mg PO OD for 1 week before stopping and commencing sertraline. I have referred him to NHS Talking Therapies for Cognitive Behavioural Therapy (CBT) and will review him in the outpatient clinic in 4 weeks to assess treatment tolerability and efficacy.

Please contact me if you need any additional information or clarification.

Yours sincerely,

Dr Eleanor Vance Consultant Psychiatrist South Manchester Community Mental Health Team, Tel: 0161 555 0192, Email: e.vance@nhs.net