hardpolypharmacydeprescribingakathisiaaripiprazoleoutcome evaluation
A 58-year-old male with treatment-resistant depression and generalized anxiety disorder has been maintained on a regimen of fluoxetine 60 mg daily, bupropion SR 200 mg twice daily, buspirone 15 mg twice daily, trazodone 150 mg at bedtime, and low-dose aripiprazole 2 mg daily for the past three years. His depression has been in partial remission with a PHQ-9 score of 8. The PMHNP initiated a polypharmacy reduction plan six months ago, successfully tapering and discontinuing buspirone and reducing trazodone to 50 mg. His current PHQ-9 score is 7, GAD-7 is 6, and he reports improved daytime alertness and no worsening of sleep. However, he reports new-onset mild restlessness and increased caffeine consumption over the past month. Which evaluation finding most accurately reflects the outcome of the polypharmacy reduction?