Appropriate drug therapy for a patient who presents with MDD
1. In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse ( use an SSRI Sertraline and an alcohol cessation medication naltrexone). Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?
2. List 4 predictors of late onset generalized anxiety disorder.
3. List 4 potential neurobiology causes of psychotic major depression.
4. An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.
5. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.
Sample Solution
- Appropriate drug therapy for a patient with MDD and a history of alcohol abuse:
- SSRI antidepressant: Sertraline (Zoloft) is a good choice because it is effective for MDD and has a low risk of interaction with alcohol.
- Alcohol cessation medication: Naltrexone (Vivitrol) is an effective medication for alcohol cessation and can also help to reduce symptoms of depression in patients with comorbid MDD and alcohol use disorder.
Contraindicated drugs:
- Monoamine oxidase inhibitors (MAOIs): MAOIs are contraindicated in patients with alcohol use disorder due to the risk of a life-threatening interaction.
- Benzodiazepines: Benzodiazepines are contraindicated in patients with alcohol use disorder due to the high risk of abuse and overdose.
Full Answer Section
Timeframe for resolution of symptoms: The timeframe for resolution of symptoms will vary depending on the individual patient. Some patients may start to feel better within a few weeks, while others may need several months of treatment. It is important to be patient and to work with your doctor to find the right treatment plan for you.- Predictors of late onset generalized anxiety disorder:
- Early life trauma: People who experience trauma in early childhood are at increased risk of developing generalized anxiety disorder later in life.
- Family history: Generalized anxiety disorder tends to run in families, suggesting that there may be a genetic component to the disorder.
- Personality traits: People with certain personality traits, such as neuroticism and perfectionism, are more likely to develop generalized anxiety disorder.
- Medical conditions: Certain medical conditions, such as thyroid problems and heart disease, can increase the risk of developing generalized anxiety disorder.
- Potential neurobiology causes of psychotic major depression:
- Brain chemistry: Researchers believe that psychotic major depression may be caused by an imbalance in certain brain chemicals, such as serotonin and dopamine.
- Brain structure: People with psychotic major depression may have certain brain abnormalities, such as reduced volume in the hippocampus and prefrontal cortex.
- Genetics: Psychotic major depression is thought to be a heritable condition, suggesting that there may be a genetic component to the disorder.
- Symptoms of a major depressive episode:
- Depressed mood: A depressed mood is the cardinal symptom of major depression. It is characterized by persistent feelings of sadness, emptiness, or hopelessness.
- Loss of interest: People with major depression often lose interest in activities that they used to enjoy.
- Changes in appetite and sleep: People with major depression may experience changes in appetite and sleep, such as weight loss or gain, insomnia, or hypersomnia.
- Psychomotor changes: People with major depression may experience psychomotor changes, such as restlessness or agitation, or slowing down and appearing lethargic.
- Fatigue: People with major depression often experience fatigue and difficulty concentrating.
- Feelings of worthlessness and guilt: People with major depression often feel worthless and guilty, even for minor things.
- Thoughts of death or suicide: People with major depression may have thoughts of death or suicide.
- Classes of drugs that precipitate insomnia, with an example for each class:
- Stimulants: Adderall (amphetamine/dextroamphetamine)
- Antidepressants: Bupropion (Wellbutrin)
- Corticosteroids: Prednisone