The appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse
In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?
List 4 predictors of late onset generalized anxiety disorder.
List 4 potential neurobiology causes of psychotic major depression.
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.
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.
Full Answer Section
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.
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.