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
The appropriate drug therapy for a patient with MDD and a history of alcohol abuse is a selective serotonin reuptake inhibitor (SSRI) or a serotonin-norepinephrine reuptake inhibitor (SNRI). SSRIs and SNRIs are generally safe and effective for treating MDD, and they have a lower risk of abuse and dependence than other types of antidepressants.
Some specific SSRIs and SNRIs that are appropriate for treating MDD in patients with a history of alcohol abuse include:
Contraindicated drugs
Tricyclic antidepressants (TCAs) are contraindicated in patients with a history of alcohol abuse due to their increased risk of side effects, including seizures and heart problems. Atypical antidepressants, such as bupropion (Wellbutrin) and mirtazapine (Remeron), are also contraindicated in some patients with a history of alcohol abuse due to their potential to increase alcohol consumption.
Timeframe for resolution of symptoms
It is important to note that antidepressants take time to work. Most patients will not experience significant relief from their symptoms until after 2-4 weeks of treatment. Some patients may need to take antidepressants for several months or even years to maintain their mood stability.
Predictors of late onset generalized anxiety disorder
The following are four predictors of late onset generalized anxiety disorder:
Potential neurobiology causes of psychotic major depression
The following are four potential neurobiology causes of psychotic major depression:
Symptoms required for a major depressive episode
The following are at least five symptoms required for a major depressive episode:
Classes of drugs that precipitate insomnia, with an example for each class
The following are three classes of drugs, with a corresponding example for each class, that precipitate insomnia:
It is important to note that this is not an exhaustive list of all drugs that can precipitate insomnia. Many other types of drugs can cause insomnia, including over-the-counter medications, herbal supplements, and illicit drugs.