Week 8 assignment 1 Walden University Psychopharmacology

 

 

 

           

Week 8: Assignment 1: Psychopharmacology

 

 

 

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Week 8: Assignment 1: Psychopharmacology

In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse.

            The FDA in addition to several clinical practice guidelines for alcohol use disorder and co-occurring depression recommends the use of selective serotonin reuptake inhibitors (SSRIs) like Paxil among adults. Patients with MDD and a history of alcohol use normally display increased craving and relapse with the use of several psychotropic medications (Hunt et al., 2020). However, studies show that SSRIs are better tolerated and safer to use among these patients as compared to other antidepressants like tricyclic antidepressants (TCAs). Consequently, the frequency of adverse effects of the use of SSRIs among patients with a history of alcohol use is relatively low and resolves with time.

Which drugs are contraindicated if any, and why? Be specific.

            Among patients with a history of alcohol abuse, antidepressants such as monoamine oxidase inhibitors like Azilect should be avoided as they can lead to a dangerous spike in the patient’s blood pressure which might require immediate medical attention (Murthy et al., 2019). Serotonin and norepinephrine reuptake inhibitors (SNRIs), like Strattera, are also discouraged as they can worsen damage to the liver. Lastly, TCAs as only considered safer in small amounts as they can worsen depressive symptoms among patients taking alcohol.

What is the timeframe that the patient should see the resolution of symptoms?

            With the use of Paxil, the patient is expected to start experiencing the effectiveness of the medication in the management of the depressive symptoms after 2 to 3 weeks of using the drug (Hunt et al., 2020). Studies show that parixil takes approximately 8 to 12 weeks for complete remission of the patient’s symptoms of MDD.

List 4 predictors of late-onset generalized anxiety disorder.

1. Female gender (Murthy et al., 2019).
2. Recent adverse life event
3. Chronic mental disorders such as depression
4. Chronic physical disorders such as heart failure, arrhythmia, or respiratory disorders.

List 4 potential neurobiology causes of psychotic major depression.

1. Elevated cortisol levels circulating in the patient’s body (Cherian et al., 2019).
2. High ventricular ratio in the brain of the patient.
3. Abnormalities in the patient’s hypothalamic-pituitary axis
4. Imbalance in the dopamine levels in the CNS is congruent with major depressive disorder.

An episode of major depression is defined as a period lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.

According to the DSM-V criteria, the following symptoms are required for a patient to report an episode of MDD (Alang, 2018):

1. Loss of energy or fatigue
2. Diminished ability to concentrate or think
3. Recurrent thoughts of death
4. Feeling worthless

List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.

1. Selective serotonin reuptake inhibitors (SSRIs) like Prozac and Zoloft (Van Gastel, 2018)
2. Dopamine agonists like ropinirole and rotigotine.
3. Psychostimulants and amphetamines like Ritalin and methamphetamine.

 

 

References

Alang, S. (2018). Contrasting depression among African Americans and major depressive disorder in the DSM-V. Journal of Public Mental Health, 17(1), 11–19. https://doi.org/10.1108/jpmh-12-2016-0061‌

Cherian, K., Schatzberg, A. F., & Keller, J. (2019). HPA axis in psychotic major depression and schizophrenia spectrum disorders: Cortisol, clinical symptomatology, and cognition. Schizophrenia Research, 213, 72–79. https://doiorg.ezp.waldenulibrary.org/10.1016/j.schres.2019.07.00

Hunt, G. E., Malhi, G. S., Lai, H. M. X., & Cleary, M. (2020). Prevalence of comorbid substance use in major depressive disorder in the community and clinical settings, 1990–2019: Systematic review and meta-analysis. Journal of affective disorders, 266, 288-304.

Murthy, P., Mahadevan, J., & Chand, P. K. (2019). Treatment of substance use disorders with co-occurring severe mental health disorders. Current opinion in psychiatry, 32(4), 293-299. DOI: 10.1097/YCO.0000000000000510

Van Gastel, A. (2018). Drug-induced insomnia and excessive sleepiness. Sleep medicine clinics, 13(2), 147-159.