Address the following Short Answer prompts for your quiz. Be sure to include references:
1. 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?
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.
Short Answer Assessment
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Short Answer Assessment
Introduction
Treatment of comorbid depression and alcohol abuse disorder
The three medications commonly used in the treatment of people presenting with both alcohol and depression are naltrexone, disulfiram, and acamprosate. These medications are used to stop drinking and reduce depressive symptoms, as an alcohol deterrent, and to help maintain abstinence from alcohol, respectively (Kim, 2021). The patient takes three to four weeks to begin experiencing significant change. Duloxetine is contraindicated in patients who take alcohol because it may lead to liver damage.
Predictors of late-onset generalized anxiety disorder according to Gerlach & Gloster (2021).
• Being female.
• Recent adverse life events.
• Having chronic physical and mental health disorders.
• Parental loss or separation and low affective support during childhood.
Potential neurobiology causes of psychotic major depression according to Kim (2021).
• Changes in the prefrontal cortex
• Subcortical white matter abnormalities.
• Brain-derived neurotrophic factors.
• Stress-induced changes in the dopamine system.
Symptoms of an episode of major depression according to Kim (2021).
• A feeling of sadness.
• Loss of interest or pleasure in things once loved.
• Angry outbursts, irritation, or frustration.
• A feeling of worthlessness or guilt.
• Insomnia
Three classes of drugs that precipitate insomnia
• Alpha-blockers- are linked to reduced REM (rapid eye movement) sleep. Examples include alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), silodosin (Rapaflo), terazosin (Hytrin) and tamsulosin (Flomax) (Neel & AARP, 2021).
• Beta-blockers-inhibits the nighttime secretion of melatonin, a hormone involved in regulating both sleep and the body’s circadian clock. Examples include atenolol (Tenormin), carvedilol (Coreg), metoprolol (Lopressor, Toprol), and others (Neel & AARP, 2021).
• Corticosteroids- they wreak havoc on all the systems that allow one to relax and sleep, causing insomnia and unpleasant dreams. Examples include cortisone, methylprednisolone (Medrol), prednisone (Deltasone and Sterapred), and triamcinolone (Neel & AARP, 2021).
References
Gerlach, A., & Gloster, A. T. (2021). Generalized anxiety disorder and worrying: A comprehensive handbook for clinicians and researchers. Chichester Wiley Blackwell.
Neel, A., & AARP. (2021). Drugs & Supplements: 10 Types of Meds That Can Cause Insomnia. https://www.aarp.org/health/drugs-supplements/info-04-2013/medications-that-can-cause-insomnia.html
Kim, Y.-K. (2021). Major depressive disorder: Rethinking and understanding recent discoveries. Springer.