6630N Week 8 assignment 1 – SHORT ANSWER ASSESSMENT

Week 8 assignment 1 6630N – SHORT ANSWER ASSESSMENT

6630N Week 8 assignment 1 – SHORT ANSWER ASSESSMENT

Drug therapy for MDD with a History of Alcohol Abuse

Managing the treatment of major depressive disorder in individuals with a history of alcohol abuse poses challenges due to potential interactions between antidepressants and alcohol. While selective serotonin reuptake inhibitors like fluoxetine or citalopram are commonly prescribed for MDD and typically have fewer interactions with alcohol compared to other types of antidepressants, it is still essential to advise patients against consuming alcohol as it can worsen depressive symptoms and enhance sedative effects when combined with medication (Stahl, 2022). Tricyclic antidepressants and monoamine oxidase inhibitors should not be used alongside alcohol due to severe interaction risks. The time frame for symptom alleviation may vary; however, many patients usually start experiencing progress within 2-6 weeks after initiating treatment.

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Predictors of Late Onset Generalized Anxiety Disorder

• Recent major life events or traumatic experiences.
• Previous history of anxiety symptoms in the past.
• Presence of physical health conditions, particularly chronic illnesses like cardiovascular diseases.
• Cognitive impairment or perceived difficulties with cognitive functioning.

Potential neurobiology causes of psychotic major depression.

• Changes in the dopamine system.
• Impairment of the serotonergic pathways.
• Disruption of the glutamatergic system.
• Abnormalities in the brain’s structural connectivity, specifically within frontal-subcortical circuits (Stahl, 2022).

Symptoms of Major Depression Episode

To receive a diagnosis of a major depressive episode, the DSM-5 specifies that individuals must display at least five of the following symptoms consistently over two weeks (Gangopadhyay, 2023):

• Feeling low or depressed for most of the day.
• Experiencing significantly reduced interest or enjoyment in almost all activities.
• Demonstrating noticeable weight loss/gain or changes in appetite.
• Having trouble sleeping (insomnia) or sleeping excessively (hypersomnia).
• Displaying either restlessness/agitation or slowed movement/retardation.

Classes of Drugs that Precipitate Insomnia:

• Stimulants such as Methylphenidate.
• Antihypertensives, for example, Beta-blockers like propranolol.
• Corticosteroids, for example Prednisone (Sateia et al., 2017; Winkelman, 2015)

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References

Gangopadhyay, M. (2023). DSM-5-TR® self-exam questions: Test questions for the diagnostic criteria (P. R. Muskin, A. L. Dickerman, A. Drysdale, & C. C. Holderness, Eds.). American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425787

Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine, 13(02), 307–349. https://doi.org/10.5664/jcsm.6470

Stahl, S. M. (2022). Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. Cambridge University Press. https://doi.org/10.1017/9781009053365

Winkelman, J. W. (2015). Insomnia disorder. The New England Journal of Medicine, 373(15), 1437–1444. https://doi.org/10.1056/nejmcp1412740