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Treatment For Major Depressive Disorder Of Alcohol Abuse Assignment

Treatment For Major Depressive Disorder Of Alcohol Abuse Assignment

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Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.

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. Treatment For Major Depressive Disorder Of Alcohol Abuse Assignment

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Appropriate Drug Therapy for MDD with Alcohol Abuse

The first-line treatment for Major Depressive Disorder (MDD) with a history of alcohol abuse typically involves selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) (Carey, 2019). Examples include fluoxetine, sertraline, and venlafaxine. These medications have shown effectiveness in treating depression and are generally considered safer in patients with a history of alcohol abuse. Contraindicated drugs include monoamine oxidase inhibitors (MAOIs) due to potentially dangerous interactions with alcohol. The combination of MAOIs and alcohol can lead to a hypertensive crisis, which is a severe and potentially life-threatening condition. The timeframe for resolution of symptoms can vary, but improvement may be noticed within the first few weeks. However, it usually takes 6 to 8 weeks for the full therapeutic effect of antidepressants to be achieved. Regular monitoring and close follow-up with a healthcare professional are essential during this period. Treatment For Major Depressive Disorder Of Alcohol Abuse Assignment

Predictors of Late-Onset Generalized Anxiety Disorder

  • Chronic medical conditions: Individuals with chronic health issues, such as cardiovascular diseases or diabetes, may be more prone to late-onset generalized anxiety disorder.
  • Traumatic life events: Experiencing significant life stressors, such as the death of a loved one or a traumatic event, can contribute to the development of late-onset anxiety (Murayama et al., 2020).
  • Genetic factors: A family history of anxiety disorders may increase the risk of late-onset generalized anxiety disorder.
  • Cognitive decline: A decline in cognitive function, especially in executive functions, has been associated with late-onset anxiety. Treatment For Major Depressive Disorder Of Alcohol Abuse Assignment

Neurobiological Causes of Psychotic Major Depression

  • Dysregulation of neurotransmitters: Imbalances in serotonin, dopamine, and norepinephrine levels are implicated in psychotic major depression.
  • Hypothalamic-pituitary-adrenal (HPA) axis dysfunction: Dysregulation of the stress response system may contribute to the development of psychotic symptoms.
  • Structural brain abnormalities: Changes in brain structures, such as the prefrontal cortex and hippocampus, have been observed in individuals with psychotic depression.
  • Inflammatory processes: Increased inflammation, as indicated by elevated levels of certain cytokines, has been associated with psychotic depression.

Symptoms Required for an Episode of Major Depression

  • Depressed mood: Persistent sadness or an irritable mood.
  • Diminished interest or pleasure in activities (anhedonia): Markedly diminished interest or pleasure in almost all activities.
  • Sleep Disturbances: Insomnia or hypersomnia
  • Fatigue or loss of energy: Persistent tiredness and lack of energy.
  • Recurrent thoughts of death or suicide: Thoughts of death, suicidal thoughts, or suicide attempts. Treatment For Major Depressive Disorder Of Alcohol Abuse Assignment

Classes of Drugs that Precipitate Insomnia

  • Stimulants: Medications like amphetamines (e.g., Adderall) and methylphenidate (e.g., Ritalin) can cause insomnia due to their stimulating effects on the central nervous system (Steinbuchel & Greenhill, 2022).
  • Corticosteroids: Drugs like prednisone, used for various inflammatory conditions, can disrupt sleep patterns.
  • Bronchodilators: Medications used in conditions like asthma, such as albuterol, may lead to insomnia.

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References

Carey, T. L. (2019). Use of antidepressants in patients with co-occurring depression and substance use disorders. Antidepressants: From Biogenic Amines to New Mechanisms of Action, 359-370. https://doi.org/10.1007/164_2018_162

Murayama, K., Nakao, T., Ohno, A., Tsuruta, S., Tomiyama, H., Hasuzawa, S., … & Kanba, S. (2020). Impacts of stressful life events and traumatic experiences on onset of obsessive-compulsive disorder. Frontiers in psychiatry11, 561266. https://doi.org/10.3389/fpsyt.2020.561266

Steinbuchel, P., & Greenhill, L. (2022). Stimulants: definition, pharmacology, indications, side effects, and treatment strategies. In NeuroPsychopharmacotherapy (pp. 2421-2449). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-62059-2_324 Treatment For Major Depressive Disorder Of Alcohol Abuse Assignment

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