WK8Assgn1_Alagbe_A

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Jomo Kenyatta University of Agriculture and Technology, Nairobi *

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Nursing

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Nov 24, 2024

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1 Short Answer Assessment Adekemi Alagbe Walden University NURS 6630 Approaches to Treatment Dr. Reome April 23, 2022

2 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? Doctors should give patients who are abusing both alcohol and major depressive disorder SSRIs like Paxil. Meyer et al. (2018) state that when it comes to treating both alcoholism and anxiety, Paxil is the best and most successful medicine. Major depressive disorder (MDD) has been shown to have a correlation with alcohol addiction as a coping mechanism (Meyer et al., 2018). Seizures can be triggered by Effexor XR, hence any medical expert should advise against using it (Wilens & Rosenbaum, 2019). In addition, three weeks after starting Paxil, patients should begin to see an improvement in their symptoms. List 4 predictors of late onset generalized anxiety disorder. According to Zhang et al. (2015), GAD is a chronic and exceedingly common ailment that increases the risk of disability or incapacity and death in the elderly. However, its treatment is challenging, leading to lower complete remission rates, highlighting the need to classify early predictors for prevention in the older population (Zhang et al., 2015). Below, we discuss risk factors for developing GAD later in life. a. Female. b. Anxiety scores above average on the AMSTEL or a history of depression. c. PTSD d. The NESARC and the Infection with Narcissism List 4 potential neurobiology causes of psychotic major depression. The likely neurobiological foundations of significant depressive episodes of psychosis.

3 a. Increased levels of cortisol in the human body are one of four possible reasons of psychotic severe depression. b. Patients with any kind of abnormality in their hypothalamic-pituitary axis. c. The infection can be triggered by an increased ventricular ratio in the human brain (Cherian & Keller, 2019). d. Psychotic severe depression can be caused by a dopamine imbalance in the patient, as stated by Cherian and Keller (2019). 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. The American Psychiatric Association (2013) states that DSM-F is a reliable method for identifying MDD. On the other hand, the following are the five diagnostic criteria for MDD: a) The patients may have trouble sleeping on a daily basis, bordering on chronic insomnia. b) They are able to verbalize suicide ideation. The American Psychiatric Association (2013) reports that suicidal ideation occurs repeatedly, although without any concrete plans. c) The patient may exhibit signs of depression that last more than a day and may face these difficulties on a daily, if not hourly, basis. d) Lack of enthusiasm for or disinterest in previously enjoyed but now necessary routines like tooth-brushing, eating, and exercise. e) Alterations in body weight, either gain or reduction, may be present (American Psychiatric Association, 2013). List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.

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4 a. Medication containing amphetamines or other psychostimulants, such as Adderall (KöhlerForsberg et al., 2017). b. Cortisone and other steroid medications. c. SSRIs, such Prozac and Zoloft.

5 References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 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.2019.07.003 Köhler-Forsberg, O., Buttenschøn, H. N., Tansey, K. E., Maier, W., Hauser, J., Dernovsek, M. Z., Henigsberg, N., Souery, D., Farmer, A., Rietschel, M., McGuffin, P., Aitchison, K. J., Uher, R., & Mors, O. (2017). Association between C-reactive protein (CRP) with depression symptom severity and specific depressive symptoms in major depression. Brain Behavior and Immunity, 62 , 344–350. https://doiorg.ezp.waldenulibrary.org/10.1016/j.bbi.2017.02.020 Meyer, A., Nelson, B., Perlman, G., Klein, D. N., & Kotov, R. (2018). A neural biomarker, the error related negativity, predicts the first onset of generalized anxiety disorder in a large ‐ sample of adolescent females. Journal of Child Psychology & Psychiatry, 59 (11), 1162– 1170. https://doi-org.ezp.waldenulibrary.org/10.1111/jcpp.12922 Zhang, X., Norton, J., Carriere, I., Ritchie, K., Chaudieu, I., & Ancelin, M.-L. (2015). Risk factors for late-onset generalized anxiety disorder: results from a 12-year prospective cohort (The ESPRIT study). Translational Psychiatry, 5 , e536. https://doiorg.ezp.waldenulibrary.org/10.1038/tp.2015.31 Wilens, E & Rosenbaum, J.F. (2019). Massachusetts General Hospital psychopharmacology and Elsevier.

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