Assessment: review and apply your understanding of psychopharmacologic treatments for patients with multiple mental health disorders.

Assessment: review and apply your understanding of psychopharmacologic treatments for patients with multiple mental health disorders.

Assessment: review and apply your understanding of psychopharmacologic treatments for patients with multiple mental health disorders.

Short-Answer Assessment
Appropriate Drug Therapy for a Patient Who Presents With MDD and A History of Alcohol Abuse
Patients with major depressive disorder and a history of alcohol abuse should be prescribed selective serotonin reuptake inhibitors. Examples of these drugs include sertraline, which re effective in treating major depression with comorbid conditions such as alcohol abuse. Antidepressants take some time to produce their desired effect (Skidmore-Roth, 2022). The patient should expect symptom resolution within 3-4 weeks.

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Predictors of Late-Onset Generalized Anxiety Disorder
One of the predictors of late onset generalized anxiety disorder is a history of mental health disorders such as anxiety and depression. Patients with a history of depression and anxiety disorders are highly at a risk of late onset generalized anxiety disorder. The other predictor is gender. Females are highly likely to develop it than men are. The other predictor is traumatic or stressful experiences such as losing a loved one. Lastly, chronic conditions such as arrythmias, respiratory disorders, and heart failure increase the risk of the disorder(Jones et al., 2022).
Neurobiology Causes of Psychotic Major Depression
One of the neurobiological causes of major depression is structural abnormalities in the limbic and cortex systems. It also arises from an imbalance in the neurotransmitters such as serotonin and dopamine. Abnormalities in the HPA axis have also been identified to play a role. Lastly, dysfunctions in neural networks alter the normal brain functioning leading to major depression(Nh et al., 2020).
Symptoms of Major Depression Episode
One of the symptoms of major depression episode according to DSM-5 is having depressed mood most of the days almost every day. The other symptom is diminished interest or pleasure in most of the activities of the day and nearly every day. The third symptom is changes in weight and appetite(Tucker, 2022). The other symptom is fatigue being experienced almost every day. Lastly, patients feel worthless or have inappropriate guilt almost every day.
Classes of Drugs that Precipitate Insomnia
The examples of drugs that precipitate insomnia are selective serotonin reuptake inhibitors such as sertraline, monoamine oxidase inhibitors such as phenelzine, and beta 2 agonists such as salmeterol.

References
Jones, D. J. S., Jones, J. S., & Beauvais, D. A. M. (2022). Psychiatric Mental Health Nursing: An Interpersonal Approach. Jones & Bartlett Learning.
Nh, N., An, K., A, S., Bh, M., Ew, D., Aj, F., Bs, M., Gs, A., Aj, R., Em, W., L, M., J, N., Mj, H., C, D., Td, S., & An, V. (2020). Structural brain networks in remitted psychotic depression. Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology, 45(7). https://doi.org/10.1038/s41386-020-0646-7
Skidmore-Roth, L. (2022). Mosby’s 2023 Nursing Drug Reference—E-Book. Elsevier Health Sciences.
Tucker, R. G. (2022). 2023 Lippincott Pocket Drug Guide for Nurses. Lippincott Williams & Wilkins.

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As a psychiatric nurse practitioner, you will likely encounter patients who suffer from various mental health disorders. Not surprisingly, ensuring that your patients have the appropriate psychopharmacologic treatments will be essential for their overall health and well-being. The psychopharmacologic treatments you might recommend for patients may have potential impacts on other mental health conditions and, therefore, require additional consideration for positive patient outcomes. For this Assignment, you will review and apply your understanding of psychopharmacologic treatments for patients with multiple mental health disorders.

To Prepare

Review the Learning Resources for this week.

Reflect on the psychopharmacologic treatments that you have covered up to this point that may be available to treat patients with mental health disorders.

Consider the potential effects these psychopharmacologic treatments may have on co-existing mental health conditions and/or their potential effects on your patient’s overall health.

TO COMPLETE:

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 the 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.

Reading Requirements

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disordersLinks to an external site. (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Fernandez-Mendoza, J., & Vgontzas, A. N. (2013). Insomnia and its impact on physical and mental health. Current Psychiatry ReportsLinks to an external site., 15(12), 418. https://doi.org/10.1007/s11920-012-0418-8

Levenson, J. C., Kay, D. B., & Buysse, D. J. (2015). The pathophysiology of insomnia. ChestLinks to an external site., 147(4), 1179–1192. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388122/

Morgenthaler, T. I., Kapur, V. K., Brown, T. M., Swick, T. J., Alessi, C., Aurora, R. N., Boehlecke, B., Chesson, A. L., Friedman, L., Maganti, R., Owens, J., Pancer, J., & Zak, R. (2007). Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. SLEEPLinks to an external site., 30(12), 1705–1711. https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/PP_Narcolepsy.pdf

Morgenthaler, T. I., Owens, J., Alessi, C., Boehlecke, B, Brown, T. M., Coleman, J., Friedman, L., Kapur, V. K., Lee-Chiong, T., Pancer, J., & Swick, T. J. (2006). Practice parameters for behavioral treatment of bedtime problems and night wakings in infants and young children. SLEEPLinks to an external site., 29(1), 1277–1281. https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/PP_NightWakingsChildren.pdf

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 MedicineLinks to an external site., 13(2), 307–349. https://jcsm.aasm.org/doi/pdf/10.5664/jcsm.6470

Winkleman, J. W. (2015). Insomnia disorder. The New England Journal of MedicineLinks to an external site., 373(15), 1437–1444. https://doi.org/10.1056/NEJMcp1412740

Medication Resources

U.S. Food & Drug Administration. (n.d.). Drugs@FDA: FDA-approved drugsLinks to an external site.. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm

alprazolam

amitriptyline

amoxapine

amphetamine

desipramine

diazepam

doxepin

eszopiclone

flunitrazepam

flurazepam

hydroxyzine

imipramine

lemborexant

lorazepam

melatonin

methylphenedate

modafinil

armodafinil

carnitine

clomipramine

clonazepam

nortriptyline

pitolisant

ramelteon

sodium oxybate

solriamfetol

SSRI’s

temazepam

trazodone

triazolam

trimipramine

wellbutrin

zaleplon

zolpidem