Short answer question
- 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 potential neurobiology causes of psychotic major depression.
Short Answer Assessment
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Short Answer Assessment
Question 1
Almost one-third of people diagnosed with the major depressive disorder also have alcohol use disorder. According to McHugh & Weiss (2019), there seems to be a bidirectional relationship between alcohol use disorder (AUD) and depressive disorders. The three major common medications for treating individuals who present with both depression and alcohol use disorder include naltrexone, disulfiram, and acamprosate. Each of these medications is useful in the situation described above. naltrexone helps the patients to stop drinking and reduces depressive symptoms. Disulfiram, which is used as an alcohol deterrent, causes unpleasant symptoms if one drinks alcohol. Acamprosate is often used to help maintain abstinence from alcohol (McHugh & Weiss, 2019). However, duloxetine is contraindicated in patients who take alcohol. Chronic alcohol abuse can elevate the risk for liver disease. Duloxetine may also cause liver damage. Combining this medication with alcohol may further increase that risk.
Question 2
Neurobiological factors have been recognized as possible causes of depression. Various brain sites and their connections have been widely studied (Quevedo et al., 2019). They are responsible for maintaining emotional stability and their malfunction and are considered central to the pathophysiology of depression. They include changes in the prefrontal cortex, subcortical white matter abnormalities, brain-derived neurotrophic factors, and stress-induced changes in the dopamine system. Computer-assisted three-dimensional cell count shows a reduction in both neuronal and glial density in the orbitofrontal and dorsolateral PFC of depressed patients (Quevedo et al., 2019). Additionally, a study has shown micros structural subcortical white matter abnormalities in depressed individuals.
References
McHugh, R. K., & Weiss, R. D. (2019). Alcohol use disorder and depressive disorders. Alcohol research: current reviews, 40(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6799954/#:~:text=People%20with%20DSM%2DIV%20alcohol,11%25%20met%20criteria%20for%20dysthymia.
Quevedo, J., Carvalho, A. F., & Zarate, C. A. (2019). Neurobiology of depression: Road to novel therapeutics. Academic Press.