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?

Drug Therapy, Anxiety Disorder, Psychotic Major Depression and Insomnia

In addition to abstinence from alcohol and supportive care, pharmacotherapies and pharmacological measures like antidepressants and serotonin reuptake inhibitors and antidepressants like paroxetine, fluoxetine, escitalopram, sertraline, and citalopram are both regarded as the first-line therapeutic interventions.

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Corticosteroids, Beta-blockers, Antiparkinson’s medications, Benzodiazepines, Endocrine drugs, Anticonvulsants, Stimulants, H2 Blockers and Proton Pump Inhibitors, Cholesterol-decreasing medications such as Statins, and Anticholinergic medications are the ten medications that are believed to be contraindicated for MDD patients. These medications are regarded as contraindicated because they have the potential to either worsen or contribute to depression in patients who already have substance abuse disorders and depression (Bains & Abdijadid, 2022). These medications are not advised because they either directly or indirectly affect the central nervous system of the patients.

Any antidepressant should typically be taken for a minimum of two to six weeks before results improve. They also mentioned that a patient must go through several trials before discovering the best medication for them. Once the appropriate drug has been identified, it may take several months to determine the optimal dosage and to get the full benefits.

List 4 predictors of late-onset generalized anxiety disorder.

The four main determinants of delayed generalized anxiety disorder are as follows: Compared to men, women are more susceptible. Second is the recent negative life occurrences, including accidents, suicides, or crime-associated circumstances. Third is suffering from persistent physical conditions, including respiratory issues, cardiac arrhythmias and heart failure, hypercholesterolemia, and mental retardation (Stern et al., 2015). I am, lastly, having a history of generalized anxiety disorder, depression, or another mental health problem.

List 4 potential neurobiology causes of psychotic major depression.

The following four neurobiological factors may contribute to major depression in psychosis: Foremost, changes and unbalances in the brain’s neurotransmitters, including serotonin, glutamate, and dopamine. Secondly, there is a decrease in brain networks between the network in default mode (DMN) and the somatic motor or sensory systems, bilaterally insular, and the auditory cortex, with the polar of the right planum showing the most significant spike of decreased connection. This indicates that the functional connection of diminished DMN, which is linked with psychotic depression, and reduced network connections are related to the remission of these conditions. Thirdly, monoamine neurotransmitters such as norepinephrine and serotonin hypothesis (Bains & Abdijadid, 2022). Because different antidepressant medications significantly raise these neurotransmitters’ levels, depressed people are inclined to decrease them. Lastly, one variant in the gene responsible for brain-derived neurotrophic protein is hypothesized to control the interaction between stressors and the serotonergic transporter polymorphisms, leading to severe psychotic depression.

An episode of major depression is defined as a period lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.

The five most frequent signs of major depressive illness include Violence, where the patient exhibits frequent irritability—even over trivial things—angry bouts, worry, restlessness, and agitation. Excessive emotions make the patients isolate themselves because they feel unbearably depressed, crying, hopeless, and empty. Difficulties with appetite where the patient has a decreased appetite and loses excessive amounts of weight, or they may have an enhanced appetite and acquire excessive amounts of weight, nightmares, and other sleep disorders such as insomnia—lastly, Anhedonia and apathy (Bains & Abdijadid, 2022). Apathy refers to the absence of feelings, interest, emotions, or care for the things around the patient. Anhedonia refers to the sensation of lack of interest in pastimes the patient once enjoyed, such as intercourse, leisure, and hobbies.