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Psychopharmacological Approaches to Treat Psychopathology
The first question is, how many meals do you have in a day and have lost your appetite? Considering that her BMI indicates she is underweight, we need to establish if she is getting enough food and nutrients for her body. The second question will be, how is your current sleep pattern? The question tries to uncover the patients sleep and wake schedule, bedtime routine, and daily functioning. Obtaining the patients sleep routine helps determine the diagnosis and identify the best treatment plan. The third question is, do you consume caffeine? If so, how many cups do you take in a day? Caffeine is a stimulant that has a negative effect on sleep at night. The lack of sleep can be due to caffeine if the patient consumes coffee before bedtime.
We can get further information from children and caregivers familiar with the patient. The question to ask the children will be if they have noticed any changes in their mothers energy, mood, appetite, or interests. The question offers information on what others have seen and if it is similar to what has been reported by the patient. Another question to ask the children is how their mother has been coping with the loss of their father. Dealing with a loss of a loved one can be devastating, and we should understand the support system she has at home. Caregivers can offer insights into the patients functioning in daily activities, especially after the loss of her husband.
The test to administer to the patient would aid in determining her anxiety and depression. The Hamilton Anxiety Rating Scale (HAM-A) assesses the severity of the patients anxiety, assisting in determining the cause of insomnia for the patient (Zimmerman et al.,...…depressive mood once she starts getting a good nights sleep. Combining the two drugs would cause the patient to have hallucinations, increased heart rate, fever, seizure, excessive sweating, shivering, blurred vision, and muscle spasms.
The starting dose for Trazodone would be 25 to 150 mg daily for the patient (Yi et al., 2018). The low dosage is suitable for treating insomnia. However, higher doses can be prescribed if the low dosage is ineffective. The expected outcome is that the patient will have an increased sleep ability, and their depressive mood will reduce. The side effects of the drug, like daytime sleepiness, should not be a significant concern, considering the patient is an elderly woman and does not need to stay awake the whole day. We should evaluate the effects of the drug after four weeks to determine efficacy and if there is a need to change the dosage…
References
Lähteenmäki, R., Neuvonen, P. J., Puustinen, J., Vahlberg, T., Partinen, M., Räihä, I., & Kivelä, S. L. (2019). Withdrawal from long?term use of zopiclone, zolpidem and temazepam may improve perceived sleep and quality of life in older adults with primary insomnia. Basic & Clinical Pharmacology & Toxicology, 124(3), 330-340. https://doi.org/10.1111/bcpt.13144Yi, X.-y., Ni, S.-f., Ghadami, M. R., Meng, H.-q., Chen, M.-y., Kuang, L., Zhang, Y.-q., Zhang, L., & Zhou, X.-y. (2018). Trazodone for the treatment of insomnia: a meta-analysis of randomized placebo-controlled trials. Sleep medicine, 45, 25-32. https://doi.org/10.1016/j.sleep.2018.01.010
Zimmerman, M., Thompson, J. S., Diehl, J. M., Balling, C., & Kiefer, R. (2020). Is the DSM-5 anxious distress specifier interview a valid measure of anxiety in patients with generalized anxiety disorder: a comparison to the Hamilton anxiety scale. Psychiatry research, 286, 112859. https://doi.org/10.1016/j.psychres.2020.112859
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