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NURSING
Nursing: Therapy for Patients with Sleep-Wake Disorders
Depression and stress disorder are some of the most prominent causes of sleep-wake disorders. Insomnia is one of the most commonly discussed problems, ad n sleep difficulties have caused physical and worsened emotional problems. Seep is studied vastly by medical professionals because seven to nine hours of sleep is recommended by scientists for accurate body functioning. The co-existing complication of health start showing as soon as signs of stress, depression, and anxiety appear, further obscuring neurobiology and leading to heart failure, osteoarthritis, and Parkinsons diseases in severe conditions (American Psychiatric Association, 2020). This paper aims to reflect on psychopharmacological treatments for patients suffering from sleep-wake disorders and other co-existing mental disorders that could degrade the effects of those medications.
Major depressive disorder (MDD) and alcohol abuse are usually seen going hand in hand as patients suffering from depression feel they need to find solace, and alcohol numbs their nerves for some time, helping them relieve distress for a little while (Chan et al., 2015). For such patients, evidence has corroborated the effectiveness of medications like nefazodone, imipramine, desipramine, fluoxetine, and sertraline (Chan et al., 2015; DeVido & Weiss, 2012). Behavioral therapies are also suggested along with medication to bring about a change in alcohol use. Medications alone have not been proved to show a higher prevalence of sobriety since some drugs have different impacts on the various sociodemographic factors of patients, such as homelessness, low socioeconomic status, smoking, and family history, leading to higher hospital re-admission rates (Chan et al., 2015).
Most studies have indicated that the use of two drugs at a single time might create adverse symptoms for patients with MDD and alcohol. The results might be witnessed in greater dependency on alcohol as confusion is aggravated. An example of such a situation is the prescription of sertraline and naltrexone as polytherapy showed greater side effects or drug reactions for extremely sensitive patients (Chan et al., 2015). Long-term results might be different for diverse people as the benefits would be visible for those with high motivation for behavioral change instigation. Patients cannot be forced to...…has become uncertain due to changing environmental conditions and the recent diet and lifestyles people undergo. The diagnostic criteria cause diverse clinical implications as MDE, a serious indicator of psychotic depression, could be unipolar or bipolar (Dubovsky et al., 2021).
An episode of major depressive disorder is believed to last at least two weeks. The symptoms of such an episode include having a depressed mood for a major portion of the day, such as a feeling of sadness, hopelessness, and barrenness, loss of interest in daily activities and appearing subjective to others, decrease in weight due to a fall in appetite which would be up to 5%, insomnia or sometimes hypersomnia and extreme weariness and tiredness (MD Calc, n.d.).
The three classifications of drugs that can precipitate insomnia include (National Jewish Health, 2017):
Selective serotonin reuptake inhibitors. This classification includes Zoloft and Prozac (National Jewish Health, 2017).
Psychostimulants and amphetamines. The examples of this classification encompass Addrerall XR and Dexedrine (Cherney, 2020). Both are generically variable.
Anticonvulsants. This category includes drugs like Tegretol- Csrbatrol, Lyrica, Neurotin, Depakote, etc. (Web…
References
American Psychiatric Association. (2020, August). What are sleep disorders? https://www.psychiatry.org/patients-families/sleep-disorders/what-are-sleep-disorders#:~:text=There%20are%20several%20different%20types,both%20physical%20and%20emotional%20problems.
Chan, P., Yomen, K., Turcios, J. & Richman, M. (2015). Prescription for antidepressants in reducing future alcohol-related re-admission in patients suffering from depression and alcohol use disorder: A retrospective medical record review. Substance Abuse Treatment, Prevention, and Policy, 10. https://doi.org/10.1186/s13011-015-0045-y
Cherney, K. (2020, March 12). ADHD medications list. Health Line. https://www.healthline.com/health/adhd/medication-list
Collins, S. (n.d.). Can medicine help with alcohol use disorder? Web MD. https://www.webmd.com/mental-health/addiction/features/fighting-alcoholism-with-medications#1
DeVido, J. J., & Weiss, R. D. (2012). Treatment of the depressed alcoholic patient. Current Psychiatry Reports, 14(6), 610–618. https://doi.org/10.1007/s11920-012-0314-7
Dubovsky, S.L., Ghosh, B.M., Serotte, J.C. & Cranwell, V. (2021). Psychotic depression: Diagnosis, differential diagnosis, and treatment. Psychother Psychosom, 90, 160-177. https://doi.org/10.1159/000511348
MD Calc. (n.d.). DSM-5 criteria for major depressive disorder. https://www.mdcalc.com/calc/10195/dsm-5-criteria-major-depressive-disorder
National Jewish Health. (2017, March 1). Medicines that can cause insomnia. https://www.nationaljewish.org/conditions/insomnia/causes/medicines-that-can-cause-insomnia#:~:text=Medications%20that%20can%20cause%20insomnia,Psychostimulants%20and%20amphetamines
Web MD. (2022, April 22). Drug treatments for sleep problems. https://www.webmd.com/sleep-disorders/drug-treatments#:~:text=It%20is%20used%20to%20treat,Depakon)%3B%20gabapentin%20(Neurontin).
Zhang, X., Norton, J., Carrière, 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(3), e536. https://doi.org/10.1038/tp.2015.31
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