Causes of Psychotic Major Depression

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Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.

  1. 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?
  2. List 4 predictors of late onset generalized anxiety disorder.
  3. List 4 potential neurobiology causes of psychotic major depression.
  4. 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.
  5. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.

causes of psychotic major depression

  1. For a patient presenting with Major Depressive Disorder (MDD) and a history of alcohol abuse, appropriate drug therapy often involves a combination of psychotherapy and pharmacotherapy. Selective Serotonin Reuptake Inhibitors (SSRIs) like sertraline and escitalopram are commonly prescribed as they have shown efficacy in treating MDD and are generally considered safe in patients with a history of alcohol abuse. Contraindicated drugs include Monoamine Oxidase Inhibitors (MAOIs) due to potential dangerous interactions with alcohol and benzodiazepines due to their addictive nature. The timeframe for symptom resolution can vary, but patients may start to see improvement in 2-4 weeks, while the full benefit may take 6-12 weeks of treatment (NIMH, 2021).
  2. Four predictors of late-onset Generalized Anxiety Disorder (GAD) include: a) Female gender, as women are more commonly affected; b) Family history of anxiety disorders, indicating a genetic predisposition; c) Chronic medical conditions or health problems, which can contribute to late-onset anxiety; and d) Recent life stressors, such as loss of a loved one or significant life changes, triggering the development of GAD (American Psychiatric Association, 2013).
  3. Four potential neurobiological causes of psychotic Major Depression include: a) Dysregulation of the serotonergic system, with abnormal serotonin levels affecting mood and perception; b) Dysfunction in the dopaminergic pathways, leading to altered reward processing and hallucinations; c) Abnormalities in the glutamatergic system, contributing to cognitive deficits and psychotic symptoms; and d) Structural brain changes, like alterations in the prefrontal cortex, which can impact mood and cognition (Murrough et al., 2015).
  4. An episode of Major Depression is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as lasting at least 2 weeks and must include at least five of the following symptoms: a) Depressed mood; b) Diminished interest or pleasure in most activities; c) Significant weight loss or gain; d) Insomnia or hypersomnia; e) Psychomotor agitation or retardation; f) Fatigue or loss of energy; g) Feelings of worthlessness or excessive guilt; h) Diminished ability to think or concentrate; and i) Recurrent thoughts of death or suicide (American Psychiatric Association, 2013).
  5. Three classes of drugs that can precipitate insomnia include: a) Stimulants, such as amphetamines (e.g., Adderall), which can disrupt sleep patterns due to their alertness-promoting effects; b) Corticosteroids, like prednisone, which may lead to insomnia as a side effect; and c) Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac), as they can sometimes interfere with sleep and lead to increased wakefulness (Roth, 2007)
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