Desvenlafaxine Case Study

Desvenlafaxine Case Study
Answer: Desvenlafaxine is recommended for this patient among SSRI and SNRI. Because
desvenlafaxine is least affected by this patient's CYP2D6 poor metabolizer and CYP2C19 poor
metabolizer status among SSRI and SNRI, has no drug–drug interaction with the current
medications and has better safety profile compared with other SSRI and SNRI. Rationale: Based on
the PharmGKB website and relative articles, the patient has CYP2D6 *4/*4 genotype means she is a
poor metabolizer of the CYP2D6 enzyme, CYP2D6 *4 allele has inactive CYP2D6 enzyme activity,
she has two inactive alleles resulting being a poor metabolizer of CYP2D6. Also, the patient has
CYP3A4 *1/*1 genotype, CYP3A4 * 1 allele has active CYP3A4 activity, however, there is no
uniform phenotype ... Show more content on Helpwriting.net ...
Among SSRIs, paroxetine, fluvoxamine, and fluoxetine are mainly metabolized by CYP2D6.
Sertraline, citalopram, and escitalopram are mainly metabolized by CYP2C19. There are CPIC
guidelines for fluvoxamine and paroxetine regarding CYP2D6, also for citalopram, escitalopram,
sertraline regarding CYP2C19. These guidelines suggest the reduction of the dose or alteration of
medication if the patient has a poor metabolizer phenotype. Since this patient is a poor metabolizer
for both CYP2D6 and CYP2C19, patients may experience side effects from relevant SSRIs due to
higher plasma concentration, we may need to avoid using the above SSRIs. Additionally, she tried
paroxetine, fluoxetine, and sertraline in the past which were all not successful, we would like to
avoid those as well. SNRI that approved to treat depression includes desvenlafaxine, duloxetine, and
venlafaxine. Among these SNRIs, venlafaxine is mainly metabolized by CYP2D6, desvenlafaxine is
mainly metabolized by conjugation and minor metabolized by CYP3A4, it is also an inhibitor of
CYP2D6. Duloxetine is mainly metabolized by CYP1A2 and CYP2D6. Based on the information
above and patient's genotyping result, desvenlafaxine will be the best choice for her. Although it is a
dose–dependent inhibitor of CYP2D6, this patient has no CYP2D6 enzyme activity, desvenlafaxine
won't cause the clinical impact on CYP2D6 in this
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Chronic Alcohol Intoxication: A Case Study
PRINCIPAL DIAGNOSIS: Acute and chronic alcohol intoxication.
OTHER PROBLEMS: Chronic obstructive lung disease, depression, anxiety, history of seizures
related to acute and chronic alcohol intoxication (number 1), benign prostatic hypertrophy (BPH),
panic disorder and tobacco use disorder.
ALLERGIES: NO KNOWN ALLERGIES.
OPERATIONS(/)PROCEDURES: No invasive procedures were performed during this
hospitalization.
REASON FOR ADMISSION: Patient presented to the urgent care area, brought by a friend. Patient
is requesting detoxification.
SUBJECTIVE: Patient states he has been drinking 18 beers a day, states, "I blew it."
OBJECTIVE: Vital signs: Blood pressure 106/62. (Pulse 95). Respirations are 20. Temperature is
97.5. Patient weighs 150 pounds. (Pain is)(0) (___) (0/10). ... Show more content on Helpwriting.net
...
Crackles are noted in the lungs throughout. Heart is regular rate and rhythm with a rate in the 90s.
Patient is on telemetry. Bowel sounds are active x4. Denies abdominal tenderness. Skin is dry and
intact.
LABORATORY: O2 saturation on 3 liters on ___ [DATE] was 92%. On ___ [DATE] on 2 liters
94%, and on 2 liters on the ___ [DATE] (at) 97%. Telemetry on ___ [DATE] shows normal sinus
rhythm. Patient off the ward very often (and) smokes. The patient was discontinued from telemetry.
HOSPITAL COURSE: Patient was admitted to the hospital for detoxification on routine detox
orders and placed on telemetry. Patient progressed safely and without incidents and is ready for
discharge today ___

A Study Of The Nervous System
All feelings and emotions that people experience are produced through chemical changes in the
brain. A lack of certain chemicals or an abundance of chemicals can lead individuals to have
emotional imbalances often classifying them as more commonly and more seriously known as
mental disorders. Specific chemicals cause certain moods in individuals, often times substances
containing these chemicals influence the way a person may feel. Discussing what happens in the
brain as it reacts to different chemical build ups will help us as individuals better understand our
body and communicate and respond to these experiences in a healthier way. The study of the
nervous system is known as Neurochemistry. It 's the practice of observing ... Show more content on
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To get a sense of how activity takes place in an event of experience a feeling, any one neuron may
be receiving many chemical messages both positive and negative from surrounding neurons.
Neurotransmitters may be "competing" to get the neuron to respond in different ways or they may
work together to produce a certain effect, when a neurotransmitter fails to affect a neuron it ceases
to exist by returning back into separate chemicals. When succeeding, you begin to have an
emotional response. Every day we experience different combinations of emotions being exposed to
different events in our lives. If you were to search a list of feelings, you'd find lists that are longer
than you'd think. Chemical build up for these feelings are easier to classify. "Feel good" chemicals
are chemicals that activate responses of well, feeling good. These include Oxytocin
(C43H66N12O12S2), Serotonin (C10H12N2O), and Dopamine (C8H11NO2). Depression linked
chemicals are Norepinephrine (C8H11NO3), and lack of Dopamine and Serotonin. Noteworthy,
Dopamine controls arousal levels and motor control in many parts of the brain. Serotonin is the
neurotransmitter enhanced by many antidepressants and has a profound effect on mood, anxiety, and
aggression. These chemical formulas are compounds of simpler chemicals (example of Dopamine
Synthesis provided on page 6). When is it classified as having too much or too little of

Obsessive Compulsive Disorder ( Ocd )
The definition of Obsessive–compulsive disorder (OCD) is typically defined by the disorders
characteristics. The characteristics of OCD are obsessions and compulsions. Obsessions often
manifest from unreasonable beliefs, thoughts, and fears. Compulsions often manifest in the form of
ritualistic behaviors. Mayoclinic.org explains that individuals with OCD can have one of the other
where the issues of compulsions or obsessions are concerned (Diseases and Conditions).
"Obsessive–Compulsive Disorder" written by Gyula Bokor, MD, and Peter D. Anderson further
distinguishes OCD by stating that "(OCD) consists of a pervasive pattern of preoccupation with
orderliness, perfectionism, and mental and interpersonal control to the degree that flexibility,
openness, and efficiency are impaired" (2014, p. 117). There are a number of disorders that are
comorbid to OCD, meaning in the presence of one or more disorder. Bokor and Anderson state that
often times Tourette's syndrome and Tic disorders are a frequent comorbidity with OCD (2014, p.
117). Psychotic disorders like schizophrenia has been reported a comorbidity of OCD. Bokor and
Anderson state that the mental composition of a patient with OCD can lie in comorbidity with
numerous psychiatric disorders as well like panic disorder, social phobia, and posttraumatic stress
disorder (2014, p. 118). The National Institute of Mental Health's website explains that there are a
number of treatments for OCD. The two most predominant forms of

Cognitive Behavioral Analysis
In a study conducted by Wagner et al.in 2004, researchers investigated the efficacy and safety of
citalopram compared to placebo to treat Major Depressive Disorder (MDD) in children and
adolescents. The problem described in the study was that up to 5%of children and 8% of adolescents
meet diagnostic criteria for depression, which often continues to adulthood. The purpose to examine
it and find a solution is because depression in children and adolescents can negatively affect school
performance, peer relationships, and risk of suicide could increase. The general hypothesis was that
by citalopram being effective in the treatment of depression in the adult population, it would also be
effective in the use of children and adolescents because of ... Show more content on Helpwriting.net
...
As a result of a successful study on omega–3 fatty acids in adult major depressive disorder, they
were determined to investigate the benefits omega–3 fatty acids have in childhood major depression.
Major depressive disorder is common in children and adolescents. Frequently, it appears with poor
psychosocial outcome, comorbid conditions, and high risk of suicide and substance abuse, which
indicate that the condition needs to be treated. Researchers found that omega–3 fatty acids were
effective in adult depression as an add–on therapy, and they inferred that it would have the similar
effects in pediatric patients. The participants selected for this study were children between the ages
of 6 and 12, and were submitted to the omega–3 trial for 16 weeks. Participants with unstable
physical illness or psychiatric disorders other than anxiety, attention deficit hyperactivity disorder,
dysthymia, or tic syndrome were excluded from the study. All participants needed at least one
parent's written informed consent and the consenting parent's commitment to inform the other
parent. The IV in this study was the Omega–3 acids treatment, and the DVs were the children with
depressive disorder. Patients received two 500 mg or one 1,000 mg capsule of the treatment daily for
16 weeks, depending on their ability to

Selective Serotonin Reuptake Inhibitor ( Ssri )
Escitalopram is a second generation antidepressant; a selective serotonin reuptake inhibitor (SSRI)
that is used in the treatment of major depressive disorder (MDD) and anxiety related disorders. It is
generic for Lexapro and was approved by the FDA in 2012 for adults and children 12 years and
older who suffer from major depressive disorder and adults who have generalized anxiety disorder.
(FDA, 2012). Since its approval, Escitalopram has also been used in the treatment of Obsessive
compulsive disorder, body dysmorphic disorder, and even premenstrual dysphoric disorder. This
review will discuss the overall effectiveness of Escitalopram, the pharmacokinetic factors of the
medication, the mechanism of action, common adverse reactions, pharmacological effects of the
medication, and its efficacy across different populations. The Pharmacokinetics of Escitalopram
While many selective serotonin reuptake inhibitors (SSRI's) are accepted as first line treatments for
depression and anxiety, they differ greatly in their chemical structure and pharmacokinetic profile.
These differences are especially important when selecting the appropriate antidepressant drug for
the client. It is also important to understand the different drug interactions and pharmacological
profiles when considering an SSRI for a patient as well. An initial starting dose of escitalopram is
usually 10 mg/day. It may be necessary to increase dosage after at least one week of treatment to a
maximum dosage of up to 20

Escitalopram Case Study
Escitalopram is an antidepressant approved by the FDA for treatment of major depressive disorder
(MDD) or generalized anxiety disorder (GAD). Development of escitalopram, achieved by
collaboration of Lundbeck and Forest Laboratories, began in the summer of 1997 and took only 3.5
years. The first patients participated in studies for marketing authorization in summer of 1999, and
the first clinical results were published in December 2000. A year later, in December 2001,
Lundbeck received Swedish approval for the treatment of depression and panic disorder. By May of
2002, the product had been approved in many European countries thanks to the European Mutual
Recognition Procedure. Meanwhile, in March 2001 Forest submitted a New Drug Application ...
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Therefore, escitalopram has been claimed to be a more potent antidepressant than a racemic mixture,
citalopram, of the two enantiomers. Researchers from Lundbeck tried to explain this phenomenon
by proposing that escitalopram enhances its own binding by interacting with another allosteric site
on the transporter. However, additional research showed that (R)–citalopram also enhances the
binding of escitalopram, so allosteric interaction cannot explain the observed counteracting effect.
Of the SSRIs currently on the market, escitalopram has the highest affinity for the serotonin
transporter, and thus has a relatively mild side–effect profile. Some of the more commonly reported
side effects are diarrhea, drowsiness, headache, ejaculatory disorder, nausea, insomnia, and delayed
ejaculation. More include anorgasmia, constipation, fatigue, dizziness, and decreased libido. Many
side effects affect the reproductive system, probably because serotonin also plays a role in sexual
desire and function. Other SSRIs that may be used as antidepressants include Zoloft, Celexa, Paxil,
and Prozac. Other common antidepressants include Wellbutrin and Xanax, and Abilify is commonly
used in combination with

Benzodiazepine Vs Pharmacotherapy
Most of the patients exhibit improvement in the symptoms of panic disorder after receiving the
treatments, the two most effective treatments are cognitive behavioral therapy and pharmacotherapy.
Pharmacotherapy:
The selective serotonin reuptake inhibitor and the tricyclic antidepressant have shown superiority
over the benzodiazepines, monoamine–oxidase inhibitor in term of effectiveness and tolerance.
The commonly used drugs are:
1) SSRI group: PAROXETINE, FLUOXETINE, SERTRALINE,FLUVOXAMINE,CITALOPRAM.
2) Tricyclic antidepressant: CLOMIPRAMINE, IMIPRAMINE, DESIPRAMINE.
3) Benzodiazepines group: ALPRAZOLAM, CLONAZEPAM, DIAZEPAM, LORAZEPAM.
4) Mao–i: PHENELZINE, TRANYLCYPROMINE, REVERSIBLE INHIBITORS OF
MONOAMINE OXIDASE, MOCLOBEMIDE, BROFAROMINE. ... Show more content on
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While the benzodiazepines are administered the serotonergic drug can titrated to reach the
therapeutic dose, and then four to twelve weeks after benzodiazepines can be tapered slowly. (13)
The role of atypical antipsychotic and antidepressant in treating panic disorder: Atypical
antipsychotic:
Many studies proved the efficacy and tolerability of the atypical antipsychotics on patients that
diagnosed with panic, one method was constructed by searching for relevant published articles that
investigate the antipsychotic effect on panic patients. After removing duplicated and the case report
studies they obtained seven studies, 4 out of 7 were open label studies, 2 out of 7 were randomized
controlled trials for PD comorbid with major depressive disorder and one randomized control trial
for PD comorbid with bipolar disorder.
The most common drugs that have been used in these studies were the Risperidone, Aripiprazole,
olanzapine and Quetiapine.
The results shows that 6 out of the 7 studies have proved the efficacy of these drugs on panic
disorder patients alone or with comorbidity, being introduced either as a mono therapy agent or an
augmenting

Effectiveness of Antidepressant Drugs Essay example
Effectiveness of Antidepressant Drugs
In Issue 13 of Taking Sides, the controversial question Have Antidepressant Drugs Proven to be
Effective is analyzed. Psychiatrist Peter D. Kramer argues in this issue that antidepressant drugs
"can transform depressed patients into happy people with almost no side effects" (p.212). On the
contrary, professors of psychology Seymour Fisher and Roger P. Greenburg "claim that the studies
that demonstrate the effectiveness of antidepressants are seriously flawed" (p.212). Kramer's
agreement with the statement above is due mostly to the testing he did with his patient Tess and
antidepressant drugs. However Fisher and Greenberg disagree with the statement mainly because of
the bias drug studies that ... Show more content on Helpwriting.net ...
In Tess taking the drug Kramer found out very quickly what remarkable changes it had on her.
Kramer learned that the drug had a "quickly alteration in ordinary intractable problem of personality
and social functioning" (p.218). Kramer also learned that Prozac enabled a person to understand
what was important to them and who they were and wanted to be. Although Kramer saw the effects
Prozac had on Tess, Tess also taught him to look at the border picture. Tess made Kramer think what
if this "redefinition of self led to a culture in which this biologically driven sort of self understanding
becomes widespread" (p.222). Kramer found it unbelievable what the drug Prozac could do to a
patient, something that psychiatrists have always hoped to accomplish. The main thing though that
Tess taught Kramer and what the drug itself taught him was that the effects of the drug would have
to re examined and our sense of what is constant in the self to be revised. As earlier stated, Fisher
and Greenberg disagree with the effectiveness of antidepressant drugs which is mainly due to the
bias studies. As Fisher and Greenberg state, "no one actually knows how effective antidepressants
are. Confident declarations about their potency go well beyond the existing evidence" (p.223). One
of the main biases on antidepressant drugs is that "patients learn to discriminate between drug and
placebo largely from body sensations and symptoms" (p.225). Another point Fisher and

Movie Sex And The City
The romantic comedy movie Sex and the City was centered on four main characters. The story was
told in the point of view of the main character, Carrie Bradshaw. For the purpose of the concept
analysis paper, we were told to evaluate possible characters who may exhibit possible mental
disorders. According to MedlinePlus Medical Dictionary (2015), a mental disorder is define as the
disorganization of emotions, personality, and mind that have a serious impact on the normal
psychological functioning of a person. There were several examples presented in the movie,
however three characters revealed the most examples of a mental disorder. Movie Plot The movie
Sex and the City was based off the series Sex and the City, in the movie began 4 years after the
series ended in New York City. Carrie Bradshaw is the main character and the narrator for the movie
and the storyline is based on her and her three best friends, Miranda Hobbes, Charlotte York, and
Samantha Jones. Carrie Bradshaw has been in a long term relationship with Mr. Big and they have
decided to live together which turns into getting married. Carrie begins to plans her wedding
accompanied by the help of her four best friends. Along with helping Carrie plan her wedding her
best friends have lives and problems of their own. Charlotte York and her husband have recently
adopted a child after realizing Charlotte was unable to conceive. Later in the movie Charlotte
actually becomes pregnant and is able to birth her own child.

The Effects Of Antidepressant Pills On Teenagers And...
Jacqueline Mendez
Mrs. Kehrmeyer
AP English
9 February 2016
Teenagers and Antidepressants In recent discussions of antidepressant pills a controversial issue has
been whether doctors should prescribe antidepressants to teenagers. Antidepressant pills are
prescribed to
individuals who suffer from a condition called Major Depression Disorder, labeled MDD for
abbreviation. Major Depressive Disorder is a mental disorder characterized by a pervasive and
persistent low mood that is accompanied by low self–esteem and by loss of interest or pleasure in
normally enjoyable activities. The objectives of antidepressant pills are to stabilize, and
normalize the abnormal low levels of brain chemicals for those who suffer from MDD. On the
other hand, some argue that antidepressants are harmful and do a disadvantage to teenagers,
therefore should not be prescribed to them. However, others argue that the pills are not harmful
and in some cases the strong need of antidepressants outweigh the risks the pills might provide.
Antidepressants prevent teenagers from recuperating on their own and prevents them from
learning how to cope with conflicts thus, they should not be prescribed.
Depression results in symptoms such as sadness, it affects a person's emotions and leads
to both emotional and physical problems. The antidepressant pills are meant to help the brain
recuperate and adjust to normality. The reason why people reconsider taking the pills in the first
place is

The Challenges Of Nursing : A History Of Vascular Dementia
This is a new admission transferred from Florida got here last night with a history of vascular
dementia with the addition of head trauma in 05/2016. The patient has minimal communication
skills and all of this is related by her daughter, Linda Abrams. Linda tells me that her mother was
born in Brooklyn, graduated from high school, worked both at Macy's and a ladies dress factory that
her father owned. Around the age of 22, she married had three children. Linda Abrams lives in the
Briar Creek area of Durham. Arlene Lambert the second daughter lives in Reno, Nevada. The third
daughter is deceased. Apparently, Beulah's husband and she lived in Brooklyn, but in 1954 moved to
Edison, New Jersey where he worked in the vending machine ... Show more content on
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She was still fairly independent in her ADL's while living at home, but obviously, some cognition
problems because the daughter described that she would subscribed every magazine ad that came
along, that she made contributions inappropriately to every organization, and apparently, she did a
lot of shopping for multiple items that she really did not need. All of this culminated in the fact that
she was moved to an assisted living in Jacksonville, Florida near where her brother lived in 03/2016.
She was just there a few months, in 05/2016 sustained another fall, actually had a fracture of her
frontal bone and had an associated intracerebral hemorrhage as a result of that. Following that fall
and injury, she was referred back to the same assisted living facility, no longer ambulatory but she
was admitted to their memory care unit where she has remained up until the time she came to
Mayview yesterday. I have very few records from Florida, but I do have a physician making house
calls note from 09/16/2016. Apparently at that period of time, she had a DVT in the left lower
extremity. She was on Xarelto 15 mg a day. She was going to see a vascular surgeon for a
Greenfield filter. She was getting some physical therapy through home health nursing but had very
poor endurance and tone. She had a sacral ulcer at that time and a history of having a previous DVT
one year earlier. It said

Parkinson 's Disease Is A Progressive Loss Of Functioning...
Introduction:
Parkinson's disease is a progressive loss of functioning of the brain that results in stiffness,
trembling and loss of fine motor control. This disease mainly affects the neurons in the particular
area called the substantia nigra with a total loss of dopamine, the absence of these dopamine–
producing cells causes the loss of the brain's ability to control the body movements progressively
("Parkinson's disease", 2016). Parkinson's disease is very common, with about 70000 Australians as
well as the average age of diagnosis is 65 years, however, upcoming generations can also be
diagnosed with Parkinson's. It is also not easy to analyze Parkinson's as there is no laboratory test,
but a neurologist can make the diagnosis of this disease ("What is Parkinson 's", 2016). John Magill
has a case of Parkinson's disease before 5 years and after having a fall at home, he was admitted to
the hospital and was recognised as having a generalised tremor and decrease in mobility. This essay
aims to provide the risk factors, clinical manifestation, medical managements, holistic nursing care
plan and discharge plan for John Magill.
Risk factors for Parkinson's disease.
The researchers usually accord with the most of cases that Parkinson's disease is the result of the
mixture of nature and nurture, as there are a number of potential risk factors which may lead to
Parkinson's disease such as age, gender (more likely in men than in women), head injury, exposure
of metal and genetic

Depression Treatments: The Use Of Antidepressant Medication
In general, depression can be effectively treated, even in some of the most severe cases. However,
the earlier depression treatments begin, the more effective they are.
The most common depression treatments are medication and psychotherapy. Medications most often
begin with antidepressant medication. Antidepressants primarily work on brain chemicals called
neurotransmitters, especially serotonin and norepinephrine, although there are some antidepressants
that work on the neurotransmitter dopamine. Some of the newest and most popular antidepressants
are called selective serotonin reuptake inhibitors (SSRIs). Fluoxetine (Prozac), sertraline (Zoloft),
escitalopram (Lexapro), paroxetine (Paxil) and citalopram (Celexa) are some of the most common

Escitalopram Research Paper
Escitalopram Lexapro is a widely prescribed selective serotonin reuptake inhibitor that is used in the
treatment of depression and anxiety. Lexapro is also known by its generic name of escitalopram or
s–citalopram. History Escitalopram is an enantiomer of a drug called citalopram. Citalopram was
discovered in 1977 and is a highly powerful and selective serotonin inhibitor. Citalopram has a
chiral center due to its central atom being surrounded by two non matching arrangements of atoms.
These surrounding atoms are called enantiomers and are classified as either r–enantiomers or s–
enantiomers (Schatzberg & Nemeroff, 2013). It was discovered that many of the positive properties
about the drug lie in the s–enantiomer, which is 30 times more potent than the r–enantiomer
(Braestrup & Sanchez, 2004). Scientists removed the r–enantiomer, and s–citalopram or
escitalopram was created. Some studies have shown that escitalopram may be more effective than
citalopram due to the inhibitory effects of histamine of the r–enantiomer (Cipriani, et al., 2012).
Escitalopram was discovered in 1997 and submitted to the Food and Drug Administration for
approval in the United States of America in 2001. It was approved for the treatment of major
depressive disorder in 2002 and for the treatment of generalized anxiety disorder in ... Show more
content on Helpwriting.net ...
The reported side effects include nausea, vomiting, increased sweating, dry mouth, headache,
insomnia, and ejaculatory disorder (Schatzberg & Nemeroff, 2013). The authors report that it may
also cause hyponatremia in elderly patients or discontinuation syndrome if usage is stopped
abruptly. Discontinuation syndrome can present as dizziness, lethargy, nausea, vomiting, or flu like
symptoms which can be prevented by titrating down under the supervision of a professional
(Schatzberg & Nemeroff,

Anti American Depression Case Study
As you know Eugene you are dealing with depression which was caused by the death of your wife.
With that fact it leaves me to believe that your depression was caused by the biochemical changes in
your brain, which is sometimes described as a "chemical imbalance".
For depression, we have effective treatments for it. With these treatments, Eugene, you would have
an excellent chance of getting over your depression within a matter of a few weeks. However,
without these treatments Eugene, you may get better immediately, but just keep in mind that your
depression could take a few months to a few years. However though, taking antidepressants do not
quite work for depressive episodes like aspirin would for a headache. It may take anywhere from 2
to ... Show more content on Helpwriting.net ...
However, don't drink while taking these medications because alcohol also changes the brain
chemistry. While alcohol may help you fall asleep, its sedative wears off quickly and that will cause
you to wake–up early in the morning. This also includes illegal drug use, other sedative agents, and
stimulants, please for my peace of mind and yours don't do it.
Eugene, please keep in mind that major depression is treatable and that the vast majority of our
patients respond to using antidepressants and we choose the medication that we think is going to
mostly help you. If you do not respond to it, then we will use a different antidepressant that will.
Therefore, as you can see, if treated properly, major depression can be nipped in the bud and you
should begin to feel better

Ptsd Essay
PTSD is a growing issue in New Zealand and our current methods for treating this are in sufficient.
6.1% of people living in New Zealand have some kind of anxiety disorder in the year 2010 and in
2006, 3.5% of the New Zealand population at that time, had been diagnosed with PTSD. The New
Zealand Government should subsidize 70% of surf lesson costs for people with PTSD and build 6
Float Centers in New Zealand's key cities. In conjunction with this, the Ministry of Social
Development should raise awareness of their funding program for people with mental illness. This
report will be focusing on what is PTSD, what is PTSD, what is being done, what could be done and
what should be done. What is PTSD? PTSD means Post–Traumatic Stress ... Show more content on
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Another sign of PTSD is avoidance. People suffering from PTSD can feel somewhat detached from
society, their friends, family and they can end up stopping activities they had once enjoyed. An
additional indication that someone has PTSD is hyperarousal. Hyperarousal is when a person with
PTSD constantly feel on alert and jumpy. Also disturbed sleep and are more irritable. There are may
risks of PTSD This can lead depression, that can lead to suicidal thoughts and this happened mostly
when it isn't treated. It can lead to panic attacks. This can develop food disorders. Issues with drugs
or alcohol use. People who have experienced depression in their lives are more likely to be affected
by PTSD. PTSD is an individual mental illness but involves depression and anxiety. Meaning that
someone who has PTSD is constantly feeling on edge. In the 2011/2012 New Zealand health survey
it revealed that 14.3% of New Zealand adults (over 500,000 people) had been diagnosed with
depression at some time in their lives, and over 200,000 people (6.1%) had been diagnosed with
anxiety disorder including PTSD. The rates of depression and anxiety in Women is much higher
than the rate of Men with these illnesses. 17.9% of Women in New Zealand had been diagnosed
with depression, and 7.7% with anxiety. Compared to men with depression, 10.4%, and anxiety,
4.4%. These figures include everyone with any kind of depressive illness and any kind of anxiety
disorder which include many other

Symptoms And Treatment Of Depression
Depression is a word that people commonly use in everyday life. On any given day you will hear
someone say "I am feeling depressed", "that was depressing", exc, but depression is not just a state
of being but "a serious medical condition in which a person feels very sad, hopeless, and
unimportant and often is unable to live in a normal way. " Because of overuse of this word, people
often mistake when someone should be medically diagnosed with depression for them just being
sad. This is problematic in someone who is medically ill and faces consequences because of a
chronic illness that goes undaginosed. These consequences ranging from minor harm to oneself or
others to death all because no one saw the signs that they were actually clinically depressed. Often
people who seek help for depression by way of medicine do not feel that it works because
antidepressents take on average two months to begin reducing symptoms. This is a problem in the
medical field because when results are not being seen patients tend to find themselves in harms way.
In order for depression to become treatable the pharmasutical industry is going to have to
significantly improve how long antidepressents take to work and the rate of which antidepressents
are effective. Depression effects one in every six americans at some point during life. The National
Center for Health Statistics estimates more than one in 10 Americans over the age of 12 took
antidepressants between 2005 and 2008, and the rate of

Obsessive-Compulsive-Disorder
Obsessive–compulsive–disorder,OCD,is an anxiety disorder and is characterized by
recurrent,unwanted thoughts (obsessions) and or repetitive behaviors(compulsion). obsessive –
compulsive–disorder is a relatively common, if not always recognized, chronic disorder that is often
associated with significant distress and impairment in functioning. Due to stigma and lack of
recognition,individuals with OCD often must wait many years before they receive a correct
diagnosis and indicated treatment.OCD is a condition characterized by intense unwanted,obsessive,
thoughts and compulsive rituals like: Fearing germs perfectionism Hoarding Unwanted sexual
thoughts Religious obsessions (scrupulosity) OCD is, however , considered to have

Symptoms And Treatment Of Migraine
Pharmacological Treatment of Migraine
Chronic migraine is a significant disorder as approximately 2 percent of the world's population
suffers from it. "In 2010 the World Health Organization ranked migraine as the 19th leading cause
of medical–related disability in high–income countries." (Young, 2014) Preventive treatments are
often given to patients with frequent migraine, which is considered to be more than four headache
days per month. Many migraine patients are prescribed medicines as a preventive treatment and a
majority of drugs used as migraine preventatives are actually medications developed to treat other
disorders such as certain antihypertensives, antidepressants, seizure medications, and even Botox.
(Young, 2014) My client, AB, has chronic migraine and also takes daily medications for migraine
that are often used to treat other disorders.
Patient Demographics and History
Upon interviewing, my client AB disclosed that she has chronic migraine headaches. My client is a
38 year old single white female, classified as middle class, who is a master–level student. AB has
full–time employment in an office and customer service setting. She stated that she has experienced
migraines since she was an adolescent. AB is taking three different medications including:
gabapentin, 300 mg via capsules am/pm four times a day, Citalopram, 40mg tablets once by mouth
each morning, and Tramadol 50 mg 1–2 pills every 4–6 hours for acute pain.
According to AB's history, she states she

Depression: The Myth Leading Cause Of Suicide
Depression causes problems throughout thousands of people's lives. Did you know that suicides
caused by depression are the tenth leading causes of death in united states? For every suicide
committed there is at least 25 more attempted because the feeling of loss and grief. Scientists have
been working hard on the social issue so people can lower our suicide rates here in America.
Scientist solutions to lowering depression rates is to use electroshock therapies, special depressive
disorder medications and therapy.
Depression is a serious illness caused by changes in brain chemistry (grief,stress,difficult life
circumstances )
Scientist believe that monoamine (mood changing chemicals) changed our moods to make us feel as
if

Citalopram Case Study
Question: What are the possible complications for an adult AAM who has been diagnosed with
depression and is also taking Citalopram and Trazadone every night?
Background: WJ is an African American male with depression, and chronic pain. Due to a tragic car
accident, he is now permanently in a wheelchair. The patient has been taking 20 mg of citalopram
and 50 mg of trazodone every night and has heard about possible complications from taking these
medications together. The patient wants to know if there is any truth to this and what potential issues
can arise. Information: Depression is much more than a momentary case of the blues. It is an
ongoing problem that can considerably impair a person's conduct, judgments, daily activities, ...
Show more content on Helpwriting.net ...
Citalopram, which was one of the first selective serotonin reuptake inhibitors approved by the Food
and Drug Administration, is one of the antidepressant drugs that clinicians prescribe for routine
generalized depression.3 "Thirty–seven trials compared citalopram with other antidepressants (such
as tricyclics, heterocyclics, SSRIs and other antidepressants, either conventional ones, such as
mirtazapine, venlafaxine and reboxetine, or non–conventional, like hypericum). Citalopram was
shown to be significantly less effective than escitalopram in achieving acute response (odds ratio
(OR) 1.47, 95% confidence interval (CI) 1.08 to 2.02), but more effective than paroxetine (OR 0.65,
95% CI 0.44 to 0.96) and reboxetine (OR 0.63, 95% CI 0.43 to 0.91). Significantly fewer patients
allocated to citalopram withdrew from trials due to adverse events compared with patients allocated
to tricyclics (OR 0.54, 95% CI 0.38 to 0.78) and fewer patients allocated to citalopram reported at
least one side effect than reboxetine or venlafaxine (OR 0.64, 95% CI 0.42 to 0.97 and OR 0.46,
95% CI 0.24 to 0.88, respectively)."4 Citalopram is a great drug choice for depression due to its low
cost, good efficacy, and reduction of the amount of side effects. 4, 8 Trazodone effects are does
dependent, depending upon what it is going to be used for.

Compulsive Disorder Case Study
In Tina behaviors, it indicated that she has anxiety and obsessive–compulsive disorders (OCD).
OCD has 2 parts, obsession and compulsions. Obsessions are thoughts, impulses, or images that
persist and recur, so that they cannot be dismissed from the mind even though the individual
attempts to do so (Halter & Vacarolis, 2014). With Tina, she has an obsession of negative and
harmful thoughts would come to her daughter even thought she knows it is irrational but she cannot
get those thoughts out of her head. Compulsions are ritualistic behaviors an individual feels driven
to perform in an attempt to reduce anxiety or prevent an imagined calamity. Performing the
compulsive can only reduce the anxiety only temporarlity, which makes patient with ... Show more
Tina can join a community support groups for people that has the same mental problem as Tina.
With the support group, the patients can offers different tips and ideas on how to reduce the
obsession and compulsive disorder (Halter & Vacarolis, 2014).
– Tina has difficulty sleeping due to her anxiety and her compulsive of checking on her daughter
constantly at night. One thing that may help her is educate her on ways to promote sleep such as
warm baths, warm milk, and relaxing music, and monitor her sleep thought a sleep record (Halter &
Vacarolis, 2014).
– Thought stopping technique; Tina can shout out the word "Stop" out loud or snap a rubber band on
her wrist when she starts having negative thoughts of something harmful coming to her daughter.
This technique can briefly blocks the automatic undesirable thought and help her to select an
alternative and positive thoughts that her daughter is safe (Halter & Vacarolis, 2014).
– The uses of medication can help Tina with her anxiety and OCD symotoms. There are medications
that help treatment both disorders such as Citalopram (Celexa) and Paroxetina (Paxil). (Halter &
Vacarolis,

A Short Note On Anxiety Disorder And Anxiety Disorders Essay
Anxiety
Case Study
Wendy is a 32 year old woman who has presented at her general practitioner with a six month
history of disturbed sleep, fatigue, restlessness and difficulty concentrating. On assessment, she
reports that these symptoms have become worse since she was promoted at work. Wendy is in a
senior position at work and now finds herself worrying constantly about work. She is also more
irritable than usual and this is impacting on her relationship with her husband and she is now
worried that he might leave her. She has been diagnosed with Generalised Anxiety Disorder (GAD).
A Discuss the aetiology of anxiety disorders, and identify some specific risk factors which may have
predisposed Wendy to developing GAD. (300 words)
Anxiety itself is a normal human emotion, experienced regularly and on a lesser scale than those
suffering from GAD disorder. Although nothing is known of Wendy's genetics or youth, it is thought
that traumatic experiences, over protective parents, "stress, biological predisposition, personality
characteristics, psychodynamic factors and interpersonal and behavioural dynamics" (Elder, Evans,
& Nizette, 2013, p. 320) all play a part in the development of GAD. Though none have been
significantly identified as definitive GAD risk factors.
The age old debate of nature verses nurture is at the forefront of anxiety causation discussion.
Genetically, it is been concluded that the risk of developing GAD increases, especially amongst first
degree

Millennials In American Culture
Jamaica, a small island, in the Caribbean, known for its music and rich culture. The people are
vibrant and live by the motto "we don't have problems, we have situations." One will most likely
never hear the word "depression' thrown around in Jamaica. But, does it exists? Sure it does! Only
not as much as the United States, and there is minimal need for prescription medications. Many
people, living in Jamaica, utilize music, and the land (therapeutic streams, walks in the valleys, and
the beaches) to heal their sorrows. Many people within the United States do not have the luxury of
these things or the time to take a dip or walk in Nature. Instead, they are encouraged to take
medications to heal their sadness, whether it is depression episodes ... Show more content on
Helpwriting.net ...
Natural Therapy, otherwise known, as Eco–therapy, and Music Therapy are two effective ways that
help people recover from mental health issues such as depression and anxiety. Eco Therapy is
widely practiced in Japan, many people participate in what they call "Nature–Bathing," the practice
is starting to trickle into the United States. In a Ted Talks video, Yohimifumi Miyazaki explained the
practice of Eco–therapy. He explained that humans

Idiopathic Peripheral Dementia
Nguyen Tran SOAP note for pt on >8 Meds Subjective Introduction: JK is a 79 yo Caucasian male
present at the clinic for follow–up after starting citalopram for major depression on 12/16/2015.
HPI: Pt reported feeling more anxious and depressed due to moving to a new location in Colorado.
Pt reported sleeping adequately and feels he has good sleep on most nights. Pt does not exercise but
goes on walks around his neighborhood once in a while. Pt reported he has been feeling down in the
past but has not seen a PCP for this problem prior to last visit. Pt was started on citalopram 20 mg
one–half tablet by PCP on 12/16/2015. Past Medical History: HTN Hypercholesterolemia Dementia
Major Depression BPH Diverticulosis of Colon Idiopathic Peripheral ... Show more content on
Helpwriting.net ...
Assessment Assessment of Disease: Pt's major depression is currently controlled as evidenced by
improvement in moods, being less explosive, feeling more relaxed and less anxious according to pt's
spouse. Contributing factor includes dementia. Goals of therapy include improve mood, quality of
life, and prevent mortality and morbidity. Assessment of Current Therapy: Pt is currently on
citalopram 20 mg one–half tablet by mouth once daily. Citalopram is appropriate as first line therapy
for treatment of major depression per APA Practice guidelines. Starting dose of citalopram is also
appropriate as patient is elderly. Citalopram has no major drug interactions with pt's current
medications or current medical conditions. Pt reports tolerating it well and has been adherent to

Stop Bang Theory
Patients were recruited from the Late–life Depression Clinic and Memory Disorders Clinic at New
York State Psychiatric Institute (NYSPI)/Columbia University Medical Center. Patients were
eligible for participation in a long–term open antidepressant treatment trial, if they were 55 to 95
years of age with a minimum 8 years of education, who had subjective memory complaints and met
the inclusion criteria: 1), the Diagnostic and Statistical Manual of Mental Disorders, 4th edition
(DSM–IV) criteria by SCID for major depressive disorder or dysthymic disorder for a minimum of
6 months; 2), a baseline 24–item Hamilton Rating Scale for Depression (HRSD)(Hamilton 1960)
score was ≥ 14; 3), the criteria for cognitive impairment, a score ≤ 11 on the Logical ... Show more
The Stop–Bang has eight yes/no questions with scores ranging from 0 to 8, including four questions
in STOP (loud Snore, Tired, Observed apnea, and high blood Pressure) and four questions in BANG
(BMI, Age, Neck size, and Gender). It has the highest methodological quality and the highest
sensitivity in predicting moderate (AHI≥15) and severe OSA (AHI ≥ 30).(Abrishami, Khajehdehi et
al. 2010) For Stop–Bang 5 or higher, the specificity is 79.7%, and the positive predictive value is
79.4% (PPV %) for OSA.(Chung, Subramanyam et al. 2012) In this study, patients were separated
into two groups based on the Stop–Bang scores. The OSA–group had a high probability of OSA
(Stop–Bang ≥5) and the non–OSA group had a moderate–to–low probability of OSA (stop–Bang s
Disease Assessment Scale–cognitive subscale (ADAS–cog, delayed recall test).(Rosen, Mohs et al.
1984, Raghavan, Samtani et al. 2013) Stroop and SRT results were presented with z–scores, which
represent the number of standard deviations (SD) from the norms (z score=0). Lower z scores
indicate worse cognitive functioning compared to the population. Other measurements were
vascular risk factors (CVRFs), including hypertension, obesity (BMI ≥ 30), diabetes, and
cardiovascular

The Effects Of Citalopram On Depressive Illness, Panic...
Overview
Citalopram is a prescription only, anti–depressant drug used to treat depressive illness, panic
disorder and mood disorders (Hammen, 1997). Like most anti–depressants, Citalopram is a selective
serotonin re–uptake inhibitor (SSRI). This means it prevents the neurotransmitter Serotonin from
being reabsorbed by neurones and hence increasing its concentration in the brain (Fernández–Pastor
& Ortega & Meana, 2013). Serotonin is responsible for maintaining mood balance and a feeling of
happiness, and so increasing its levels can successfully relieve the symptoms of depression.
Chemical Structure
Citalopram is a chiral molecule and exists as two enantiomers; S–citalopram and R–citalopram.
(Hall, 2001) They are optical isomers with ... Show more content on Helpwriting.net ...
The chemical formula is C20H21FN2O and its full IUPAC name is 1–[3–(dimethylamino)propyl]–
1–(4–fluorophenyl)–1,3–dihydro–2–benzofuran–5–carbonitrile (Hall, 2001).
Pharmacodynamics
Serotonin, (or 5–hydroxytryptamine) is a neurotransmitter released by neurones in the brain. It is a
chemical responsible for good mood and well–being. Therefore one of the possible causes of
depression is a chemical imbalance of Serotonin levels in the brain and consequently, ineffective
neuronal transmission at the synaptic cleft. (Lovatt, 2010) This has negative implications on mood,
sleep and appetite.
The neurotransmitter is released from vesicles from a pre–synaptic neurone and diffuses across the
synapse, which is a gap between two neurones, and travels to the post synaptic neurone. Serotonin
binds to reuptake channels on the presynaptic neurone, from which it was released, and is
transported back so that it can be stored and reused.
Citalopram selectively binds to these reuptake channels on the surface of neurones. This effectively
blocks the reuptake channels so serotonin cannot be removed from the synaptic cleft (Beckham &
Leber, 1995). Over time, this increases the concentration of serotonin in the synapse which gives
serotonin more time to interact with the serotonin receptors in the brain. This enhances the effect on
the post synaptic neurone (Stone, 2010).
Pharmacokinetics
Citalopram is rapidly absorbed from the Gastro Intestinal tract and

Argumentative Essay On Anti Depressants
Depression is a serious mental disorder that may be displayed by major episodes of sadness,
restlessness, and loss of interest. Depression has several symptoms such as excessive sleep,
increased or loss of appetite, aches, cramps, insomnia, and fatigue. It can affect anyone of all ages
and may not be recognizable for those who are experiencing it. A medication called anti–depressants
helps treat depression by altering the serotonin receptors levels. There are several types of anti–
depressant medications such as Abilify, Celexa, Aplenzin, Asendin, and many more. There are
individuals that may argue that anti–depressants are an over–prescribed medications. They believe
that this medication can affect the patient's mental status and inhibit self–control with this addictive
drug. On the other hand, the opposition may argue that anti–depressants are not overly prescribed
and that it should not be problematic because it is an accessible, helpful, and a quicker treatment.
The debate of whether anti–depressants are an over–prescribed medication has been an ongoing
controversial issue as evidenced by statements of supporters and those in opposition.
According to Wehrwein (2011), statistics usage of antidepressants demonstrated that 23% of women
between ages of 40 to 50 take antidepressants as compared to other age groups. Wehrwein
mentioned that 14% of non–Hispanic white people use antidepressants more often compared to 4%
of Hispanics and 3% of Mexican Americans.
There are better

Hypochondriasis Outline
Hypochondriasis Definition An anxiety disorder in which an individual worry excessively that they
are or may develop serious illness. According to: https://medlineplus.gov/ency/article/001236.htm
Cause Beliefs Family history of health anxiety Stressful or Traumatic event Chemical imbalance
Risk Factors Stress Threat of serious illness Serious childhood illness Worrying personality
Excessive health–related internet use History of personal traumatic experience Signs and Symptoms
Paranoia Anxiety Chronic fear of serious illness Many physical complaints that change overtime
Compulsive behavior Repeatedly going over thoughts Tension and stress in daily life Confusing
normal bodily sensations as a serious problem ... Show more content on Helpwriting.net ...
Nursing Interventions Provide safe environment. Rationale: Reduce risk of harm to self and others.
Assess client's level of knowledge about how emotional stress influence physiologic functioning.
Rationale: Help establish effective teaching plan. Provide accurate information about condition.
Rationale: Help reduce anxiety. Avoid excessive reassurance Rationale: May reinforce undue worry.
Encourage client to use positive self–talk. Rationale: Help change behavior and feelings by
changing thoughts. Teach client techniques to manage anxiety. Rationale: Help reduce level of
anxiety. Teach client/family methods to distinguish between panic attack and serious physical
illness. Rationale: Family members are greatest resource for helping plan patient care. Administer
medication (Xanax) per physician's order o Avoid other CNS depressants o Monitor LOC o Monitor
CBC, liver and renal function during long–term use; may cause decrease hematocrit and
neutropenia. o Flumazenil is antidote for toxicity or

The Effect Of Nutritionist On Health Treatment Of Bn
The nutritionist's role in treatment of BN is to help develop a reasonableplan of controlled eating
while assessing the patient'stolerance for structure.Immediate goals must beinterruption of the
binge–and–purge cycle, restoration of normaleating behavior, and stabilization of body weight, even
if already overweight. Attemptsat dietary exacerbatebinge–purge behavior.Metabolic state must be
considered when prescribing thebaseline diet.Assessment ofclinical signs of ahypometabolic state,
like a low T3 level and cold intolerance, is useful in determining the caloric prescription. If a low
metabolismis suspected, a caloric prescription of 1600 to 1800calories daily is a reasonable startbut
this prescriptionshould be titrated upwards, in 100 to 200 calorie increments,to stimulate the
metabolic rate. Ultimately, a weightmaintenance diet of 2200 to 2400 kcal/day is attainable and
welltolerated (Halmi, 2005). Body weight should be monitored with a goal of stabilization;however,
BN patients need a great deal of encouragement to followweight maintenance versus weight loss
diets. They must bereminded that attempts to restrict caloric intake may only increasethe risk of
binge eating.A balanced macronutrient intake is essential for the provisionof a regular meal pattern.
This should include sufficientcarbohydrates to prevent craving and adequate protein and fatto
promote satiety. In general, a balanced diet providing 50% to55% of the calories from carbohydrate,
15% to 20% from

Depression Vs Anxiety Research Paper
Nahal Abtahi
Turnbull
English 1A
26 April 2016
Depression vs. Anxiety
Mental health disorders have a huge impact on everyday life tasks. There is a fine line between
depression and anxiety yet; they are still put in the same category. Depression is a "mood disorder
that [causes] a persistent feeling of sadness and loss of interest." On the other hand, anxiety is
classified as a "nervous disorder characterized by a state of excessive uneasiness and apprehension,
typically with compulsive behavior or panic attacks." These two disorders are usually categorized
together but their differences are prevalent. While depression stimulates feelings of despair,
hopelessness, and low energy levels, anxiety on the other side of the spectrum is a disorder that
generates excessive feelings of uneasiness and apprehension.
The constant feeling of anguish or loss of interest that constitutes major depression can lead to an
amplified emotional and physical state. These include the failure to sleep or focus on tasks. Changes
in appetite, a decline in energy levels, and thoughts of suicide are also ... Show more content on
Helpwriting.net ...
A predicted 16 million American adults had at least 1 major depressive episode last year. Depression
can co–occur with other deliberate medical illnesses, such as diabetes, cancer, heart disease, and
Parkinson's disease. There are many different treatments to possibly diminish or subside the side
effects of depression. Some treatments for depression are cognitive behavioral therapy, behavior
therapy, and psychotherapy. The main treatment is talk therapy with a trained psychologist or
psychiatrist. Medications (for example citalopram and paroxetine) that act on the chemical
imbalance in the brain are also useful treatments for major depression. This mood disorder is
common and causes serious symptoms that affect how you feel, think, and handle daily

Compare And Contrast Autism And The American Academy Of...
Every case of autism is different. Symptoms and behaviors vary in severity and often change over
time, thus, the method of treatment is specialized to the needs of that child or adult. It is said that
early diagnosis can help these individuals develop to their full potential as the primary goal of
treatment is to improve their overall ability to function. Individuals with autism positively respond
to highly structured treatments that help improve communication, social, behavioral, and learning
aspects of their lives. The American Academy of Pediatrics (AAP) suggests that strategies such as;
specialized therapies, behavioral training and management, medicines, and community support and
parent training are the best ways to help individuals with

Panic Anxiety Disorder: A Case Study
Panic Anxiety Disorder
Definition: an abrupt onset of discomfort and fear
Causes: exact causes is unknown but these factors may be involved –family history –abnormalities
in the brain –substance abuse –life stress
Signs and symptoms: attacks of fear/nervousness, sensations of shortness of breath/smothering,
chest pain, trembling/shaking, palpitations/increased heart rate, sweating, feeling dizzy/faint,
depersonalization, and numbness/tingling
Treatment: –Psychotherapy (counseling) –Cognitive behavioral therapy – Selective Serotonin
Reuptake Inhibitors (SSRIs): Citalopram, Fluoxetine, and Paroxetine – Serotonin–Norepinephrine
Reuptake Inhibitors (SNRIs): venlafaxine and duloxetine – Tricyclic Antidepressants: Amitriptyline,
Imipramine, and Nortriptyline ... Show more content on Helpwriting.net ...
Assist patient in slowing breathing by a paper bag technique or breathing with him/her
2. Stay calm and reassure patient that you won't leave their side
3. Remind patient that they will survive the panic attack
4. Assess patient's level of anxiety, physical attributes, and cause
5. Help patient identify precursors for attacks to help prevent future attacks
6. Encourage patient to clarify needs, concerns, and questions
7. Practice coping skills to relieve anxiety
8. Administer prescribed medication, such as Mirtazapine (Remeron) –Monitor dosage, excess to
higher quantities can be dangerous –Monitor complete blood count in patients with signs of
infection –Establish safety precautions
Expected outcome of Panic Anxiety disorder: patients treated successfully can lead full and
satisfying lives while patients, while patients who don't seek treatment can have a severely impaired
quality of

Obsessive-Compulsive Disorder (OCD)
Obsessive–Compulsive Disorder (OCD)
What is obsessive–compulsive disorder?
Obsessive–compulsive disorder (OCD) is a chronic psychiatric condition characterized by
obsession, compulsion, or both. The condition typically affects individuals during childhood or
adolescence and often continues until adulthood. Obsessions are characterized by intrusive thought
or urges that lead to anxiety and distress. Compulsions are repetitive behaviors that the person feels
compelled to accomplish according to set rules.
Patients with obsessive–compulsive disorder often have coexisting psychiatric disorders such as
depression, anxiety, and substance abuse. Symptoms may lead to significant social and functional
impairment. Due to the importance of this ... Show more content on Helpwriting.net ...
Most of these medications typically take at least 2 weeks to a month for individuals to notice any
symptomatic improvement. They should be trialed for at least 6 weeks in most cases. Refractory
obsessive–compulsive disorder may require the use of antipsychotic drugs such as Risperdal
(risperidone).
Summary:
Obsessive compulsive disorder is a chronic a psychiatric condition characterized by obsession,
compulsion, or both. It is likely caused by genetic and environmental factors.
Studies show that a network in the brain called the cortico–striato–thalamo–cortical circuit
contributes to the pathogenesis of the disease.
The condition typically affects individuals during childhood or adolescence and often continues
until adulthood.
Obsession are characterized by intrusive thought or urges that lead to anxiety and distress.
Compulsion are repetitive behaviors that the person feels compelled to accomplish according to set
rules.
The diagnosis of obsessive compulsive disorder is based on criteria set by the diagnostic and
statistical manual of mental

Case Study: Follow Up Depression
CC Follow up depression. ADD. S The patient is a 49–year–old female who I saw last on July 8,
2015. Please see details of that note. She states ever since increasing her dose of citalopram from 20
mg one p.o. daily to one and a half p.o. daily, she has been feeling much better. She is much more
motivated to take better care of herself. She is doing things like getting her eyes checked, new
eyeglasses, exercising more, trying to be more social. She continues to see her counselor from
Exeter Counseling and likes her a lot. She will be talking with her about finding couples counselor
as well, to see if this will help with her relationship with her wife. She continues on her Adderall XR
10 mg one p.o. daily and does find that this is helpful.

Armod (Armodafinil)
Uses Armod (Armodafinil) is a tablet form of Armodafinil containing 50mg per tablet. Armodafinil
is prescribed to treat people with ADHD (Attention–Deficit–Hyperactivity–Disorder) and sleep
disorders related to shift–work, as well as sleep apnea. The drug works elevates heart rate and blood
pressure, thereby promoting wakefulness. Dosage and Administration Armod (Armodafinil) is a
tablet that should be swallowed whole with a glass of water. It needs to be taken when the stomach
is full. It is crucial to consume lots of water and other fluids when taking Armodafinil. Dosage is
dependent on your condition and will be advised by your doctor. Generally, the recommended
dosage will be 50mg taken once daily in the morning. Even if symptoms disappear or reduce, make
sure ... Show more content on Helpwriting.net ...
Make sure to let your doctor know beforehand if you are breastfeeding since the drug is easily
passed in milk. If you are pregnant, the drug could cause further complications. Before taking
Armod (Armodafinil) you should advise your doctor if you have: Previous case of psychosis Mania
Renal or hepatic impairment Lactating or pregnant Armodafinil should not be taken by patients who
have cardiac arrhythmias or severe HTN. Patients with prolapsed of the mitral valve, or changes in
ischaemic ECG, as well as those with a previous record of hypertrophy of the left ventricle should
not take this medicine. Drug Interactions with Armodafinil: Celexa (citalopram) Clopidogrel Ibrance
(palbociclib) Lynparza (olaparib) Orlaam (Levomethadyl acetate) Palbociclib Plavix

What Is Amlodipine Impurity?
Amlodipine Impurity–D 3–ethyl 5–methyl 2–((2–aminoethoxy)methyl)–4–(2–chlorophenyl)–6–
methylpyridine–3,5–dicarboxylate
Amlodipine Impurity–E diethyl 2–((2–aminoethoxy)methyl)–4–(2–chlorophenyl)–1,4–dihydro–6–
Amlodipine Impurity–F dimethyl 2–((2–aminoethoxy)methyl)–4–(2–chlorophenyl)–1,4–dihydro–6–
Amlodipine Impurity–I 3–ethyl 5–methyl 2–((2–aminoethoxy)methyl)–4–(4–chlorophenyl)–1,4–
dihydro–6–methylpyridine–3,5–dicarboxylate
Aripiprazole n–oxide 7–{4–[4–(2,3–dichlorophenyl)piperazin–1–yl]butoxy–n–oxide}–3,4–
dihydroquinolin–2(1H)–one.
Aspartane Impurity–A 2–(5–benzyl–3,6–dioxopiperazin–2–yl)acetic acid.
Atenolol Impurity–A 2–(4–hydroxyphenyl)acetamide
Atenolol Impurity–B 2–(4–((oxiran–2–yl)methoxy)phenyl)acetamide ... Show more content on
Helpwriting.net ...
Memantine 1–chloro–3,5–Dimethyl Adamantane 1–chloro–3,5–dimethyladamantane
Memantine 1–Hydroxy–3,5–Dimethyl Admanatane 3,5–dimethyladamantan–1–ol.
Memantine Impurity–D 1–Methyl Adamanatane
Memantine Impurity–E 1,3,5–Trimethyl adamentine
Memantine N–Formyl memantine 1–formyl memantine
Memantine 1–hydroxy 3,5–dimethyl adamantane 1–hydroxy 3,5–dimethyl adamantane
Metamizole Acetyl metamizole N–(2,5–dihydro–2,3–dimethyl–5–oxo–1–phenyl–1H–pyrazol–4–
yl)acetamide
Metamizole Impurity–A N–(2,5–dihydro–2,3–dimethyl–5–oxo–1–phenyl–1H–pyrazol–4–
yl)formamide
Metamizole Impurity–C

Summary Of The Citalopram Ad And DTCA
This drawback of the Citalopram ad and DTCA increases stigmas associated with mental health
disorders, especially mood or personality disorders. MSL's ad included a picture of a depressed
Caucasian middle–aged woman. As a reader, one could perceive that picture as a public
representation of what individuals experiencing depression resembles. Another implicit weakens of
the MSL's ad is that it encouraged the use of medication and implied that depression is biological
when that might not always the case. The ad, passively, excluded therapies and other alternative
health–care personals from the patient–informed discussion and the diagnostic process. Chananie
2005, Vallée, M., 1998 and several others identified that this is a common weakens amongst

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