History of pervasive dysthymia and primary insomnia reports

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Reference no: EM133712491

Question

A 62 y/o biracial female with a history of pervasive dysthymia and primary insomnia reports to the PMHNP at medication follow up that she has been sleeping better on mirtazapine 15 mg at bedtime. However, she is concerned that her consistently dysthymic mood seems to be unremitting in spite of not mission any doses, as well as alcohol cessation. The PMHNP understands that the rationale underlying why the patient's mood has not improved is a. Mirtazapine targets the norepinephrine and serotonin transporters, respectively, with a higher affinity than SSRI's and SNRI's b. Mirtazapine is a highly histaminergic medication with sedating properties c. Mirtazapine is effective in treating insomnia at higher dose due to affinity for alpha 1 adrenergic receptor and treats depression at lower doses d. Mirtazapine is more effective in treating depression at higher doses and treats insomnia effectively at lower doses due to antagonism of alpha 2 adrenergic receptors.

Reference no: EM133712491

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