determine
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A 72-year-old woman enters the hospital having lost 7 kg and saying she has no interest in eating. Her physical examination and laboratory findings are normal. She has been awakening at 5 a.m. for several months and cannot fall back to sleep. She says she has been feeling anxious and helpless since her husband died 3 years ago. Which one of the following is a reasonable medication to prescribe for her?
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1) olanzapine (Zyprexa®)
2) venlafaxine (Effexor®)
3) clonazepam (Rivotril®)
4) quetiapine (Seroquel®)
5) risperidone (Risperdol®)
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| p53
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2) venlafaxine
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| mesh
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2
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| determine
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but 2 has insomnia side effect?
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| srf
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2
venlafaxine is serotonergic ,so should not cause insomnia.
other three are antiphychotic .cionazepam will produce excessive sedation.
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| yasmeen
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2 is the only reasonable choice.rest r not first line antidepressants
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| p53
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determine, are you sure?
'Venlafaxine has generally been reported to be well tolerated. The most common adverse reactions are nausea, somnolence, dry mouth...'
from 'Kaplan & Sadock's Concise Textbook of Clinical Psychiatry', 2nd ed. 2003, page 499.
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| Rasul
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Effexor is a good choice because it's the only antidepressant among meds mentioned, and she might be depressed. But I would go with Clonazepam coz she says she 's anxious, and Clonazepam would make her sleep and be less anxious.
What's the right answer, determine?
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| msyamp
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Effexor
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| determine
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I thought as a SNRI, Venf. has also insomnia side effect. But I double checked, it has only %3 insomnia side eff.
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| determine
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I don`t have the right answer. I can`t decide between 2 AND 3?
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| Rasul
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I checked out- Effexor XR has been approved for both depression and Anxiety Disorder. I was choosing Clonazepam because of anxiety, Effexor has stimulating activity, so I thought prescribing it to smb with anxiety wouldn't be right. Apparently, I'm wrong-Effexor is the right choice-treats both depression and anxiety.
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| achilles
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thanks rasul. i did'nt know the answer to this one.
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| determine
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thanks a lot friends 
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| AAAAA
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Effexor is an excellent choice for depression, pain control .
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| frank100
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velaxafine
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