docdoc9
Forum Guru
Topics: 63
Posts: 513
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1. A 30-year-old woman has had progressive fatigue and muscle stiffness over the past 6 months. She is the primary caretaker for her three children and her elderly disabled parents and has had difficulty sleeping because of the needs of her children. She says that she has to stay motivated because of her responsibilities and has had no difficulty concentrating. She has not had suicidal ideation. She has had an increased appetite and has had a 14-kg (30-Ib) weight gain over the past year. She has a previous history of binge-eating and purging by vomiting. She has no history of psychoactive substance abuse or dependence, cold or heat intolerance, or changes in bowel
or urinary function. Range of motion of the upper extremities is limited by pain. There is no evidence of muscle atrophy. She has good eye contact. She describes her mood as down and stressed. Her affect is dysphoric and intermittently tearful. Which of the following is
the most appropriate pharmacotherapy?
O A) Bupropion
O B) Diazepam
O C) Fluoxetine
O D) Imipramine
0 E) Phenelzine
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| nightflight1945
banned
Topics: 32
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E) Phenelzine
Atypical depression------> i wil go for MAOI
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| alb123
Forum Newbie
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atypical because of weight gain? I was having trouble diagnosing her with MDD.. what was the give away?
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| becky
Forum Junior
Topics: 6
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doesnt phenelzine coz weight gain why not bupropion as it is the only drug not causing wt gain
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| DrAlex_76
Forum Guru
Topics: 120
Posts: 410
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how about her stiffness and muscle pain ? it it likely fibromyalgia therefore we should Rx TCA ?
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| lampard
Forum Junior
Topics: 8
Posts: 95
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what about imipramine ( a tricyclic anti deprssant):
helps in pain syndromes associated with depression
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| dr.d.r.agicha
Forum Newbie
Topics: 0
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:confused lz post an ans with explanation docdoc
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| omz2302
Forum Newbie
Topics: 1
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you cannot prescribe buproprion as it is contraindicated in patients with eating disorders, she has a history of binging and purging...she could be a bulimic patient. I believe buproprion causes seizures in these type of patients.
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| Tiff
Forum Guru
Topics: 55
Posts: 581
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Can't give TCA for atypical depression. MAO-I are best used, then SSRIs. Stiffness and muscle pain is common in atypical depression.
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