Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult
Insomnia
31-year-old Male
Trazodone 50 mg po at bedtimeRESULTS OF DECISION POINT ONE
- Patient returns to clinic in 2 weeks
- Patient states medication works well but gives him an unpleasant side effect of an erection lasting approximately 15 minutes after waking
- Patient states this makes it difficult to get ready for work or go downstairs and have coffee with his girlfriend and daughter in the morning
- Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult
- Patient denies auditory/visual hallucinations and is future oriented
Explain that an erection lasting 15 minutes is not considered a priapism and should diminish over time, continue with current doseRESULTS OF DECISION POINT TWO
- Patient returns to clinic in 2 weeks
- Patient states priapism has diminished over time
- Patient denies auditory/visual hallucinations and is future oriented
- Patient states trazodone is effective at 50 mg dose but sometimes wakes up following day with next-day drowsiness
- Patient denies auditory/visual hallucinations and is future oriented
Continue dose. Explain to patient he may split the 50 mg tablet in half. The decreased dose should minimize next-day drowsiness. Follow up in 4 weeksGuidance to Student
Trazodone is a selective serotonin reuptake inhibitor that has a low side effect profile. It would not be prudent to prescribe sonata as it carries with it the risk of complex sleep behaviors. Hydroxyzine is an antihistamine with strong sedative properties. However, many patients complain of anticholinergic adverse effects the following morning, such as Xerostomia and Xerophthalmia Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult.The patient is presenting with excessive somnolence. It would be prudent to reduce the dose of trazodone by 50% and reassess in 4 weeks.
https://cdn-media.waldenu.edu/2dett4d/Walden/NURS/6630/DT/week_11/2.html
Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult