A 42-year-old Caucasian female with a history of major depressive disorder presents to the PMHNP with a chief complaint
A 42-year-old Caucasian female with a history of major depressive disorder presents to the PMHNP with a chief complaint of “I am feeling fine, I just haven’t been able to sleep over the past 2 months.” The patient reports she has been frequently waking in the middle of the night for hours. She has been stable on 40mg qd fluoxetine, and history is negative for substance use disorder. The PMHNP considering treatment with a hypnotic understands that: a. Treatment with a benzodiazepine with a shorter half-life is recommended as first line, as pt’s history is negative for substance use disorder b. Treatment with low-dose trazodone could augment antidepressant effects of fluoxetine, treat insomnia, and/or cause side effects c. Treatment with trazodone dosed above 200mg is not usually recommended for insomnia A. Treatment with trazodone dosed above 200mg is not usually recommended for insomnia d. B and C
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