INSOMNIA DECISION TREE 6 Insomnia Decision Tree Student name ✓ Solved

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The case that I will focus on in this paper is about a 31 years male that is suffering from insomnia. This got worse when he lost his fiancée 6 months ago. Nowadays the case is just worse because he falls asleep even as he is undertaking his job. There is a history of opiate abuse which has been evidenced since it was recorded that he got involved in an accident for the past 4 years he said that he has never taken any sleeping oils or any pain relieving medicine. However, the addiction that the man has is that he has to take at least 4 bottles of beer on a daily basis. He states that this will help him to do away with hard time that he is facing currently. After some of the relatives saw his condition getting worse each and every day that’s when they decided to take him to a medical center so that his condition can be assessed and at the same time so that he can be given any assistance that will help him to overcome all the challenges that he has.

From the assessment, the patient had all the symptoms of a person suffering from insomnia. The patient had two problems; he states that he was not in a position to find sleep especially in the time that he was wishing to sleep. The other problem was not staying asleep even though after struggle he will get some sleep. The purpose of the assignment was to examine a case study of a man who had insomnia. I will also discuss the three decisions about the medications which the patient can be prescribed.

Decision 1

It was necessary that the patient was supposed to be treated as early as possible because the longer the patient stayed without getting treated, the higher the chances that he would risk towards getting heart diseases, accidents, depression, memory loss, and many other complications. This can be attributed to the fact that they will not be in a position to fall asleep for a very long time.

The first attempt to treat this insomnia from the patient was using Trazodone 50-100mg daily at bedtime. This medication gave him prolonged erection for 15 minutes when awake. However, this was a side effect that needed to be addressed based on the fact that the girlfriend had died 6 months ago and thereby administering such a drug would likely cause him further psychological harm by making him think more of his girlfriend. Therefore, a remedy or any other drug which could be more environmentally friendly for him at that moment would be the most appropriate approach.

Based on all the many side effects that this drug would have on the patient, it was necessary for the attending healthcare professionals not to settle on it. The goal that the medicine was supposed to achieve was not being accomplished. Therefore, it was important that the doctors should make another decision to make sure that they were addressing the insomnia problem appropriately. When treating the patient, side effects should not outweigh the positive impacts that the medication is going to cause to the patient.

Decision 2

After assessing the side effects that the patient had from the previous decision, the healthcare personnel wished to decrease Trazodone to 25mg. However, the patient was supposed to visit the clinic every two weeks for progress assessment. This was crucial because he was not supposed to stop the medication even if he felt as though he was getting better; continuous monitoring was necessary to ensure that he did not experience relapse. Stopping medication without a doctor’s guidance could lead to withdrawal symptoms, such as anxiety and agitation, along with difficulties in sleeping.

It was important for the doctor to continue monitoring the patient upon his return to the clinic. Upon assessing the patient's condition, it was noted that there was a diminishing effect of 35mg, and the medication was not effective enough for him to stay asleep throughout the night. It was positive to observe that auditory hallucination was absent, which indicated that there was hope for improvement. Nonetheless, he had not reached a level where he could be considered completely free of the disease, which necessitated further ethical treatment interventions.

Decision 3

At this juncture, as the condition was improving, it was vital for the patient to continue receiving assistance in the form of advice to ensure that his condition did not deteriorate further. The healthcare practitioners provided encouragement for him to continue taking his medication to avoid relapse, emphasizing that his improvement indicated that the medicine was interacting positively with his body. Additional advice included tips for healthy sleep hygiene, which involved establishing a consistent sleep routine, avoiding daytime naps, and ensuring a distraction-free sleep environment.

The patient was to have follow-up visits after 4 weeks to assess the treatment's progress. Since Trazodone is therapeutic, other medications such as Hydroxyzine and Benadryl, known to have adverse side effects, were not recommended. It is crucial that any medication prescribed is accompanied by a thorough assessment of potential negative impacts to ensure patient welfare.

Conclusion

Insomnia is a significant issue that causes distress for many individuals, stemming from various underlying factors. Medical practitioners must carefully consider treatment options to ensure that their decisions result in more advantages than disadvantages for the patient.

Specific treatments must address particular medical disorders, and therapeutic approaches, both pharmacologic and behavioral, can assist in managing insomnia effectively. Medications vary in their efficacy among individuals, thus highlighting the importance of a tailored treatment strategy. A decision tree becomes essential in ensuring that all patient decisions are evaluated comprehensively, thereby targeting the most effective solutions for the patient’s best interest.

References

• Centers for Disease Control and Prevention. (2018). Prevalence of depression among adults aged 20 and over: United States.
• Fava, M., Rush, J., Thase, M., Clayton, A., Stahl, S., & Pradko, J. (2016). 15 Years of Clinical Experience with Bupropion HCL: From Bupropion to Bupropion SR to Bupropion XL. Primary Care Companion Journal of Psychiatry, 7(3).
• Gaxiloa-Aguilar, S. & Gullotta, T. (2018). Depression in Latinos.
• Guzman, F. (2018). Sertraline Essentials: Mechanism of Action, Indications, Pharmacokinetics and Dosing.
• Physician Desk Reference. (2018). Phenelzine sulfate drug summary.

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