A 51-year-old woman presents to the PMHNP with complaints of depressed mood, fatigue, and anhedonia. She is in menopause and reports vasomotor symptoms. Which of the following medications effectively treats both depressive and vasomotor symptoms?
Bupropion (Wellbutrin)
Escitalopram (Lexapro)
Desvenlafaxine (Pristiq)
Duloxetine (Cymbalta)
The Correct Answer is C
Choice A reason: Bupropion primarily acts as a norepinephrine-dopamine reuptake inhibitor and is effective in treating depressive symptoms. However, it has little to no efficacy in managing vasomotor symptoms associated with menopause, such as hot flashes or night sweats, and therefore would not address both conditions simultaneously.
Choice B reason: Escitalopram, a selective serotonin reuptake inhibitor, is effective in treating depression and anxiety but has limited effectiveness in alleviating vasomotor symptoms. While SSRIs can sometimes help with hot flashes, their efficacy is not as pronounced as that of certain SNRIs like desvenlafaxine.
Choice C reason: Desvenlafaxine, a serotonin-norepinephrine reuptake inhibitor, has demonstrated efficacy in treating both depressive symptoms and vasomotor symptoms such as hot flashes in menopausal women. Its dual action on serotonin and norepinephrine pathways contributes to both mood stabilization and modulation of thermoregulatory symptoms, making it the optimal choice for patients presenting with both conditions.
Choice D reason: Duloxetine is also an SNRI effective for depression and anxiety. While it can have some effect on vasomotor symptoms, its evidence base for treating menopausal hot flashes is less robust compared to desvenlafaxine. Therefore, it is not the first-line option when targeting both depression and vasomotor symptoms simultaneously.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Risk is not equal; epidemiological data consistently show differences between genders.
Choice B reason: Women more frequently attempt suicide, but men are more likely to die by suicide due to the use of more lethal methods, reflecting differences in completion rates.
Choice C reason: While women attempt suicide more often, they do not have higher completion rates than men.
Choice D reason: Men have higher completion rates, but attempt rates are lower than women, making this statement incomplete.
Correct Answer is C
Explanation
Choice A reason: Major depressive disorder typically involves discrete episodes lasting at least 2 weeks with more acute severity. This patient’s 4-year chronic course suggests a different diagnosis.
Choice B reason: Generalized anxiety disorder is characterized by excessive worry rather than chronic low mood, fatigue, and anhedonia.
Choice C reason: Persistent depressive disorder (dysthymia) involves chronic depressive symptoms lasting at least 2 years in adults. The patient’s long-term low mood, fatigue, hypersomnia, poor concentration, and weight changes are consistent with dysthymia.
Choice D reason: Cyclothymic disorder involves fluctuating hypomanic and depressive symptoms; this patient has no hypomanic features.
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