insomnia Archives - Med Ed 101

Mirtazapine For Insomnia – Are You Using It Correctly?

Date August 9, 2020 Author By Eric Christianson Category Insomnia

Mirtazapine is commonly used in elderly patients with depression who are also suffering from insomnia. Mirtazapine is often chosen because it is much safer than benzodiazepines, “z-drugs”, and antipsychotics. The mechanisms of mirtazapine (podcast episode on the pharmacology) include the release of norepinephrine via presynaptic adrenergic auto-receptor blockade, increased serotonin production through stimulation of adrenoreceptors […]

Falls, Dementia, and Constipation

Date January 29, 2020 Author By Eric Christianson Category Insomnia

YS is a 79-year-old female with a medical history of osteoarthritis, insomnia, CVD, GERD, constipation, dementia, and falls. Her current medication list includes donepezil, Senna-S, lisinopril, zolpidem, amitriptyline, baby aspirin, acetaminophen, and omeprazole. Over the last three months, she has had a total of 7 falls and one that resulted in a fractured wrist. Because […]

Insomnia Polypharmacy

Date November 17, 2019 Author By Eric Christianson Category Polypharmacy

Insomnia is a sneaky condition that can lead to polypharmacy. Many of the medications used in the management of insomnia can work for a short period of time, but I’ve seen so many cases where the effects wear off over time. Always remember to do our due diligence on non-pharmacologic interventions! Here’s a case scenario […]

Case Scenario: Polypharmacy List Review

Date November 3, 2019 Author By Eric Christianson Category Case Studies

KS is a 79-year-old female. She states that she takes too many pills and would like to try to reduce some. Here’s her list. Aspirin 81 mg daily Clopidogrel 75 mg daily Pantoprazole 40 mg daily Valsartan 80 mg daily Metoprolol 25 mg BID Amlodipine 5 mg daily Mirtazapine 15 mg at bedtime Famotidine 20 […]

Can You Use a TCA With an SNRI? Case Review

Date September 4, 2019 Author By Eric Christianson Category Pain

A 66-year-old female has a past medical history of diabetes, neuropathy, depression, and hypertension. In this case scenario, I discuss the use of a TCA with an SNRI. Her current medication list includes: Aspirin 81 mg daily Capsaicin cream prn Amitriptyline 10 mg at night Metformin 500 mg BID Losartan 50 mg daily Glipizide 5 […]