QuestionAugust 18, 2025

Scenario: A 47-year-old patient with major depressive disorder and chronic insomnia has been taking mirtazapine 30 mg at bedtime for three weeks. The patient reports no improvement in mood and worsening insomnia. Question: What is the most appropriate action for the nurse practitioner to take? Decrease the mirtazapine dose to 15 mg at bedtime. Increase the mirtazapine dose to 45 mg at bedtime. Add a sleep aid to the current regimen. Discontinue mirtazapine and switch to another antidepressant.

Scenario: A 47-year-old patient with major depressive disorder and chronic insomnia has been taking mirtazapine 30 mg at bedtime for three weeks. The patient reports no improvement in mood and worsening insomnia. Question: What is the most appropriate action for the nurse practitioner to take? Decrease the mirtazapine dose to 15 mg at bedtime. Increase the mirtazapine dose to 45 mg at bedtime. Add a sleep aid to the current regimen. Discontinue mirtazapine and switch to another antidepressant.
Scenario: A 47-year-old patient with major depressive disorder and chronic insomnia has
been taking mirtazapine 30 mg at bedtime for three weeks. The patient reports no
improvement in mood and worsening insomnia.
Question: What is the most appropriate action for the nurse practitioner to take?
Decrease the mirtazapine dose to 15 mg at bedtime.
Increase the mirtazapine dose to 45 mg at bedtime.
Add a sleep aid to the current regimen.
Discontinue mirtazapine and switch to another antidepressant.

Solution
4.7(184 votes)

Answer

Discontinue mirtazapine and switch to another antidepressant. Explanation 1. Evaluate current treatment effectiveness Mirtazapine is used for depression and can aid sleep. No mood improvement and worsening insomnia suggest ineffectiveness. 2. Consider medication adjustment options Increasing the dose may worsen insomnia; decreasing might not improve mood. Adding a sleep aid could address insomnia without changing antidepressant. 3. Assess alternative treatments Switching to another antidepressant may be necessary if mirtazapine is ineffective after three weeks.

Explanation

1. Evaluate current treatment effectiveness<br /> Mirtazapine is used for depression and can aid sleep. No mood improvement and worsening insomnia suggest ineffectiveness.<br />2. Consider medication adjustment options<br /> Increasing the dose may worsen insomnia; decreasing might not improve mood. Adding a sleep aid could address insomnia without changing antidepressant.<br />3. Assess alternative treatments<br /> Switching to another antidepressant may be necessary if mirtazapine is ineffective after three weeks.
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