JN is a 27-year-old female patient suffering from depression and PTSD which stems from abuse as a child. She has a past history of substance use disorder which included alcohol and narcotics.

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  • JN is a 27-year-old female patient suffering from depression and PTSD which stems from abuse as a child. She has a past history of substance use disorder which included alcohol and narcotics. She has been sober for 5 years and routinely attends Alcoholics Anonymous and Narcotics Anonymous. She has a supportive sponsor and is in regular contact with her. She is overweight with a height of 5’4’’ and a weight of 185 pounds. She has type II diabetes that is treated with metformin 1000mg daily and pioglitazone 30mg daily. Her depression and PTSD were treated with sertraline 100mg once daily. The sertraline has allowed for a moderate improvement in her depression, but the patient is complaining about not being able to sleep in part because of nightmares and flashbacks.
  1. List at least three different treatment options for this patient.
  2. When taking into consideration the patient’s metabolic comorbidities and history of substance abuse, what treatments should be avoided?
  3. What treatment course would you prescribe (include the medication/medications, dose, monitoring and patient education)?
 
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