Interviewer: Sedation is commonly used in the intensive care unit to make patients that require mechanical ventilation more comfortable and less anxious.
What many don't realize is that sedation can have side effects that can endanger the patient's life. Richard Barton, Director of Surgical Critical Care at the University Hospital, and Nick Lonardo, Pharmacy Clinical Coordinator are investigating best practices for sedation use in the ICU. Barton, what is the problem that you're concerned with? Richard Barton: First, let me describe the patients that we have in the surgical and intensive care units. That means we have a machine that helps the patient breathe, but in order to do this these people have an endotracheal tube, which is stiffer and bigger than a soda straw, smaller than a garden hose. Richard Barton: Yes, well, imagine what it feels like when you stick your finger down your throat; it makes you throw up.
Psychiatrists take sleep quality as an indicator of depression because depressed patients don't sleep well.
But if a patient is taking Remeron it might improve sleep quality because it's sedating without improving depressive symptoms.
Benzodiazepines and z-drugs both affect the GABA receptor in the brain.
Long-term use of these sleep aids can result in protracted cognitive impairment.
The cumulative probabilities of being among the four best treatments in terms of acceptability were: escitalopram (27·6%), sertraline (21·3%), bupropion (19·3%), citalopram (18·7%), milnacipran (7·1%), mirtazapine (4·4%), fluoxetine (3·4%), venlafaxine (0·9%), duloxetine (0·7%), fluvoxamine (0·4%), paroxetine (0·2%), and reboxetine (0·1%).
Remeron perhaps outperform other antidepressants because it treats both insomnia and depression. Other effective antidepressants, like SSRIs, tend to exacerbate insomnia.
When sleep issues become unmanageable – that's when you should turn to sleep aids.
Since Remeron is a sleep aid, it has an edge over drugs that are pure antidepressants. It improves sleep architecture (the structure of sleep), and reduces sleep fragmentation.
Remeron helps with both sleep initiation (falling asleep) and sleep maintenance (staying asleep).
Remeron often causes residual sedation the next day due to its long half-life.
This sedation can benefit individuals with anxiety.